Gastrointestinal Results | Turned In Advanced Health Assessment - Spring 2019, NSG516 Online

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Gastrointestinal Results | Turned In Advanced Health Assessment - Spring 2019, NSG516 Online Return to Assignment Your Results Reopen Lab Passss This score measures your performance on the Student... Performance Index in relation to other students in comparable academic programs. Your instructor has chosen to scale your Student Performance Index score so that the average score on the index is a 84.0%. This score may not be your final grade if your instructor chooses to include additional components, such as documentation or time spent. Patient: Tina Jones Digital Clinical Experience Score 99.3% Beginning Developing Proficient Subjective Data Collection 30 out of 30 Objective Data Collection 17 out of 18 Education and Empathy 2 out of 4 Interaction with patient 59 minutes Post-exam activities 8 minutes Time 67 minutes total spent in assignment Student Performance Index 49 out of 52 Proficiency Level: Proficient Students rated as “proficient” demonstrate an entrylevel expertise in advanced practice competencies and clinical reasoning skills. In comparable programs, the top 25% of students perform at the level of a proficient practitioner. Started: Mar 09, 2019 | Patient Exam Time: 59 min Transcript Overview Transcript Subjective Data Collection Objective Data Collection Education & Empathy Documentation Self-Reflection Student Survey Experience Overview Allll Liiness ((114455)) IIntterrvviiew Quessttiionss ((7733)) Sttattementtss ((1133)) Exxam Acttiionss ((5599)) Greet 03/09/19 9:51 AM EST Question 03/09/19 9:51 AM EST Empathize 03/09/19 9:52 AM EST Question 03/09/19 9:52 AM EST Question 03/09/19 9:52 AM EST Question 03/09/19 9:52 AM EST Empathize 03/09/19 9:53 AM EST Question 03/09/19 9:53 AM EST Hii Tiina,, II am JJulliiana,, tthe nurrsse prracttiittiionerr ssttudentt.. II wiillll iintterrvviiew and exxamiine yyou ttodayy.. Niice sseeiing yyou agaiin.. Hey. Whatt brriingss yyou iin? I've been having this stomach pain for awhile. It keeps coming back, and it really is starting to bother me. Sorrrryy tto hearr yyou arre havviing ttrroublle wiitth ssttomach paiin.. Lett;;ss ssee iiff we can fifigurre outt whatt tthe prrobllem iiss.. Thanks for saying that. When diid tthe ssttomach paiin ssttarrtt? Probably at least a month ago. Maybe longer. It started out really minor so it took me awhile to realize it was getting bad. Can yyou desscrriibe tthe ssttomach paiin? Um, it feels like heartburn. But sometimes, if it's bad, it's sharper than that. Doess anyytthiing makke tthe paiin worrsse? Eating seems to cause it. Oh,, whatt a burrden!! Hopeffullllyy yyou arre nott exxperriienciing iitt allll tthe ttiime!! I appreciate you telling me that. Do grreassyy ffoodss makke tthe paiin worrsse? Question 03/09/19 9:53 AM EST Question 03/09/19 9:53 AM EST Question 03/09/19 9:54 AM EST Question 03/09/19 9:54 AM EST Empathize 03/09/19 9:54 AM EST Question 03/09/19 9:55 AM EST Question 03/09/19 9:55 AM EST I don't think so. Whatt makkess tthe paiin worrsse? Eating seems to cause it. Whatt makkess tthe ssttomach paiin betttterr? I feel the best in-between meals. And sitting up on the couch seems to help. And sometimes I take an antacid. How offtten do yyou ttakke anttaciidss? I take them every few days. Just if the heartburn gets bad. How much do anttaciidss hellp? Yeah, they help. I try to only take them when the pain seems worse than usual. II am gllad tto hearr yyou arre ablle tto gett ssome rrelliieff ffrrom tthe anttaciidss Thanks. Doess tthe ssttomach paiin rradiiatte? No, it's right in the center of my stomach, like between my belly button and my ribs. How offtten do yyou gett ssttomach paiin? It started really gradually, so I didn't notice for awhile that it was happening more and more often. Now it's like, every day. Empathize 03/09/19 9:55 AM EST Question 03/09/19 9:55 AM EST Question 03/09/19 9:56 AM EST Question 03/09/19 9:56 AM EST Empathize 03/09/19 9:56 AM EST Question 03/09/19 9:57 AM EST Question 03/09/19 9:59 AM EST IItt musstt be harrd tto havve tto deall wiitth ssttomach paiinss daiillyy.. I appreciate you saying that. How llong doess tthe paiin llasstt? For a few hours after I eat. How woulld yyou rratte tthe ssttomach paiin ffrrom 0--10? Right now, it's like a 1 or 2. But after I eat, it's like a. . . 5? How llong doess tthe ssttomach paiin llasstt? For a few hours after I eat. A daiillyy paiin off 5//10 iiss a llott tto deall wiitth.. Thanks for understanding. Doess tthe paiin iintterrfferre wiitth yyourr lliiffe? ((Cllarriifified tto Hass tthe paiin affffectted yyourr ussuall acttiivviittiiess?..)) Not too much. I'm still able to do everything with work and school. But it affects the way I eat -- I haven't wanted to eat much, because I feel like it's gonna hurt if I eat the wrong thing, or if I eat too much at one time. (Clarified to if my pain has affected my activities.) Whatt ffoodss makke iitt worrsse? Question 03/09/19 9:59 AM EST Empathize 03/09/19 10:00 AM EST Question 03/09/19 10:00 AM EST Empathize 03/09/19 10:01 AM EST Educate 03/09/19 10:01 AM EST Question 03/09/19 10:01 AM EST Question 03/09/19 10:02 AM EST Definitely spicy food. I stopped eating anything spicy. And any really big meal makes it hurt worse. How doess tthe ssttomach paiin affffectt yyourr appettiitte? Yes. Every time I eat it hurts. I've been eating less because I don't like being in pain. II am ssurrprriissed yyou havventt llosstt morre weiightt.. Lettss come up wiitth a pllan tto addrressss iitt Thanks for saying that. Hass tthe ssttomach paiin caussed weiightt llossss? Yeah, I've been trying to eat really little meals. I haven't been that hungry, and I don't want to have the pain of eating a big meal. II compllettellyy underrssttand.. Thanks for understanding. Eattiing ssmallllerr meallss and makkiing ssome diiett modiifificattiionss can hellp wiitth tthesse ssyympttomss.. That makes sense. Havve yyou llosstt weiightt? No, I don't think so. Havve yyou been burrpiing llattellyy? Yeah, that's been happening after I eat. Question 03/09/19 10:02 AM EST Question 03/09/19 10:02 AM EST Question 03/09/19 10:02 AM EST Question 03/09/19 10:02 AM EST Question 03/09/19 10:02 AM EST Question 03/09/19 10:03 AM EST Question 03/09/19 10:03 AM EST DO yyou havve anyy allllerrgiiess? Yeah, I'm allergic to cats. Whatt iiss yyourr rreacttiion tto catt allllerrgiiess? Whenever I'm around cats, I start sneezing, my eyes get itchy. . . and my asthma starts to act up. Do yyou havve mediicattiion allllerrgiiess? Yeah, I'm allergic to penicillin. Whatt iiss yyourr rreacttiion tto peniiciilllliin? I don't remember that well because the last time I had penicillin I was pretty little. . . I think I got a rash, like, hives. The doctor told me not to take it again after that. Do yyou havve anyy ttrroublle brreatthiing? Well, I have asthma, but I haven't had much trouble with it. With my inhaler, it's under control. Whatt mediicattiionss do yyou currrrenttllyy ttakke? I have a daily inhaler. And I've been taking antacid chews sometimes for my stomach, too. Do yyou ttakke anyy ottherr ovverr tthe countterr mediicattiionss? No, the only thing lately has been those antacid chews. How offtten do yyou usse tthe anttaciid chewss Question 03/09/19 10:03 AM EST Question 03/09/19 10:04 AM EST Question 03/09/19 10:04 AM EST Question 03/09/19 10:04 AM EST Question 03/09/19 10:05 AM EST Empathize 03/09/19 10:05 AM EST Question 03/09/19 10:05 AM EST I take them every few days. Just if the heartburn gets bad. Do yyou drriinkk allcoholl? Not lately, but I do every so often. How much allcoholl do yyou drriinkk perr montth? I only go out 2 or 3 times a month at the most. I haven't been out in a couple weeks. How manyy drriinkkss do yyou havve perr montth? We're talking, like... maybe twice a month, I meet up with friends and have 2 to 3 drinks. That's like, 6 a month. And I haven't had a drink in at least 2 weeks. DO yyou ssmokke? No, I've never smoked a cigarette in my life. Good fforr yyou!! Thanks. Do yyou usse rrecrreattiionall drrugss? Yeah, in high school and a little after that I smoked pot sometimes. But I haven't done anything like that in a long time. Question 03/09/19 10:05 AM EST Question 03/09/19 10:06 AM EST Question 03/09/19 10:06 AM EST Question 03/09/19 10:06 AM EST Question 03/09/19 10:06 AM EST Question 03/09/19 10:07 AM EST Question 03/09/19 10:07 AM EST Do yyou havve a hiissttorryy off gassttrroiinttessttiinall prrobllemss? I don't have a history of gastrointestinal problems. I've never experienced this before. [AUDIO COMING SOON] Arre yyou conssttiipatted? I don't have that problem. Do yyou havve rregullarr bowell movvementtss? Um, I don't go every day... I probably go every two days. That's normal for me. Do yyou havve rregullarr urriinattiion? Well. . . I would say I've been peeing a lot more lately. When diid yyou ssttarrtt peeiing a llott morre? I guess it started. . . maybe a few months? But I've been drinking a lot more water, too. Havve yyou been morre tthiirrssttyy? You know, I did notice lately that I've been really thirsty. When diid yyou llasstt havve a bowell movvementt? I haven't gone yet today, but I did last night. Question 03/09/19 10:07 AM EST Question 03/09/19 10:08 AM EST Question 03/09/19 10:08 AM EST Question 03/09/19 10:08 AM EST Question 03/09/19 10:08 AM EST Question 03/09/19 10:08 AM EST Empathize 03/09/19 10:09 AM EST Question 03/09/19 10:09 AM EST Do yyou havve lloosse ssttoollss? No. Do yyou havve bllood iin tthe ssttoollss? Um, no. Havve yyou had diiarrrrhea? No. Havve yyou had a llott off gass? ((Cllarriifified tto Do yyou ffeell gassssyy?..)) No. (Clarified to if I am gassy.) Do yyou ffeell nausseouss? No, I'm fine. Do yyou ffeell diizzzzyy? No, I'm not dizzy but I feel pretty crappy. II am ssorrrryy tto hearr yyou ffeell tthiiss wayy!! I appreciate you saying that. Do yyou havve rregullarr perriiodss? Question 03/09/19 10:09 AM EST Question 03/09/19 10:09 AM EST Question 03/09/19 10:09 AM EST Question 03/09/19 10:10 AM EST Question 03/09/19 10:10 AM EST Question 03/09/19 10:10 AM EST Question 03/09/19 10:11 AM EST It's not regular. Sometimes it's every month, but sometimes it's more like every two months. I don't write it down or anything. I probably get...six periods a year. Arre yyou ssexxuallllyy acttiivve? Um, not right now. When wass yyourr llasstt meall? This morning, I had breakfast at home. Whatt diid yyou eatt fforr brreakkffasstt? This morning, I had toast with butter and honey, and some orange juice. Diid yyourr brreakkffasstt causse paiin? ((No mattchiing quessttiionss ffound..)) Whatt diid yyou eatt iin tthe llasstt 24 hourrss? Um ...Yesterday, I had ... Let me start at breakfast. I had a bowl of cereal. For lunch ... I had a piece of pizza. For dinner, I made baked potatoes with broccoli and cheese soup. This morning I had toast with butter and honey, and some orange juice, and that's the last thing I've had. Whatt iiss yyourr ttyypiicall diiett lliikke? It's pretty good, I think. I'm not a huge health nut or anything. Whatt do yyou ussuallllyy eatt fforr brreakkffasstt? Question 03/09/19 10:11 AM EST Question 03/09/19 10:11 AM EST Question 03/09/19 10:11 AM EST Question 03/09/19 10:11 AM EST Question 03/09/19 10:11 AM EST Question 03/09/19 10:12 AM EST I usually have either cereal or toast, or if I pick something up on my way to work, I'll get a muffin or some pumpkin bread. Whatt do yyou ussuallllyy eatt fforr llunch? I usually either make a sandwich and bring it with me, or I get a sandwich somewhere. And I have chips or pretzels with it. Or *maybe* French fries, but I try not to get them too often. WHatt do yyou ussuallllyy eatt fforr diinnerr? Oh, we try to make something easy. We eat a lot of frozen chicken breasts. We do hamburgers that we make at home every so often. We make sure we have a vegetable, and we eat a lot of potatoes. And we usually have rolls or something. Whatt do yyou ussuallllyy eatt fforr ssnackkss? Well, if I'm at home, I would have pretzels or chips. Or crackers, whatever we had around. If I'm on my way to work or campus... sometimes I stop and get a small thing of French fries at Sonic. Whatt do yyou lliikke tto drriinkk? Most of the time I just drink Diet Cokes. Do yyou drriinkk watterr? Yeah, I've been drinking tons of water lately. Do yyou drriinkk coffffee? No, I never drink it. Do yyou exxerrciisse? Question 03/09/19 10:12 AM EST Question 03/09/19 10:12 AM EST Educate 03/09/19 10:13 AM EST Question 03/09/19 10:14 AM EST Question 03/09/19 10:14 AM EST Empathize 03/09/19 10:15 AM EST Question 03/09/19 10:15 AM EST I don't have the energy to go to a gym or anything after work. . . I'm pretty exhausted by the end of the day. But I'm on my feet all the time at work so I feel like that's a little bit of exercise most days at least. Havve yyourr diiettarryy patttterrnss changed? Yeah, I've been trying to eat really little meals. I haven't been that hungry, and I don't want to have the pain of eating a big meal. Somettiimess,, ssiittttiing up afftterr meallss and avvoiidiing tto eatt aboutt 2--3 hourrss prriiorr tto goiing tto bed can be vverryy hellpffull wiitth tthesse ssyympttomss.. Sure, I think I understand what you mean. Diid anyy ssttrressssffull lliiffe evventtss happened? Not that I can think of. I've been really busy with work and school. That's been stressful. Arre yyou ffeelliing deprressssed? The closest I ever came to depression was after Dad died. . . I just felt sad all the time. II am ssurre yyou diid.. IIttss norrmall do ffeell ssad when we llosse a llovved one I appreciate you telling me that. Arre yyou ffeelliing ssad orr bllue? No, I'm pretty even-keel. I mean, I have good days and bad days like everybody, but nothing crazy. Question 03/09/19 10:15 AM EST Educate 03/09/19 10:16 AM EST Question 03/09/19 10:16 AM EST Question 03/09/19 10:16 AM EST Question 03/09/19 10:17 AM EST Question 03/09/19 10:17 AM EST Question 03/09/19 10:17 AM EST Arre yyou ffeelliing anxxiiouss? Not too much -- I can get a little anxious and stressed because I'm busy and I work hard. I might have some anxiety lately. Especially since I'd like to get this heartburn fixed. Wiitth ssome lliiffessttyylle modiifificattiionss yyou wiillll be ablle tto gett tthe hearrttburrn fifixxed.. Alright, thanks for letting me know. Do yyou eatt outt a llott? I try not to eat out too much, but with my schedule I end up having to. Havve yyou changed anyytthiing aboutt yyourr diiett? No, I'm a creature of habit. I eat the same foods all the time. Do yyou havve a ffamiillyy hiissttorryy off GII diissorrderrss? No, my family doesn't have any gastrointestinal issues. Well, Grandpa Jones died from colon cancer, if that counts. Anyy rrecentt majjorr ssttrressssffull lliiffe evventtss? Not that I can think of. I've been really busy with work and school. That's been stressful. Do yyou havve diiettarryy rressttrriicttiionss? I avoid sugar because of my diabetes, but otherwise I can eat whatever I want. Question 03/09/19 10:18 AM EST Question 03/09/19 10:18 AM EST Exam Action 03/09/19 10:18 AM EST Exam Action 03/09/19 10:18 AM EST Exam Action 03/09/19 10:18 AM EST Exam Action 03/09/19 10:18 AM EST Exam Action 03/09/19 10:18 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Do yyou havve a ffevverr? No. No fever. Mayy II exxamiine yyou? Sure. Tesstted sskkiin tturrgorr on fforrearrm IInsspectted rriightt ssiide off abdomen IInsspectted ffrrontt off abdomen IInsspectted llefftt ssiide off abdomen IInsspectted ffrrontt off abdomen Ausscullttatted brreatth ssoundss iin antterriiorr rriightt upperr llobe Ausscullttatted brreatth ssoundss iin antterriiorr llefftt upperr llobe Ausscullttatted brreatth ssoundss iin antterriiorr llefftt miid--chesstt ((upperr llobe)) Ausscullttatted brreatth ssoundss iin antterriiorr rriightt miiddlle llobe Ausscullttatted brreatth ssoundss iin antterriiorr rriightt llowerr llobe Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:19 AM EST Exam Action 03/09/19 10:20 AM EST Exam Action 03/09/19 10:20 AM EST Exam Action 03/09/19 10:20 AM EST Exam Action 03/09/19 10:20 AM EST Ausscullttatted brreatth ssoundss iin antterriiorr llefftt llowerr llobe Ausscullttatted brreatth ssoundss iin posstterriiorr llefftt upperr llobe Ausscullttatted brreatth ssoundss iin posstterriiorr rriightt upperr llobe Ausscullttatted brreatth ssoundss iin posstterriiorr rriightt miid--backk ((llowerr llobe)) Ausscullttatted brreatth ssoundss iin posstterriiorr llefftt miid--backk ((llowerr llobe)) Ausscullttatted brreatth ssoundss iin posstterriiorr llefftt llowerr llobe Ausscullttatted brreatth ssoundss iin posstterriiorr rriightt llowerr llobe Ausscullttatted brreatth ssoundss iin posstterriiorr rriightt llowerr llobe on ssiide Ausscullttatted brreatth ssoundss iin posstterriiorr llefftt llowerr llobe on ssiide Ausscullttatted brreatth ssoundss iin posstterriiorr llefftt llowerr llobe nearr sspiine Ausscullttatted brreatth ssoundss iin posstterriiorr rriightt llowerr llobe nearr sspiine Ausscullttatted aorrttiic arrea wiitth tthe bellll Exam Action 03/09/19 10:20 AM EST Exam Action 03/09/19 10:20 AM EST Exam Action 03/09/19 10:20 AM EST Exam Action 03/09/19 10:20 AM EST Exam Action 03/09/19 10:20 AM EST Exam Action 03/09/19 10:21 AM EST Exam Action 03/09/19 10:21 AM EST Exam Action 03/09/19 10:21 AM EST Exam Action 03/09/19 10:21 AM EST Exam Action 03/09/19 10:21 AM EST Exam Action 03/09/19 10:21 AM EST Exam Action 03/09/19 10:21 AM EST Exam Action 03/09/19 10:21 AM EST Ausscullttatted aorrttiic arrea wiitth tthe diiaphrragm Ausscullttatted pullmoniic arrea wiitth tthe diiaphrragm Ausscullttatted Errb''ss poiintt wiitth tthe diiaphrragm Ausscullttatted ttrriicusspiid arrea wiitth tthe diiaphrragm Ausscullttatted miittrrall arrea wiitth tthe diiaphrragm Ausscullttatted rriightt upperr quadrrantt Ausscullttatted rriightt llowerr quadrrantt Ausscullttatted rriightt upperr quadrrantt Ausscullttatted llefftt upperr quadrrantt Ausscullttatted llefftt llowerr quadrrantt Ausscullttatted aorrtta iin abdomen Ausscullttatted rriightt rrenall arrtterryy Ausscullttatted llefftt rrenall arrtterryy Exam Action 03/09/19 10:21 AM EST Exam Action 03/09/19 10:21 AM EST Exam Action 03/09/19 10:21 AM EST Exam Action 03/09/19 10:22 AM EST Exam Action 03/09/19 10:22 AM EST Exam Action 03/09/19 10:22 AM EST Exam Action 03/09/19 10:22 AM EST Exam Action 03/09/19 10:22 AM EST Exam Action 03/09/19 10:22 AM EST Exam Action 03/09/19 10:22 AM EST Exam Action 03/09/19 10:22 AM EST Exam Action 03/09/19 10:23 AM EST Ausscullttatted rriightt iilliiac arrtterryy Ausscullttatted llefftt iilliiac arrtterryy Ausscullttatted rriightt ffemorrall arrtterryy Ausscullttatted llefftt ffemorrall arrtterryy Perrcussssed rriightt llowerr quadrrantt Perrcussssed rriightt upperr quadrrantt Perrcussssed llefftt upperr quadrrantt Perrcussssed llefftt llowerr quadrrantt Perrcussssed rriightt flflankk fforr CVA ttenderrnessss Perrcussssed llefftt flflankk fforr CVA ttenderrnessss Perrcussssed ssplleen Perrcussssed fforr lliivverr sspan:: 7 cm iin tthe miid--cllavviicullarr lliine Exam Action 03/09/19 10:23 AM EST Exam Action 03/09/19 10:23 AM EST Exam Action 03/09/19 10:23 AM EST Exam Action 03/09/19 10:23 AM EST Exam Action 03/09/19 10:24 AM EST Exam Action 03/09/19 10:24 AM EST Exam Action 03/09/19 10:24 AM EST Exam Action 03/09/19 10:24 AM EST Exam Action 03/09/19 10:24 AM EST Exam Action 03/09/19 10:24 AM EST Exam Action 03/09/19 10:24 AM EST Exam Action 03/09/19 10:25 AM EST Pallpatted rriightt llowerr quadrrantt wiitth lliightt prressssurre:: No ttenderrnessss rreporrtted;; no massssess,, guarrdiing,, orr diissttenssiion Pallpatted rriightt upperr quadrrantt wiitth lliightt prressssurre:: No ttenderrnessss rreporrtted;; no massssess,, guarrdiing,, orr diissttenssiion Pallpatted llefftt upperr quadrrantt wiitth lliightt prressssurre:: No ttenderrnessss rreporrtted;; no massssess,, guarrdiing,, orr diissttenssiion Pallpatted llefftt llowerr quadrrantt wiitth lliightt prressssurre:: No ttenderrnessss rreporrtted;; no massssess,, guarrdiing,, orr diissttenssiion Pallpatted rriightt llowerr quadrrantt:: wiitth deep prressssurre:: No massssess Pallpatted rriightt upperr quadrrantt wiitth deep prressssurre:: No massssess Pallpatted llefftt upperr quadrrantt wiitth deep prressssurre:: No massssess Pallpatted llefftt llowerr quadrrantt wiitth deep prressssurre:: No massssess Pallpatted lliivverr:: Pallpablle 1 cm bellow rriightt cossttall marrgiin Pallpatted fforr ssplleen:: Nott pallpablle Pallpatted fforr rriightt kkiidneyy:: Nott pallpablle Pallpatted fforr llefftt kkiidneyy:: Nott pallpablle Comments If your instructor provides individual feedback on this assignment, it will appear here. © Shadow Health® 2018 [Show More]

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