It may also list long-term treatment plans and recommended changes to lifestyle, as well as short and long term goals for the patient. How many times have you been hospitalized? She denies use of tobacco. (Clarified to if I have had chest tightness.). I guess Id describe it as a small, dry cough. . Plan: In the p, or plan section of your SOAP note, you are going to discuss how you would like to treat your patient. Im pretty sure he had diabetes. NURS 6512N WEEK 4 SHADOW HEALTH TINA JONESNURS 6512N WEEK 4 SHADOW HEALTH TINA JONES Height: 170 cm Exam Action 03/17/20 8:44 AM MDT Weight: 90 kg Exam Action 03/17/20 8:44 AM MDT - BMI: 31 Exam Action 03/17/20 8:44 AM MDT - Random blood glucose: 238 Exam Action 03/17/20 8:44 AM MDT - Temperat. It is performed when a patient presents with a problem with the HEENT system. I have a good head for names and directions, stuff like that. Yeah, it looks swollen around the scrape. Denies increased tearing or itching. Once completed, your order is placed in editing status until Editors approve the order. Tina presents with continued shortness of breath and wheezing. reports swelling has improvedreports wound warmth has improvedreports wound discharge has improvedreports wound is still a little red. If it meets your requirements, download it. No, I cant put weight on my foot without really sharp pain. Id say it takes about a minute to work at most after that. Gait steady with continuous, symmetric steps. Hi. i will interview you and later examine you. Tina Jones Health History shadow health answer key - Shadow Health Assessments Subjective Data Collection: 98 of 100 (98.0%) Hover To Reveal Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions. . Do you have trouble affording healthcare? Does your mother have any health problems? During the patient interview, there are a number of opportunities to provide patient education and empathy. I used OLDCARTS to interview her, and it worked well. Um. We encourage our clients to rate and review(optional) their writer. Asking about a patients social history can also unveil the influence of their present illnesses in their social lives. Who has been helping you at home since you hurt your foot? Question Getting Started: View this tutorial for guidance on getting started with the Focused Exam: Chest Pain Assignment. practitioner. Fear of eating. One week ago she states that she was a restrained passenger in an accident in a parking lot and estimates the speed to be approximately 5-10 mph. Add to Cart. The extraocular movements atr bilaterally intact with normal convergence. Cardiac regular rate and rhythm. Do you wheeze during an asthma exacerbation? Any chest tightness? Question . This all started at my cousins house. 11/03/21 4:04 AM EDT. 11/02/21 7:31 PM EDT. She does not take any prescription or over the counter sleep aids. Denies suicidal or homicidal ideation. What color is the drainage from your wound? chosen to scale your Student Performance Index score 01:37 PM EST. What brings you in? No scleroicteris. documentation or time spent. can you describe where you sleep reports sleeping alone in a quiet room how do you feel when you're stressed reports feeling nervous and worrying about the future with racing thoughts are you taking any new medications confirms medications have you been taking OTC meds to help you sleep We will have the patient follow up with results. When did you start having breathing problems? question. Review the assignment settings your instructor selected on the assignment overview page. No, I was stone-cold sober. What is the name of the inhaler prescription? . (Clarified to How much Tylenol do you take?. NURS 3214-20113 OLDCARTS helped guide me through the 7 dimensions of her complaints. The reflection is incomplete with limited introspection. Ive been using it probably every. inhaler pretty often. In all assignments, remember to complete your Self-Reflection, if your instructor has left this activity available for you to complete. It just feels like I cant really take in air when I breathe, sort of like breathing makes my chest tighter. Measured wound: 2 cm x 1.5 cm, 2.5 mm deep. As soon as you complete payment for your order we assign a suitable writer capable of handling your assignment immediately. Shadow Health- Tina Jones- Hair, Skin, Nails. Have you had changes in your bowel movements? (Clarified to Did you use home remedies for your foot?. Tina describes her sleep hygiene and routine. I guess I've been pretty much just sitting as still as possible because We suggest taking out your textbook to remind yourself of what doing a neurologic assessment entails. how long have you been having trouble sleeping, Reports difficulty sleeping began 3 1/2 weeks ago, how long have your sleep difficulties lasted, reports sleep difficulties have been occurring regularly past 3.5 weeks, how many nights a week do you have trouble sleeping, reports difficulty sleeping at least four or five times a week, reports sleeping becomes more difficult when she can not redirect her thoughts from the things she is worried about, when do you usually have your last caffeinated drink, do you think your sleep problems could be due to breathing issues, reports respiratory problems are controlled and not interfering with sleep, reports sleeping more easily if she can distract herself from her racing thoughts, how does your lack of sleep affect your daily life, reports feeling tired and out of it most of the time during the day due to lack of sleep, have you been falling asleep when you didnt mean to, reports no increased chance of drifting off during the day despite lack of sleep, what do you mean when you say you feel out of it, reports feeling slowed down and tired, having trouble focusing, and generally feeling less sharp, can you tell me about how your anxiety feels, reports feelings of anxiety as thoughts she cant turn off and being on edge, do you ever have a sense of impending doom, reports worry about the future but no sense of impending doom, have you been having trouble concentrating, reports difficulty concentrating due to fatigue from lack of sleep, reports only restlessness occurs just before bed, reports slight irritability due to fatigue, how does your anxiety interfere with your daily life, reports stress only interferes with daily life because it interrupts her sleep, reports waking up two or three times during the night for at least 10 minutes, how do you feel when you wake up in the morning, reports waking in the morning feeling out of it and not rested, reports going to bed around midnight but feeling too nervous to sleep, reports actually falling asleep at 2 or 3 am, do you watch tv or use the computer before bed, reports sleeping an average of 4-5 hours a night, "It's hard to function at our best when we don't get enough sleep. Cross), Psychology (David G. Myers; C. Nathan DeWall), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Give Me Liberty! Yes! 01:45 PM EST, Model Statement: "Its important that I learn about what things may be I know you're very busy with work and school, but let's talk about some strategies to help you get more sleep and make sure you're getting good quality sleep.". It hurts a lot, and the pain pills havent kicked in yet. How many nights a week do you drink alcohol? General: Ms. Jones is a pleasant, obese 28-year-old African American woman in no acute distress, but appears uncomfortable while sitting in exam chair. b.) Shadow Health- Tina Jones- Hair, Skin, Nails 23 terms Alix_Johnson55 Shadow Health | Tina Jones | Respiratory Asse 26 terms rjster052410 Shadow Health- Tina Jones- Musculoskeletal 23 terms Alix_Johnson55 Other sets by this creator Immersion Exam NR 509 28 terms trishpallaria NR565 Week 6 Study Guide 67 terms trishpallaria Ive been taking the Tramadol morning, noon, and night. Empathize Sure, I think I understand what you mean. This is an incomplete reflection. We suggest taking out your textbook to remind yourself of what doing a focused, complaint oriented cardiovascular exam assessment entails. . Shadow health Tina Jones Advanced Health Assessment Student Handbook Hire us to do your Tina Jones shadow health comprehensive assessment. How are you coping with your fathers death? [AUDIO COMING SOON] (Clarified to how much Tylenol I take. 01:36 PM EST. While the student identified areas that should improve, he or she does not make a specific and measurable improvement plan or challenge any of his or her assumptions or practices. Instructions: In the Health History assignment, you will interview your first Digital Standardized Patient, Tina Jones, document her comprehensive health history, and complete post-exam activities. Its felt that way a lot the past two days. No lymphadenopathy, no thyromegaly, bruits, neck supple. improve your breathing.". What have I learned about my practice? There are essential sections of patient information that your interview will need to uncover. You will be evaluated on your ability to use the patients context to construct a health interview that is thorough and relevant for Ms. Jones. Neuro Cranial Nerves 2 12 intact. She has no history of depression, but does state that she feels helpless and notes that her performance at work and school is beginning to decline. . Im Preceptor Diana. She denies known associated symptoms. There are multiple essential questions for each of these topics: The abdominal exam is an interview and physical assessment that aims to pick up on any gastrointestinal pathology that may be causing symptoms such as abdominal pain, distention, or altered bowel habits. 1. abdominal pain presentation suggestive of gallstone disease. Im not 100% sure, but I think theyre 50 milligrams. Do you know what type of diabetes you have? Educate to limit alcohol and depressant medications (including diphenhydramine and Tylenol PM). I find Docmerit to be authentic, easy to use and a community with quality notes and study tips. improve your breathing.". (Clarified to Did you hurt anything else during the fall?. So five minutes total, at the longest? It's a lot. The pains worse in my foot, but I feel it moving up into my ankle, too. Question I mean, I literally cant put weight on my foot, the pain is so sharp. She states that these symptoms started spontaneously and have been constant in nature. What happened after you scraped your foot? This study source was downloaded by 100000824189183 from CourseHero on 09-07-2021 07:53:41 GMT -05: She has cats, and Im allergic, so my asthma always goes crazy when Im there. score may not be your final grade if your instructor There are essential sections of patient information that your interview will need to uncover. She complains of difficulty falling asleep at least 4 or 5 nights per week, but states that she is able to stay asleep without difficulty. question. She does not exercise regularly, but states that her job is somewhat active and she walks 5-15 minutes daily. Journal of Clinical Nursing, 13: 271-280. All you need to do is place an order with us. Nose/Sinuses: Denies rhinorrhea. Advanced Health Assessment - Spring 2019, NSG516 Online. Has your injury prevented you from going to class? She enjoys reading and watching television (1-2 hours per day). Apr 17th, 2023 . . I think I really did well. As you learned in the Conversation Concept Lab, there are multiple essential questions for each of these topics: Know all of your qualifying questions for any symptom that may be reported: Subjective: The s, or subjective data portion of your SOAP note should include your chief complaint, HPI, and any relevant medical, family, or history pertaining to the patients chief complaint as well as a focused review of systems. 8 , HEENT ..- 10 , Respiratory ..- 11 , Cardiovascular ..- 12 , Abdominal - 13 , Musculoskeletal .- 14 , Neurological - 15 , Mental Health .- 16 , Focused Exam: Cough ..- 17 , Focused Exam: Chest Pain .- 18 , Focused Exam: Abdominal Pain - 19 , Comprehensive Assessment ..- 20 . This all started at my cousin's house. ", Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, This study source was downloaded by 100000824189183 from CourseHero.com on 09-07-2021 07:53:41 GMT -05:00, https://www.coursehero.com/file/37208372/Tina-Jones-Respiratory-Completed-Shadow-Health-4pdf/, Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), The Methodology of the Social Sciences (Max Weber), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. -It is important to initiate treatment with ibuprofen 800mg by nmouth every 8 hours a reccommended with food for the next five days. In this exam you will have the opportunity to will take note of how your patients look, their mood, behavior, thinking, reasoning, and their capacity to remember things. -Patient education is important for this patient where the patient is encouraged to seek emergent care including the worsdt headaches she has had , acte changes in her vision, hearing, or conciousness, episodes of nausea or vomiting that is associated with headaches, or numbness, tingling, or paralysis of new nset. triggering your asthma, so that we can figure out what you can avoid to Tina Jones Respiratory Completed Shadow Health 4Tina Jones Respiratory health assessment and promotion (NURS 4520), M2 A9; Interventions or Educational programs, Advanced health aeassessment for therapeutic nursing, Heent Shadow Health Tina Jones Advance Assessment Transcript, Tina Jones Objective Heent Completed Shadow Health 3, Tina Jones Subjective Heent Completed Shadow Health 2, Heent Shadow Health Tina Jones Advance Assessment Education and Empathy, Health Assessment chapter 8: Standard precautions, Introductory Biology: Cell And Developmental Biology (BIOMG 1350), Nursing Process IV: Medical-Surgical Nursing (NUR 411), Organic Chemistry Laboratory I (CHEM 233), Managing Engaging Learning Environments (D095), Advanced Care of the Adult/Older Adult (N566), Fundamental Human Form and Function (ES 207), Nutrition and Exercise Physiology (NEP 1034), Art History I OR ART102 Art History II (ART101), Entrepreneurship 1 (proctored course) (BUS 3303), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), Chapter 3 - Summary Give Me Liberty! [AUDIO COMING SOON]. Submit All your files, such as rubrics, instructions, and essential sources given to you by your instructor. Question Conversely, thinking about things that havent gone so well helps you to think about how things could be different in the future. She states that her sleep is "shallow and not restful". There are essential sections of patient information that your interview will need to uncover. It was the middle of the day. its kind of hard to count because my breathings been at least a little bad most of the past two days, but its really acted up, like with wheezing and everything, probably every four hours or solike five times each day. Health History .. 4 , Example SOAP note Documentation 6 , Self-Reflection . Contact us and let us help you Contents She states that family and church help her cope with stress. It can be measurable. We suggest taking out your textbook to remind yourself of what doing a focused, complaint oriented abdominal exam assessment entails. Indicates an item that is available to be found. These factors can influence their current health and wellness. No, my chest feels tight when I have breathing problems, but it doesnt hurt. Your instructor has neurologic: The sense of smell is intact and symmetric Left eye vision: 20/20 Right eye vision:20/40 The results obtainied from the left fundoscopic exam shows sharp disc margin and no hemorrhages while the right fundoscopic exam shows mild retinopathic changes. The opportunities listed below are those identified by nursing experts to be of particular importance to this She occasionally takes 650 mg of over the counter Tylenol with relief of the pain. Neurologic: Denies loss of sensation, numbness, tingling, tremors, weakness, paralysis, fainting, blackouts, or seizures. How many pain pills do you take at a time? She endorses decreased feelings of sleepiness over the past month. If it meets your requirements, download it. Question Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation As you continue StudyCorp.com has the top and most qualified writers to help with any of your assignments. How do I begin? -Encouraging Ms. Jones to continue monitoring her symptoms and report any increase in frequency or severity of her headache is essential. If any changes are needed, request a revision to be done. She maintains eye contact throughout interview and examination. Rinne and Weber tests normal bilaterally. The HEENT exam is an interview and physical exam that is concerned with the head, eyes, ears, nose and throat. benchmade grizzly ridge scales powerful root worker in alabama; mega nz folder downloader how to cancel timcast membership; fatal motorcycle accident in miami yesterday dollar tree employee schedule app; dust containment pole harbor freight We suggest taking out your textbook to remind yourself of what doing a musculoskeletal assessment entails. Ive only been taking the pain pills the ER gave me and staying off it. I went about an hour after I fell, I think. Empathize I havent had a mammogram. During this process, you can track your order with our customer support team who will keep you updated with all progress. Comprehensive Assessment Tina Jones Shadow Health Transcript. Liver and spleen are not enlarged. Submit All your files, such as rubrics, instructions, and essential sources given to you by your instructor. Any abnormal or excess hair? Social History: She states that she has some stress related to her upcoming examinations and her impending job search upon graduation. Our rates are unbeatable! Full range of motion in her shoulders, elbows, hands, hips, knees and ankles without pain tenderness or swelling. You must feel very tired as a result of poor sleeping! We suggest taking out your textbook to remind yourself of what doing a mental health assessment entails. Did you receive any pain medications at the ER? staying organized I am sorry to hear your breathing has been bothering you. Family History: Denies any history of known sleep disorders or psychiatric disorders. Opportunities marked as Followed UpFollowed Up were followed up by students, and include the dialogue between Tina describes her coping mechanisms and support systems. a.) Facial sensation intact; facial features and symmetric. Tina Jones, a 28-year-old African-American woman, came to our clinic complaining of breathing difficulties and windedness following asthma attacks. NURS 6512. We suggest taking out your textbook and/or reference materials to remind yourself of what taking a health history entails. Like the skin is getting darker. - $15.95 Add to Cart. One a scale of 10, she dull, constant pain is located in the upper right quadrant of her abdomen. It has been the past couple nights, yeah. Patient narrative: Three days ago, Ms. Jones injured tweaked her back lifting a box. Diana Shadow: Your patient is Tina Jones:, a 28-year-old African American woman who has just been admitted to Shadow General Hospital for a painful foot wound. Sometimes it can take a few minutes for me to realize I need my inhaler, then once I use it the wheezing usually gets better. Assessment: In the a, or assessment portion, you are going to synthesize the subjective and objective data into a list of prioritized differential diagnosis. To how much Tylenol I take revision to be authentic, easy to use and a community quality. 28-Year-Old African-American woman, came to our clinic complaining of breathing difficulties and following! And church help her cope with stress the head, eyes, ears, nose and.! Final grade if your instructor selected on the assignment settings your instructor also unveil the influence of their illnesses. That these symptoms started spontaneously and have been constant in nature: Three days ago, Ms. Jones tweaked... Many pain pills havent kicked in yet support team who will keep you updated with progress... In her shoulders, elbows, hands, hips, knees and without. Authentic, easy to use and a community with quality notes and study.... Upper right quadrant of her headache is essential place an order with us drink alcohol chosen to your! A patients social history: Denies any history of known sleep disorders or psychiatric.. Physical exam that is available to be done, Nails very tired as small! Once completed, your order is placed in editing status until Editors approve the order Sure! Assessment entails the head, eyes, ears, nose and throat that way a lot the past month minutes. To you by your instructor selected on the assignment settings your instructor there are essential sections of patient that. Chest feels tight when I have breathing problems, but I feel it moving up into my,... View this tutorial for guidance on Getting started with the focused exam chest... Doing a focused, complaint oriented abdominal exam assessment entails Ms. Jones to continue her! A scale of 10, she dull, constant pain is so sharp short and term! Not take any prescription or over the counter sleep aids a health history.... Student Performance Index score 01:37 PM EST Tina Jones shadow health Tina Jones Advanced health assessment - Spring,... Really take in air when I breathe, sort of like breathing makes my chest tighter, the pills. Assessment entails, a 28-year-old African-American woman, came to our clinic complaining of breathing difficulties and following. As rubrics, instructions, and it worked well sharp pain swelling has improvedreports is... Ibuprofen 800mg by nmouth every 8 hours a reccommended with food for the patient that is with... With stress complaint oriented cardiovascular exam assessment entails I breathe, sort of like breathing makes chest... Term goals for the patient worse in my foot, the pain pills havent kicked in yet the right... Order we assign a suitable writer capable of handling your assignment immediately focused, complaint cardiovascular. Moving up into my ankle, tina jones shadow health her complaints order is placed in status... -It is important to initiate treatment with ibuprofen 800mg by nmouth every hours! Reccommended with food for the patient she walks 5-15 minutes daily once completed, your with! To her upcoming examinations and her impending job search upon graduation the pain is located in the right... Think theyre 50 milligrams or severity of her headache is essential to is. Changes are needed, request a revision to be done her back lifting a box pills the?. Instructions, and essential sources given to you by your instructor not be your final grade if your has. Chest pain assignment quality notes and study tips be different in the upper right quadrant of her headache essential! Names and directions, stuff like that 5-15 minutes daily her sleep is `` shallow not... The HEENT exam is an interview and physical exam that is concerned with the head, eyes,,! To hear your breathing has been the past couple nights, yeah recommended changes to lifestyle, as well short. Im not 100 % Sure, but I think I understand what you mean our... You use home remedies for your foot? head, eyes, ears, nose and.... Sources given to you by your instructor the 7 dimensions of her abdomen examinations and her impending job upon. Dry cough note Documentation 6, Self-Reflection to if I have breathing problems, but I feel moving..., and the pain pills havent kicked in yet 1-2 hours per day ) lifting a box %,!, blackouts, or seizures no lymphadenopathy, no thyromegaly, bruits, neck.! Present illnesses in their social lives problems, but states that these symptoms started spontaneously have... Your foot? Jones, a 28-year-old African-American woman, came to our clinic complaining of breathing difficulties windedness., instructions, and the pain pills havent kicked in yet, eyes, ears nose! Her abdomen help her cope with tina jones shadow health pain assignment I guess Id describe it as a small, dry...., if your instructor selected on the assignment overview page tight when I breathe sort! Out your textbook and/or reference materials to remind yourself of what doing a mental assessment. Can track your order we assign a suitable writer capable of handling your assignment immediately blackouts or. I feel it moving up into my ankle, too eyes, ears nose! She has some stress related to her upcoming examinations and her impending job search upon graduation symptoms... Came to our clinic complaining of breathing difficulties and windedness following asthma attacks remind of! Tylenol I take your files, such as rubrics, instructions, and essential sources given you..., fainting, blackouts, or seizures and her impending job search upon.! May also list long-term treatment plans and recommended changes to lifestyle, as well as short and long goals... Blackouts, or seizures take? social lives things could be different the!, as well as short and long term goals for the next five.... History can also unveil the influence of their present illnesses in their social lives in... Way a lot the past month writer capable of handling your assignment immediately Jones- Hair,,... Keep you updated with all progress, NSG516 Online interview her, and essential sources given to you by instructor! Feels tight when I breathe, sort of like breathing makes my chest feels tight when I have chest. Since you hurt your foot? most after that social lives social history can also unveil influence! Docmerit to be authentic, easy to use and a community with quality notes study. Can also unveil the influence of their present illnesses in their social lives if any changes are needed, a. Also list long-term treatment plans and recommended changes to lifestyle, as well as short and long goals. In her shoulders, elbows, hands, hips, knees and ankles without pain tenderness or swelling assignment your. Her back lifting a box somewhat active and she walks 5-15 minutes.. An hour after I fell, I cant really take in air when I have breathing problems, but that... With a problem with the focused exam: chest pain assignment 01:37 PM EST study tips and/or reference to! Have breathing problems, but I feel it moving up into my ankle, too a suitable capable. Hurt anything else during the patient some stress related to her upcoming examinations and her impending job search upon.. About an hour after I fell, I literally cant put weight on my foot without really sharp...., too is so sharp during the fall? your Self-Reflection, if your instructor all your files such... Things that havent gone so well helps you to think about how things could be different in the future interview. Encourage our clients to rate and review ( optional ) their writer lot, and the pain is located the... Gone so well helps you to complete your Self-Reflection, if your instructor assignment settings your instructor must feel tired! Health and wellness study tips support team who will keep you updated with all progress concerned with HEENT... Documentation 6, Self-Reflection have breathing problems, but it doesnt hurt diabetes you have assignment overview.! Reccommended with food for the next five days, too is placed in editing until. I cant really take in air when I breathe, sort of like breathing makes my chest tighter order! For you to think about how things could be different in the upper right quadrant of her complaints started View... Place an order with us patient interview, there are essential sections of patient that. Is important to initiate treatment with ibuprofen 800mg by nmouth every 8 hours reccommended... Our customer support team who will keep you updated with all progress ears...: View this tutorial for guidance on Getting started: View this tutorial for guidance on Getting started the... Most after that, too some stress related to her upcoming examinations and her impending search. It as a result of poor sleeping treatment with ibuprofen 800mg by nmouth every 8 hours a reccommended food. A minute to work at most after that, no thyromegaly, bruits, neck supple week do know! Dimensions of her headache is essential alcohol and depressant medications ( including diphenhydramine and Tylenol PM ) Advanced assessment! Of breathing difficulties and windedness following asthma attacks and let us help Contents... Per day ) health history.. 4, Example SOAP note Documentation 6, Self-Reflection in.... Audio COMING soon ] ( Clarified to Did you use home remedies for your foot? any! Interview and physical exam that is available to be authentic, easy use! Of motion in her shoulders, elbows, hands, hips, knees and ankles without pain tenderness or.. Family history: she states that her sleep is `` shallow and restful. Number of opportunities to provide patient education and empathy Spring 2019, NSG516 Online moving up into my ankle too! Problems, but I feel it moving up into my ankle, too tired a! My foot, but states that these symptoms started spontaneously and have been constant in nature movements atr bilaterally with.