Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript Objective Subjective

Solved: Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript Objective Subjective

Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript Objective Subjective Solved

Shadow Health Assessment Assignment

You will complete all assessment assignments using the Shadow Health  virtual reality simulation platform.

Introduction and Pre-brief

Mrs. Esther Park is a 78-year-old woman who comes to the clinic complaining of abdominal pain. She reports that the pain isn’t severe but that her daughter was concerned and brought her in. It is very important to determine whether or not the situation is an emergency and the underlying cause of Esther’s discomfort.

Be sure to inquire about various psychosocial factors related to the GI system, including her diet, toilet habits, immunizations, recent travel, etc. This case study will allow you to take a complete surgical, reproductive, and current sexual history.

During her physical examination, note where Mrs. Park verbalizes pain during palpation so that you may synthesize verbal and non-verbal cues. Be sure to apply the supportive information learned in this week’s concept lab to your critical thinking process in this case study. Esther Park abdominal pain focused shadow health assessment transcript, objective, subjective solved.

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Transcript
Started: Apr 02, 2020, | Total Time: 198 min
Hello. My name is Jones, and I will be interviewing you today and later doing a physical examination. Welcome to the clinic

Greet
04/02/xx 11:25 AM PDT
Hello.
What is your name? Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Question
04/02/xx 11:25 AM PDT
Esther Park.
What brings you to the clinic today?

Question
04/02/xx 11:26 AM PDT
I have some pain in my belly. . . and I’m having difficulty going to the bathroom. My daughter was worried about me.
i am sorry you are having pain in your belly.

Empathize
04/02/xx 11:27 AM PDT
Thank you.
Whxxx?
Esther Park abdominal pain focused shadow health assessment transcript, objective, subjective solved.

Question
04/02/xx 11:27 AM PDT
It xxxx
I am sorry to hear this.

Empathize
04/02/xx 11:28 AM PDT
Thank you.
Are yoxxxx

Question
04/02/xx 11:28 AM PDT
I xxxx
How long xxxx

Question
04/02/xx 11:29 AM PDT
The xxxx
Has the XXXX

Question
04/02/xx 11:29 AM PDT
Well, the txxx
Where is the XXXX

Question
04/02/xx 11:30 AM PDT
The xx
Have you xxxx

Question
04/02/xx 11:30 AM PDT
No, no. The xxxx
Is the pain inxxxx

Question
04/02/xx 11:31 AM PDT
Well my xxxx
How would xxx

Question
04/02/xx 11:32 AM PDT
Right now. xxx
can you xxx Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Question
04/02/2x 11:32 AM PDT
I’d say it’sxxxx
is thexxx

Question
04/02/2x 11:32 AM PDT
Yes. Certain things can make it a tiny bit better or a tiny bit worse, I suppose. But it’s always there.
Does xxxx

Question
04/02/2x 11:33 AM PDT
Well, the type of pain never changes. And it’s always in the same place. But it did get worse two or three days ago.
What ccc

Question
04/02/2x 11:33 AM PDT
I’m not taking anything for it.
Sure, fewer movements can help relieve pain.

Educate
04/02/2x 11:34 AM PDT
Thank you for explaining that.
Have you xxxx
Esther Park abdominal pain focused shadow health assessment transcript, objective, subjective solved.

Question
04/02/2x 11:35 AM PDT
I’m XXXX for it.

Subjective Data Collection: 32 of 32 (100.0%)

Hover To Reveal…

Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions.

  • Found:

     Indicates an item that you found.

  • Available:

     Indicates an item that is available to be found. Esther Park abdominal pain focused shadow health assessment transcript, objective, subjective solved.

Category

Scored Items

Experts selected these topics as essential components of a robust and thorough interview with this patient.

Patient Data Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Not Scored

A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.

Chief Complaint

Finding:

Established chief complaint

Finding:

Reports abdominal pain

Found:

Pro Tip: Abdominal pain can be caused by problems in the underlying organs, peritoneum, muscles, or blood vessels, changes in electrolytes or other blood contents, or even anxiety. Asking for details about the pain helps to determine the origin. Esther Park abdominal pain focused shadow health assessment transcript, objective, subjective solved.

Example Question:

Do you have any abdominal pain?

Fining:

Reports difficulty “going to the bathroom.”

(Found)

Pro Tip: Understanding a patient’s reason for visiting is a necessary foundation to establish. If there are multiple symptoms, follow up on each one during your interview.

Example Question:

Are you able to make a bowel movement?

History of Present Illness

Finding:

Asked about oxxx

Finding:

Reports a feeling of xxxx

(Found)

Pro Tip: Wxxxx

Example Question:

How xxxx

Finding:

Reports pain with xxxx

(Found)

Pro Tip: Whenever you are assessing a symptom or a health condition, inquiring about xxxx. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Has the XXXX

Finding:

Asked about xxxxx

Finding:

Reports xxxx

(Found)

Pro Tip: Identification of the location of your patient’s discomfort can provide important clues about its cause and how it should be best treated.

Example Question:

Where is your discomfort located? Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

Reports pain is not localized

(Found)

Pro Tip: xxxx Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

Example Question:

Is the xxxxx

Finding:

Reports attempt to treat pain by drinking small sips of warm water

(Found)

Pro Tip: Flank pain often occurs with disorders of the urinary tract. When a patient complains of flank pain, assess for co-occurring symptoms such as fever, chills, hematuria, and dysuria.

Example Question:

Do you have pain in your sides?

Finding:

Confirmed pain rating on a scale Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

Reports painxxxx

(Found)

Pro Tip: For many people, it isn’t easy to dxxxx.

Example Question:

How would you rate your pain on a scale of one to ten?

Finding:

Asked aboutxxxx

Finding:

Describes xxxx

(Found)

Pro Tip: Asking your patient tox helps identify its xxx cause and the severity. Patients may not know how to answer, so you may need to suggest words like xxxx. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Can you xxxxx

Finding:

Reports pain is ixxx

(Found)

Pro Tip: It’s important to ask your patient if her pain is xxx to determine her level of discomfort and identify the cause of the pain. xxxx pain is often best managed with around-the-clock pain medications. Esther Park abdominal pain focused shadow health assessment transcript, objective, subjective solved

Example Question:

Is your painxxxx

Finding:

Asked about xxxxx

Finding:

Reports that resting helps

(Available)

Pro Tip: It’s important to assess the nature of pain by asking about xxx. If you know your patient is taking xxxx, asking about the medication’s xxxx can help you xxxx. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

What xxx?

Finding:

Reports attempt to xxxx

(Available)

Pro Tip: Asking about how your patient has been xxxx. The results of her previous treatment may be helpful in your diagnosis and the development of her new xxxx, as well as a good opportunity toxxx your patient on xxxx.

Example Question:

How have you been xxx?

Finding:

Reports xxxstomach

(Found)

Pro Tip: Asking about how your patient has been nxxxxes her current condition and her approach to xxxx. The results of her previous treatment may be helpful in your xxxand the development of her xxx, as well as a good opportunity to x. Esther park abdominal pain focused shadow healxxxxth assessment transcript, objective, subjective solved Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Have you xxx?

Finding:

Asked about xxxx

Finding:

Reports pain is aggravated by eating

(Found)

Pro Tip: Asking your patient what aggravates her pain can point to factors that exacerbate symptoms and how your patient is approaching self-care. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Is the painxxx by xxx

Finding:

Reports xx by xx

(Found)

Pro Tip: Asking you patient what aggravates her pain can point to factors that exacerbate symptoms and the ways in which your patient is approaching self-care.

Example Question:

Is the pain aggravated by xxx

Finding:

Asked about activities of daily life

Finding:

Reports recent difficulty participating in usual activities

(Found)

Pro Tip: Asking about changes in activity level will help determine the level of disability caused by your patient’s condition. Esther Park abdominal pain focused shadow health assessment transcript, objective, subjective solved

Example Question:

How has your xxx?

Finding:

Reports low xxx

(Found)

Pro Tip: Asking about x will help determine thxxe level of xxxxcaused by your patient’sxxxx. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Do you have x?xx

Finding:

Asked aboutxxxx

Finding:

Reports current xxx

(Found)

Pro Tip: In xxx patients, xxx is often caused byxx, xxxx side effects, xxx diets, and difficulty ambulating to the toilet, which can result in deliberate retention of   xxx Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Are you xxxx?

Finding:

Reports no history of xxxx

(Available)

Pro Tip: x

Example Question:

Are you xx

Finding:

Followed up aboutxxx

Finding:

Reports constipation for 5 days

(Found)

Pro Tip: Whenever you are assessing a symptom or a health condition, inquiring about x assxxesses the xxxx and the xxx of the problem.

Example Question:

For how long have you benxxx

Finding:

Reports no attempt to treat xxx

(Found)

Pro Tip: Asking about how your patient has been managing her pain assesses her current condition and her approach to self-care. The results of her previous treatment may be helpful in your diagnosis and the development of her new treatment plan, as well as a good opportunity to educate your patient on effective self-care practices. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

How have you tried to treat thexxxx

Finding:

Asked about xxxx

Finding:

Reports recent xxxx

(Found)

Pro Tip: Whenever you are assessing a symptom or a health condition, inquiring about onset assesses the severity and the progression of the problem. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved.

Example Question: Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Have you recently had xxx

Finding:

I followed up about xxxx

Finding:

Reports xxxx

(Found)

Pro Tip: It’s important to ask about changes in stool characteristics because it may be a sign of a new onset of a gastrointestinal disease or disorder. xxxx is a common symptom of inflammatory bowel diseases, food allergies and intolerance, gastrointestinal infections, and many other conditions. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

How long ago did you xxxx

Finding:

Reports xxxx had a sudden onset

(Found)

Pro Tip: It’s important to ask about changes in stool characteristics because it may be a sign of a new onset of a gastrointestinal disease or disorder. xxx is a common symptom of inflammatory bowel diseases, food allergies and intolerance, gastrointestinal infections, and many other conditions.

Example Question:

Did the xxxx happen suddenly?

Finding:

Reports diarrhea lasted one day

(Found)

Pro Tip: It’s important to ask about changes in stool characteristics because it may be a sign of a new onset of a gastrointestinal disease or disorder. Diarrhea is a common symptom of inflammatory bowel diseases, food allergies and intolerance, gastrointestinal infections, and many other conditions. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

How long did your diarrhea last?

Finding:

Describes diarrhea as loose and watery

(Available)

Pro Tip: Asking a patient who has diarrhea to describe her stool helps identify its cause and the severity. Patients may not know how to answer, so you may need to suggest words like frothy, greasy, floating, or watery. It is also important to inquire about the presence of blood or mucus. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved.

Example Question:

How would you describe the diarrhea?

Finding:

Asked about bowel movement patterns

Finding:

Reports last bowel movement three days ago

(Found)

Pro Tip: Whenever you are assessing a symptom or a health condition, inquiring about onset assesses the severity and the progression of the problem. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

When did the constipation start?

Finding:

Reports some discomfort during bowel movement

(Available)

Pro Tip: It’s important to ask about changes in stool characteristics because it may be a sign of a new onset of a gastrointestinal disease or disorder.

Example Question:

Do you have pain during bowel movements?

Finding:

Last bowel movement was diarrhea

(Available)

Pro Tip: It’s important to ask about changes in stool characteristics because it may be a sign of a new onset of a gastrointestinal disease or disorder. Diarrhea is a common symptom of inflammatory bowel diseases, food allergies and intolerance, gastrointestinal infections, and many other conditions. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

What was the character of your last bowel movement?

Finding:

Reports no mucus in stool

(Found)

Pro Tip: While small amounts of mucus may be present in normal stool, increased mucus in the stool is associated with a variety of intestinal disorders.

Example Question:

Has there been mucus in your stool?

Finding:

Reports no blood in stool

(Found)

Pro Tip: Bloody stool is an alarming symptom indicating digestive tract bleeding. Bright red bloody stool suggests bleeding in the colon or rectum. Bloody stool that appears black or tarry suggests bleeding in upper digestive tract, such as the small intestine or stomach. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Has there been blood in your stool?

Finding:

Reports typically having a bowel movement almost every day

(Found)

Pro Tip: Asking about usual bowel movements facilitates baseline data collection. Asking specifically about bowel movement frequency aids in the identification of abnormalities.

Example Question:

How many bowel movements do you typically have per week?

Finding:

Reports stools usually brown, formed, and soft Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

(Found)

Pro Tip: Asking about usual bowel movements facilitates baseline data collection. Asking specifically about bowel movement frequency aids in the identification of abnormalities. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved.

Example Question:

Can you describe a typical bowel movement?

Finding:

Asked about urination

Finding:

Reports recent, slight decrease in frequency of urination

(Found)

Pro Tip: Frequency of urination can be an important clue to many underlying conditions. It’s important to ask whether your patient has noticed changes in her typical habits.

Example Question: Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Have you had any changes in the frequency of your urination?

Finding:

Reports darker urine recently

(Found)

Pro Tip: Darker urination can be an important clue to many underlying conditions like cirrhosis or hepatitis. It’s important to ask whether your patient has noticed changes in her typical urinary patterns.

Example Question:

Has your urine been darker recently?

Finding:

Reports no blood in urine

(Found)

Pro Tip: Blood in the urine can be an important clue to many underlying conditions like cancer or kidney problems. It’s important to ask whether your patient has noticed changes in her typical urinary patterns. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Have you had blood in your urine?

Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript, Objective, Subjective Solved

Medical History

Finding:

Asked about medications

Finding:

Reports blood pressure medication

(Found)

Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

Example Question:

Do you take medication for your blood pressure? Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

Reports Accupril

(Available)

Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

Example Question:

What medication do you take for your blood pressure?

Finding:

Accupril is 10 mg

(Found)

Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

Example Question:

What dose of blood pressure medication do you take? Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

Taken daily at 8 a.m.

(Found)

Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

Example Question:

When did you last take blood pressure medication?

Finding:

Reports no OTC use

(Found)

Pro Tip: Patients should always be asked specifically about over-the-counter medications, as many patients will overlook talking about them. Over-the-counter medications can cause medical complications of their own or can indicate medical problems that your patient has been attempting to self-treat. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Do you take any over-the-counter medications?

Finding:

Asked about allergies

Finding:

Reports latex allergy

(Found)

Pro Tip: Latex allergies can cause severe and even life-threatening consequences. Always asking specifically about allergies can help ensure that your patient does not receive medication or treatment that will do her harm.

Example Question:

Are you allergic to latex?

Finding:

Reports no medication allergies

(Found)

Pro Tip: Medication allergies can cause severe and even life-threatening consequences. Always asking specifically about these allergies can help ensure that your patient does not receive medication that will do her harm. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Are you allergic to any medications?

Finding:

Reports no food allergies

(Found)

Pro Tip: Knowing your patient’s food allergies prevents your patient from receiving harmful food. It helps identify specific allergies–such as shellfish or eggs–which can contraindicate the administration of common medications or treatments that include derivatives of these substances.

Example Question:

Do you have any food allergies

Finding: Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Asked about general known health conditions

Finding:

Reports hypertension

(Found)

Pro Tip: It’s best to determine specifically whether or not a healthcare professional has diagnosed the condition.

Example Question:

Do you have high blood pressure?

Finding:

Diagnosed with hypertension at age 54

(Available)

Pro Tip: Learning the diagnosis date of your patient’s illness is an essential element of the illness’s history.

Example Question:

At what age were you diagnosed with hypertension? Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

Finding:

Asked about relevant gastrointestinal history Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

Reports no history of gastrointestinal disorders

(Found)

Pro Tip: Broad open questions are efficient and useful in eliciting a large amount of information from your patient. Asking about any gastrointestinal problems helps guide your assessment.

Example Question:

Do you have any GI conditions?

Finding:

Reports no history of GERD, heartburn, or ulcer

(Found)

Pro Tip: If a patient has a history of GERD, ulcer, heartburn, or perceived indigestion, it could contribute to her present condition.

Example Question:

Do you have a history of heartburn?

Finding:

Reports no history of appendicitis

(Found)

Pro Tip: In patients with lower quadrant abdominal pain, confirming a previous appendectomy can help rule out appendicitis as a cause for her current symptoms. It is important to note that elderly patients with appendicitis may present atypically and often lack certain classic symptoms such as rebound tenderness, right lower quadrant pain, fever, and anorexia. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Have you ever had appendicitis?

Finding:

Reports no history of stomach cancer

(Found)

Pro Tip: If a patient has a history of stomach cancer, abdominal pain could be a sign of recurrence.

Example Question:

Do you have a history of stomach cancer?

Finding:

Reports no history of liver disease

(Found)

Pro Tip: A history of liver disease could cause additional gastrointestinal complaints for a patient. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Example Question:

Do you have a history of liver disease

Finding:

Asked about relevant history of surgery

Finding:

Reports c-section

(Found)

Pro Tip: Information about your patient’s pregnancy complications can provide you with insight into past medical conditions. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

Example Question:

Did you have any complications during pregnancy? Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

C-section at age 40

(Found)

Pro Tip: Information about your patient’s pregnancy can provide you with insight into past medical conditions.

Example Question:

At what age did you have a C-section?

Finding:

Reports cholecystectomy

(Found)

Pro Tip: Information about your patient’s past surgeries can provide you with insight into past medical conditions.

Example Question:

Have you had your gallbladder removed?

Finding:

Cholecystectomy at age 42

(Found)

Pro Tip: Establishing a timeline about your patient’s past surgeries can provide you with insight into past medical conditions.

Example Question:

At what age did you have your gallbladder removed? Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

Reports no post-operative complications

(Available)

Pro Tip: Asking about any postoperative complications in your patient’s history may provide information relevant to identifying her present condition.

Example Question:

Did you have any complications after your surgery?

Social History

Finding:

Asked about diet

Finding:

Reports last meal was toast at breakfast

(Found)

Pro Tip: A healthy and balanced diet is crucial for maintaining good health. Asking Esther about her last meal will indicate her typical eating habits and allow you to assess whether her eating habits put her at risk of cardiovascular disease or other health complications.

Example Question:

What was your last meal?

Finding:

Typically eats 3 meals

(Found)

Pro Tip: A healthy and balanced diet is crucial for maintaining good health. Asking Esther about what she typically eats will allow you to assess whether her eating habits put her at risk of cardiovascular disease or other health complications.

Example Question:

How many meals do you typically eat in a day? Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

Typically does not eat snacks

(Found)

Pro Tip: A healthy and balanced diet is crucial for maintaining good health. Asking Esther about what she typically has for a snack will allow you to assess whether her eating habits put her at risk of cardiovascular disease or other health complications.

Example Question:

  • What is a typical snack for you?:
  • A typical breakfast is a piece of fruit

(Found)

Pro Tip: A healthy and balanced diet is crucial for maintaining good health. Asking Esther about what she typically eats for breakfast will allow you to assess whether her eating habits put her at risk of cardiovascular disease or other health complications.

Example Question:

What do you usually eat for breakfast? Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

Typical lunch is soup, sometimes skips lunch

(Found)

Pro Tip: A healthy and balanced diet is crucial for maintaining good health. Asking Esther about what she typically eats for lunch will allow you to assess whether her eating habits put her at risk of cardiovascular disease or other health complications. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

Example Question:

What do you usually eat for lunch?

Finding:

Typical dinner is chicken or fish with vegetables and rice

(Found)

Pro Tip: A healthy and balanced diet is crucial for maintaining good health. Asking Esther about what she typically eats for dinner will allow you to assess whether her eating habits put her at risk of cardiovascular disease or other health complications.

Example Question:

What do you usually eat for dinner? Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

Asked about fiber intake

Finding:

Reports no fiber supplements

(Found)

Pro Tip: A high fiber diet helps to reduce constipation. Asking Esther if she takes fiber supplements will help you to assess whether she gets enough fiber in her diet.

Example Question:

Do you take fiber supplements?

Finding:

Reports belief that she gets enough fiber

(Found)

Pro Tip: A high-fiber diet helps to reduce constipation. Asking Esther about her fiber consumption will help you to assess whether she gets enough fiber in her diet.

Example Question:

Do you think you get enough fiber? Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Finding:

Reports getting fiber from a daily vegetable

(Found)

Pro Tip: A high fiber diet helps to reduce constipation. Asking Esther what sources of fiber she eats will help you to assess whether she gets enough fiber in her diet. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

Example Question:

What sources of fiber do you eat?
Finding:

Reports getting fiber from a daily piece of fruit

Objective Data Collection: 26 of 26 (100%)

  •  Correct
  •  Partially correct
  •  Incorrect
  •  Missed

 Inspected head and face

1 of 1 point

Skull Symmetry (1/3 point)

  •  Symmetric
  •  Asymmetric

Facial Feature Symmetry (1/3 point) Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

  •  Symmetric
  •  Asymmetric

Appearance (1/3 point)

  •  No visible abnormal findings
  •  Flushed appearance
  •  Rash or lesion
  •  Skin growths (freckles, moles, or birth mark)
  •  Excessive hair growth
  •  Evidence of skin trauma (scar, laceration, or bruising)
  • Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved
 Inspected nasal mucosa
1 of 1 point

Appearance (1/1 point)

  •  Moist and pink
  •  Dry appearance
  •  Redness
 Inspected mouth
1 of 1 point

Oral Mucosa (1/1 point) Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

  •  Moist and pink
  •  Dry appearance
  •  Redness
 Inspected abdomen

1 of 1 point

Checked for edema in lower extremities

1 of 1 point

 Auscultated heart sounds

1 of 1 point

 Auscultated breath sounds

1 of 1 point

 Auscultated abdominal aorta

1 of 1 point

 Auscultated bowel sounds

1 of 1 point

Bowel Sounds (1/2 point)

  •  Absent
  •  Hypoactive
  •  Normoactive
  •  Hyperactive

Location Of Non-Normoactive Bowel Sounds (1/2 point)

  •  All quadrants normoactive
  •  Right upper quadrant
  •  Right lower quadrant
  •  Left upper quadrant
  •  Left lower quadrant
 Auscultated abdominal arteries Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

1 of 1 point

 Auscultated organs

1 of 1 point

 Percussed abdomen

1 of 1 point

 Percussed spleen

1 of 1 point

 Percussed liver

1 of 1 point

 Percussed CVA tenderness

1 of 1 point

 Palpated abdomen – light

1 of 1 point

Tenderness (1/3 point)

  •  None reported
  •  Tenderness reported

Location Of Tenderness (1/3 point)

  •  No quadrants tender
  •  Right upper quadrant
  •  Right lower quadrant
  •  Left upper quadrant
  •  Left lower quadrant

Observations (1/3 point)

  •  No additional observations
  •  Masses
  •  Guarding
  •  Distension
 Palpated abdomen – deep

1 of 1 point

 Palpated aortic width
1 of 1 point
 Palpated liver
1 of 1 point
 Palpated spleen
1 of 1 point
 Palpated bladder
1 of 1 point
 Palpated kidneys
1 of 1 point Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Right (1/2 point)

  •  Not palpable
  •  Palpable

Left (1/2 point)

  •  Not palpable
  •  Palpable
  • Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved
 Tested skin turgor
1 of 1 point
 Performed pelvic exam
1 of 1 point
 Performed digital rectal exam
1 of 1 point

Observations (1/1 point)

  •  No abnormal findings
  •  Hemorrhoids
  •  Fissures
  •  Ulceration
  •  Weak sphincter tone
  •  Fecal mass in rectal vault
 Checked urinalysis
1 of 1 point

Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript, Objective, Subjective Solved

Education & Empathy: 5 of 7 (71.4%) Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A Model Statement is provided as an example of an appropriate response to each opportunity.

  • Opportunities marked as Not Encountered are opportunities that were not elicited in the interview.
  • Opportunities marked as Not Followed Up are missed opportunities that were present in the interview but where no statements were made.
  • Opportunities marked as Followed Up were followed up by students, and include the dialogue between student and patient Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved.
 1 Symptoms
  • Followed Up

 Description: Ms. Park describes the symptoms that have been bothering her.

What brings to the clinic today?

Question
11:26 AM PDT

I have some pain in my belly. . . and I’m having difficulty going to the bathroom. My daughter was worried about me.

i am sorry you are having pain in your belly.

Empathize
11:27 AM PDT

Thank you.

When did the abdominal discomfort begin?

Question
11:27 AM PDT

It all started. . . about five days ago. When I started having trouble going to the bathroom. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

I am sorry to hear this. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Empathize
11:28 AM PDT

Thank you.

Does eating aggravate the pain?

Question
11:37 AM PDT

Yes. The pain is there all the time, but eating can make it worse.

does physical activity aggravate pain?

Question
11:38 AM PDT

Yes. When I move around the house or try to garden, I feel more pain. And I did not go to my exercise classes. I was sure that would be too much. I prefer to be active, but my daughter wants me to rest.

i am sorry for th discomfort.

Empathize
11:38 AM PDT

Thank you.

do you get constipation often?

Question
11:51 AM PDT

I don’t usually have problems going to the bathroom. . . but this has been going on for. . . about five days now. [AUDIO COMING SOON] Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

How many bowel movements do you typically have per week?

Question
11:52 AM PDT

Before this? Every day. Well, I miss a day now and then, but usually every day.

Are your stools usually formed?

Question
11:53 AM PDT

Usually, yes. But not when I had the diarrhea.

are your stools typically soft ?

Question
11:54 AM PDT

I haven’t even been able to move my bowels! I had diarrhea a while back, though . . . six months ago, maybe.

You said you have latex allergy? (Clarified to: What are the symptoms of your latex allergy?)

Question
11:54 AM PDT

I get an itchy skin rash. (Clarified to: what the symptoms of my latex allergy are)

sorry about this skin rash. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Empathize
11:55 AM PDT

Thank you.

Do you have problems with eating?

Question
12:28 PM PDT

Yes. I haven’t eaten much these last few days.

Sorry about that.

Empathize
12:29 PM PDT

Thank you.

Do you have problems getting in and out of chairs?

Question
12:30 PM PDT

Any kind of movement makes my abdominal discomfort worse, but I don’t usually have problems with that.

Am sorry for that discomfort.

Empathize
12:31 PM PDT

Thank you.

 Model Statement: “I’m sorry you’re having these symptoms. It’s good that you came in today so we can see what is causing your discomfort.” Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved
 2 Medications
  • Followed Up
 3 Diet
  • Not Followed Up
 4 Activity Level
  • Followed Up
 5 Medical History
  • Followed Up
 6 Sexual Activity
  • Followed Up

 7 Family and Support Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Not Followed Up

 Description: Ms. Park describes being widowed and living with her daughter.

Do you live alone?

Question
12:40 PM PDT

No. I live with my daughter, Jennifer.

Who can you ask for support?

Question
12:41 PM PDT

Usually, I don’t need much help. But since I’ve been sick, my daughter has been helping me, doing things around the house–gardening, cleaning, and ensuring I eat something. She’s very busy with her job, and it’s very sweet of her to help me. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved.

Have you travelled travelled anywhere recently (Clarified to: Have you traveled recently?) Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Question
12:42 PM PDT

No, I haven’t gone on any trips in several years. (Clarified to: if I have traveled recently)

Have you experienced any physical abuse?

Question
12:43 PM PDT

No, never.

 Model Statement: “I’m sorry that your husband passed away. It sounds like you have a wonderful relationship with your daughter and son. I’m happy to hear that you have a strong support system in your children.”

Shadow Health Assessment Assignment

You will complete all assessment assignments using the Shadow Health  virtual reality simulation platform.

Introduction and Pre-brief

Mrs. Esther Park is a 78-year-old woman who comes to the clinic complaining of abdominal pain. She reports that the pain isn’t severe, but her daughter was concerned and brought her in. It is very important to determine whether or not the situation is an emergency and the underlying cause of Esther’s discomfort. Be sure to inquire about various psychosocial factors related to the GI system, including her diet, toilet habits, immunizations, recent travel, etc.

This case study will allow you to take a complete surgical, reproductive, and current sexual history. During her physical examination, take particular note as to where Mrs. Park verbalizes pain during palpation so that you may synthesize verbal and non-verbal cues. Be sure to apply the supportive information learned in this week’s concept lab to your critical thinking process in this case study. Esther Park Abdominal Pain-Focused Shadow Health Assessment Transcript

Tips and Tricks

Evaluating elderly patients with abdominal pain can be difficult, time-consuming, and fraught with potential missteps. Abdominal pain is the most common emergency department complaint and the fourth most common among elderly patients. The physiologic, pharmacologic, and psychosocial aspects of elderly patients evaluate their abdominal pain differently than in the general population.

As a clinician, you must develop an index of suspicion which is defined as awareness and concern for potentially serious underlying and unseen injuries or illness. Having a well-developed index of suspicion for abnormality will help to differentiate diagnoses.

To optimize your assessment experience and sharpen your skills, be sure to explore the Abdominal Concept Lab prior to beginning the assignment. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

Purposes

The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge.

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:
  1. Apply knowledge and understanding of advanced practice physical assessment skills and techniques (CO1)
  2. Perform focused and comprehensive histories and physical assessments for various patient populations (CO4 and CO5)
  3. Adapt skills and techniques to suit the individual needs of the patient (CO4)
  4. Differentiate normal from abnormal physical examination findings (CO2)
  5. Summarize, organize, and document findings using correct professional terminology (CO3)

Total Points Possible: 75 Points Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Assignment

Step One: Complete the designated Shadow Health (SH) Assignment on the SH platform.

Step Two: Document your findings on the Fillable Soap Note Template or the Printable Soap Note.

Step Three:  Upload the Lab Pass and completed SOAP Note as separate documents to the same assignment tab in the gradebook. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

Requirements

NOTE: Before initiating any activity in Shadow Health, complete the required course weekly readings and lessons as well as review the introduction and pre-brief.

  1. Complete the Shadow Health Concept Lab (Weeks 2, 4, and 5) prior to beginning the graded assignment.
  2. Gather subjective and objective data by completing a focused, detailed health history and physical examination for each physical assessment assignment.
  3. Critically appraise the findings as normal or abnormal.
  4. Complete the post activity assessment questions for each assignment .
  5. Complete all reflection questions following each physical assessment assignment.
  6. Digital Clinical Experience (DCE) scores do not round up. For example, a DCE score of 92.99 is a 92, not a 93.
  7. You have a maximum of two (2) attempts per Shadow Health assignment to improve your performance. However, you may elect not to repeat any assignment. NOTE: If you repeat an attempt, ONLY the second attempt will be graded, regardless of the DCE score. Please refer to the grading rubric categories for details.
  8. Download the Lab Pass for the final attempt on the assignment. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

On the Canvas Platform:

  1. Summarize, organize, and appropriately document findings using correct professional terminology on the SOAP Note Template.
  2. Identify three (3) differential diagnoses and provide ICD-10 codes and pertinent positive and negative findings for each diagnosis.
  3. Create a comprehensive treatment plan for each assignment. Must address the following components: Diagnostics, Medication, Education, Referral/Consultation, and Follow-up planning. If no interventions for one or more component, document “none at this time” but do not skip over the component.
  4. Provide rationales and citations for diagnoses and interventions. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved
  5. Include at least one scholarly source to support diagnoses and treatment interventions with rationales and references on the SOAP note. Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are NOT considered to be outside scholarly sources.
  6. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article.  Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript
  7.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These websites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.  For example, the American Heart Association is a .com site with scholarship and quality. Each student is responsible for determining the scholarship and quality of any .com site.  Ask your instructor before using any site if you are unsure.
  8. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.  Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.
  9. Upload the Lab Pass to the appropriate assignment area in Canvas Grades

Shadow Health Grading Rubric

Portions of the rubric are designated with a ***. The following explains those portions of the rubric:

* Shadow Health automatically translates Digital Clinical Experience (DCE) Score based on individual student performance and reflects how student work compares to their peer learners across the country for a particular assignment. The DCE Score is a fair assessment of effort, and therefore is appropriate for use when grading assignments.

**Scholarly Sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are NOT considered to be outside scholarly sources.

For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.

You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These websites are not considered scholarly as anyone can add to these. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Please be aware that .com websites can vary in scholarship and quality.  For example, the American Heart Association is a .com site with scholarship and quality. Each student is responsible for determining the scholarship and quality of any .com site. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved.

Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.  Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.

***Components of a treatment plan include  diagnostics,  medication,  education,  consultation / referral, and follow-up planning Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

****Insight refers to the capacity to gain an accurate and deep intuitive understanding of a concept or thing. For example, one might demonstrate insight by relating a concept to a personal or meaningful experience.

ASSIGNMENT CONTENT
Category Points % Description
Health History , Education, Empathy, and Summary(DCE Score or transcript)

 

 15 20% The Digital Clinical Experience (DCE)Score is automatically translates by Shadow Health based on individual student performance and reflects how student work with data collection, health history communication, education, empathy, and summarization compares to peer learners across the country for a particular assignment. The DCE Score is a fair assessment of effort, and therefore is appropriate for use when grading assignments. Occasionally, performance transcripts may be reviewed for secondary support.
Assessment, Documentation, Treatment Plan, and Scholarly Sources Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved 35 47% This category is evaluated on the quality of student’s ability to: Identify pertinent normal and abnormal findings for the assignment, utilize professional terminology, provide comprehensive and detailed subjective and objective findings, identify differential diagnoses, and create a comprehensive treatment plan. Include at least one appropriate EBP scholarly source and use the SOAP Note format template to document all findings.
Self-Reflection 15 20% Self-reflection posts must demonstrate the student’s own perspective. The quality of this criterion is based upon responding to all the reflection questions; providing responses that are substantive (add importance, meaningfulness, and relevance to the post); demonstrate analysis of own performance; and demonstrate insight. Insight refers to the capacity to gain an accurate and deep intuitive understanding of a concept or thing. For example, one might demonstrate insight by relating a concept to a personal or meaningful experience.Reflection post responses should vary from SH assignment to assignment.
65 87% Total CONTENT Points= 65
ASSIGNMENT FORMAT
Category Points % Description
Grammar, Spelling, Syntax, Mechanics and APA Format 10 13% Reflection post has minimal grammar, spelling, syntax, punctuation and APA* errors. Direct quotes (if used) is limited to 1 short statement** which adds substantively to the post.* APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included. Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

**Direct quote should not exceed 15 words & must add substantively to the assignment
10 100%
Total FORMAT Points= 10
ASSIGNMENT TOTAL= 75 points

Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript, Objective, Subjective Solved Rubric

NR509 Weeks 2-6 Shadow Health Assignment_Sept19 (4)
NR509 Weeks 2-6 Shadow Health Assignment_Sept19 (4)
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Assignment Content Possible Points = 65 PointsCriterion 1

Health History , Education, Empathy, and Summary

(DCE Score or Transcript)

 Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

15.0 ptsExcellent

DCE Score > 93

 14.0 ptsV. Good

DCE Score 86-92

 12.0 ptsSatisfactory

DCE Score 80-85

 8.0 ptsNeeds Improvement

DCE Score < 79

 0.0 ptsUnsatisfactory

No Assignment
15.0 pts
This criterion is linked to a Learning Outcome Criterion 2 Assessment, Documentation, Treatment Plan, and Scholarly SourcesMust demonstrate the following elements:

Identified all pertinent normal and abnormal findings;

Used professional terminology;

Subjective and objective documentation was detailed and comprehensive;

Used the SOAP Note Format template for documentation;

Identified three (3) differential diagnoses with ICD-10 codes and pertinent positive/negative findings;

Addressed each of the following on the treatment plan: Diagnostics, Medication, Education, Referral/Consultation, and Follow-up Planning;

Interventions are detailed and appropriate for the focused assignment;

Provided at least one appropriate EBP scholar source Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

(8 Required Elements)

 Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

35.0 ptsExcellent

Demonstrated all elements for this Criterion

 32.0 ptsV. Good

Missing 1 element for this Criterion

 29.0 ptsSatisfactory

Missing 2 or 3 elements for this Criterion

 18.0 ptsNeeds Improvement

Missing 4 or 5 elements on for this Criterion

 0.0 ptsUnsatisfactory

Missing 6 or more elements for the criterion Or No Assignment
35.0 pts
This criterion is linked to a Learning OutcomeCriterion 3 Self-ReflectionMust demonstrate the following elements:

Written from the student’s own perspective;

Responded to all the reflection questions;

Responses were each substantive (added importance, meaningfulness, and relevance to the post);

Offer self-analysis of performance and insight;

Reflection post responses should vary from SH assignment to assignment.

(5 Required Elements)

 Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

15.0 ptsExcellent

Demonstrated all elements for this Criterion

 14.0 ptsV. Good

Missing 1 element for this Criterion

 12.0 ptsSatisfactory

Missing 2 elements for this Criterion

 8.0 ptsNeeds Improvement

Missing 3 elements for this Criterion

 0.0 ptsUnsatisfactory

Missing 4 or more elements for the criterion Or No Assignment
15.0 pts
This criterion is linked to a Learning Outcome Assignment Format Possible Points = 10 PointsFormat Criterion 1

Grammar, Spelling, Syntax, Mechanics and APA Format
10.0 ptsExcellent

0-1 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

 9.0 ptsV. Good

2-3 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format

 8.0 ptsSatisfactory

4-5 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format

 5.0 ptsNeeds Improvement

6-7 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format

Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

 0.0 ptsUnsatisfactory

8 or more errors in grammar, syntax, spelling, punctuation, mechanics, or APA format Or No assignment
10.0 pts
This criterion is linked to a Learning Outcome Late Penalty Deductions Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy. Esther Park Abdominal Pain Focused Shadow Health Assessment Transcript

0.0 pts Minus Points 0.0 pts Minus Points
0.0 pts
Total Points: 75.0 Esther park abdominal pain focused shadow health assessment transcript, objective, subjective solved

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