*NURSING > CASE STUDY > Focused Exam Pain Completed Shadow Health education empathy (All)
9/18/2019 Focused Exam: Pain | Completed | Shadow Health https://app.shadowhealth.com/assignment_attempts/5344627 1/6 Focused Exam: Pain Results | Completed Gerontologic Nursing - August '19, NRSE ... 4560 Return to Assignment Your Results T Turn In urn In Reopen Reopen Lab Pass Lab Pass 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 N No ot t E En nc co ou un nt te er re ed d are opportunities that were not elicited in the interview Opportunities marked as N No ot t F Fo ol ll lo ow we ed d U Up p are missed opportunities that were present in the interview, but where no statements were made Opportunities marked as F Fo ol ll lo ow we ed d U Up p were followed up by students, and include the dialogue between student and patient 1 Symptoms F Fo ol ll lo ow we ed d U Up p Description: Mr. Carter reports coming to the ER with high levels of pain, and having frequent pain. So what brings you in today? Question 02:48 PM EDT This morning I woke up with awful pain in my hips and knees . . . When I tried to get out of bed it was as if my joints just gave out and I fell right there in my bedroom. I hit my lower back on the bed frame, which I'm sure didn't help matters. To be honest, I'm worried that it's only going to get worse as I sit here getting older every minute. Oh i am so sorry to hear that it caused you to fall, i understand getting older can be difficult. Empathize 02:49 PM EDT I appreciate that. Thanks. does anything else make the pain better (Clarified to: Does anything help the pain?) Question 02:58 PM EDT Overview Transcript Subjective Data Collection Objective Data Collection Education & Empathy QSEN Competencies Documentation SBAR Reflections Education & Empathy : 6 of 7 (85.7%) https://www.coursehero.com/file/46610611/Focused-Exam-Pain-Completed-Shadow-Health-education-empathypdf/ This study resource was shared via CourseHero.com9/18/2019 Focused Exam: Pain | Completed | Shadow Health https://app.shadowhealth.com/assignment_attempts/5344627 2/6 2 Worry F Fo ol ll lo ow we ed d U Up p Sometimes rest helps. The doctor also told me to try applying a warm, damp washcloth if I have morning stiffness in my hips. They also have me do some exercises for my knees, and I've got these elastic supports on both knees to help. If none of those things help, I take Aleve, but that didn't help this morning. The pain was unbearable. (Clarified to: if anything helps the pain) Heat is a better method to relieve joint pain instead of ice Educate 02:59 PM EDT Thanks for letting me know. Model Statement: "I’m sorry to hear you're in pain. I would like to learn more about your pain and how it may have happened, and then we can talk about treating it so you feel better." Description: Mr. Carter reports feeling worried about his decreasing mobility and gait. He feels upset about his worsening osteoarthritis. So what brings you in today? Question 02:48 PM EDT This morning I woke up with awful pain in my hips and knees . . . When I tried to get out of bed it was as if my joints just gave out and I fell right there in my bedroom. I hit my lower back on the bed frame, which I'm sure didn't help matters. To be honest, I'm worried that it's only going to get worse as I sit here getting older every minute. Oh i am so sorry to hear that it caused you to fall, i understand getting older can be difficult. Empathize 02:49 PM EDT I appreciate that. Thanks. any trouble transferring Question 03:31 PM EDT I'll usually steady myself with a cane when I get up or sit down, but I don't need anyone to help me up just yet . . . I worry I will someday though. [AUDIO COMING SOON] it is important to keep path ways clear, well lit and clutter free to ensure safety Educate 03:32 PM EDT OK, I understand. Thank you. Model Statement: "I understand that you are worried about your recent fall, and concerned about maintaining your activity level. It’s normal to feel concerned." https://www.coursehero.com/file/46610611/Focused-Exam-Pain-Completed-Shadow-Health-education-empathypdf/ This study resource was shared via CourseHero.com9/18/2019 Focused Exam: Pain | Completed | Shadow Health https://app.shadowhealth.com/assignment_attempts/5344627 3/6 3 Activity Intolerance Impaired Comfort and ADLs N No ot t F Fo ol ll lo ow we ed d U Up p 4 Fall Risk F Fo ol ll lo ow we ed d U Up p 5 Nonmedication Pain Strategies F Fo ol ll lo ow we ed d U Up p Description: Mr. Carter reports decreased activity and fatigue. has your health affected social activity (Clarified to: Do your health problems affect your social life?) Question 03:36 PM EDT I wouldn't say that. Though I do need to sit through some family events. Admittedly, I've been worried that it will get even worse as I age. (Clarified to: if my health problems affect my social life) how do you view your health Question 03:36 PM EDT Model Statement: "It sounds like your arthritis symptoms are affecting your daily activities. I'm sorry to hear that." Description: Mr. Carter reports falling at home this morning because of his pain when he tried to get out of bed. So what brings you in today? Question 02:48 PM EDT This morning I woke up with awful pain in my hips and knees . . . When I tried to get out of bed it was as if my joints just gave out and I fell right there in my bedroom. I hit my lower back on the bed frame, which I'm sure didn't help matters. To be honest, I'm worried that it's only going to get worse as I sit here getting older every minute. Oh i am so sorry to hear that it caused you to fall, i understand getting older can be difficult. Empathize 02:49 PM EDT I appreciate that. Thanks. Model Statement: "I am concerned that you fell this morning. Unintentional falls are the most common cause of injuries for people older than 65 years. Let's talk about how to keep you safe while you are here, and when you go back home." Description: Mr. Carter describes his non-medication pain strategies he uses at home. does anything else make the pain better (Clarified to: Does anything help the pain?) Question 02:58 PM EDT https://www.coursehero.com/file/46610611/Focused-Exam-Pain-Completed-Shadow-Health-education-empathypdf/ This study resource was shared via CourseHero.com9/18/2019 Focused Exam: Pain | Completed | Shadow Health https://app.shadowhealth.com/assignment_attempts/5344627 4/6 6 Inappropriate Medications for Older Adults F Fo ol ll lo ow we ed d U Up p Sometimes rest helps. The doctor also told me to try applying a warm, damp washcloth if I have morning stiffness in my hips. They also have me do some exercises for my knees, and I've got these elastic supports on both knees to help. If none of those things help, I take Aleve, but that didn't help this morning. The pain was unbearable. (Clarified to: if anything helps the pain) Heat is a better method to relieve joint pain instead of ice Educate 02:59 PM EDT Thanks for letting me know. Model Statement: "Let's talk about strategies to alleviate your pain and improve your ability to handle your daily activities and make sure you are doing everything you can. To ease your symptoms, you can rest for several minutes when your pain is at its worst. Losing a few pounds will place less strain on your joints. Exercise and having strong muscles takes some of the strain off of your joints, which will reduce your pain in the long run. You may use hot or cold packs-- whichever provide you with more comfort." Description: Mr. Carter has been taking OTC naproxen for his pain. However, this medication meets Beer's criteria of potentially inappropriate medications for older adults. did you take any medication at home for the pain? (Clarified to: Have you taken medication for the pain?) Question 02:54 PM EDT Yes, I took some Aleve before I came to the ER, but that didn't do nothing for me this morning. When I got here, the nurses gave me something for this unbearable pain I was in. (Clarified to: if I took medication for the pain) that is good to hear that the pain is now relieved. Empathize 02:55 PM EDT Hey, thanks. have you tried other ways to relieve the pain besides medication Question 02:58 PM EDT Yes, I took some Aleve before I came to the ER, but that didn't do nothing for me this morning. When I got here, the nurses gave me something for this unbearable pain I was in. does anything else make the pain better (Clarified to: Does anything help the pain?) Question 02:58 PM EDT Sometimes rest helps. The doctor also told me to try applying a warm, damp washcloth if I have morning stiffness in my hips. They also have me do some exercises for my knees, and I've got these elastic supports on both knees to help. If none of those things help, I take Aleve, but that didn't help this morning. The pain was unbearable. (Clarified to: if anything helps the pain) https://www.coursehero.com/file/46610611/Focused-Exam-Pain-Completed-Shadow-Health-education-empathypdf/ This study resource was shared via CourseHero.com9/18/2019 Focused Exam: Pain | Completed | Shadow Health https://app.shadowhealth.com/assignment_attempts/5344627 5/6 7 Medication Management F Fo ol ll lo ow we ed d U Up p Heat is a better method to relieve joint pain instead of ice Educate 02:59 PM EDT Thanks for letting me know. Model Statement: "I see that you take naproxen for your knee pain. I'd like to discuss finding an alternate medication for you to treat your pain; naproxen is a type of medication called an NSAID, which carries a risk of gastrointestinal bleeding, especially in older adults." Description: Mr. Carter discusses taking several medications at different times of day. what kind of medication do you take at home? Question 03:08 PM EDT I take several. I tave two medications to treat my atrial fib, and I take another for blood pressure. Lately, I've been getting something for my osteoarthritis. What are the names of the medication you take for atrial fib (Clarified to: What atrial fibrillation medication do you take?) Question 03:08 PM EDT I take warfarin, and verapamil. (Clarified to: what medications I take for my atrial fibrillation) What is the dose of the warfarin Question 03:09 PM EDT My doctor's got me on 2.5 milligrams. how often do you take the warfarin Question 03:09 PM EDT Once a day. We should be concerned with bleeding since you are on a blood thinner Educate 03:09 PM EDT That seems sensible. did you have any other treatment done for the atrial fib Question 03:11 PM EDT Yes, I take two medications for it. https://www.coursehero.com/file/46610611/Focused-Exam-Pain-Completed-Shadow-Health-education-empathypdf/ This study resource was shared via CourseHero.com9/18/2019 Focused Exam: Pain | Completed | Shadow Health https://app.shadowhealth.com/assignment_attempts/5344627 6/6 what stage is the kidney disease Question 03:11 PM EDT It's stage 2. I'm fortunate that my kidneys still function pretty well. That is fortunate. Empathize 03:12 PM EDT Thank you. what medication do you take for hypertension Question 03:17 PM EDT It's called Hyzaar. what is the dosage of hyzaar Question 03:17 PM EDT Let's see -- the Hyzaar is a combination drug -- I know it's 100 milligram of one of the drugs in there, and ... 25 milligram of the other. I'm afraid I don't know what those two drugs ARE, though. the medication is a combination drug of losartan and hydroclorothiazide. the Losartan is an ARB while the HCTZ is a diuretic to help treat the hypertension. Educate 03:18 PM EDT I'll remember that. Thanks. Model Statement: "I notice that you take several medications at different times of day. It's important to avoid missing doses. Some strategies to help you remember to take all of your pills are to use a pillbox to organize each day, and to set up reminders to take your pills using an alarm." Comments If your instructor provides individual feedback on this assignment, it will appear here. © Shadow Health® 2012 - 2019 https://www.coursehero.com/file/46610611/Focused-Exam-Pain-Completed-Shadow-Health-education-empathypdf/ This study resource was shared via CourseHero.com Powered by TCPDF (www.tcpdf.org) [Show More]
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