shadow health tina jones[complete solution rated A]

Category Scored Items Experts selected these topics as essential components of a strong, thorough interview with this patient. Patient Data Not Scored A combination of open and closed questions will yield better p ...

Category Scored Items Experts selected these topics as essential components of a strong, thorough interview with this patient. Patient Data 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 difficulty sleeping and "feeling nervous" (Found) Pro Tip: Foundational questions to open an interview will help the patient tell you what's bothering her in her own words. Example Question: What brings you in today?  Finding: Reports seeking treatment because she has an upcoming exam and feels "too foggy to study" (Found) Pro Tip: Foundational questions will help the patient tell you what's bothering her in her own words. It is important to ask Tina why she sought treatment to get an understanding of any recent changes with her complaint that could have made it more severe or urgent, prompting her to come in. Example Question: Why did you decide to seek treatment?  Finding: Reports excessive worry and "racing thoughts" before bed (Available) Pro Tip: Foundational questions to open an interview will help the patient tell you what's bothering her in her own words. Tina says that she "feels nervous" before bed, and it is interfering with her sleep. It is important to ask a follow­up question to gain more details about what feeling nervous means to her. Example Question: How do you feel just before bed? History of Present Illness  Finding: Asked about onset and duration of symptoms  Finding: Reports difficulty sleeping began 3 1/2 weeks ago (Found) Pro Tip: Determining if the onset of a complaint was gradual or acute is important for diagnosis. In Tina's case, you will need this information to assess what could be causing her sleep disturbance. Example Question: How long have you been having trouble sleeping?  Finding: Reports sleep difficulties have been occurring regularly during past 3 1/2 weeks (Found) Pro Tip: Knowledge of the duration of a complaint will help you assess if the issue is recent or chronic. In Tina's case, you will need this information to assess if she is suffering from chronic insomnia or a more acute sleep disturbance. Example Question: How long have your sleeping difficulties lasted?  Finding: Asked about frequency of symptoms  Finding: Reports difficulty sleeping at least four or five times a week (Available) Pro Tip: A precise question the number of occurrences of the issue in an allotted span of time will give you the most accurate estimation of frequency. In Tina's case, it is important to know that she is suffering sleep disturbances for the majority of nights in a given week. Example Question: How many nights a week do you have trouble sleeping?  Finding: Asked about aggravating factors  Finding: Reports sleeping becomes more difficult when she can not redirect her thoughts from the things she is worried about (Available) Pro Tip: An open question about aggravating factors can be used to assess what could be exacerbating the patient's complaint, as well as her knowledge of those factors. For Tina, it is important to understand what she thinks makes it more difficult for her to fall asleep. Example Question: What makes it harder to sleep?  Finding: Denies naps during the day (Available) Pro Tip: A closed question about factors that are known to aggravate the complaint will help you to eliminate the most salient possibilities. Though one short nap a day is fine, frequent or extended naps could have been making it more difficult for Tina to fall asleep, and could also indicate an inability to stay awake during her activities of daily living. Example Question: Do you take naps?  Finding: Reports drinking caffeine to stay alert (Available) Pro Tip: A closed question about factors that are known to aggravate the complaint will help you to eliminate the most salient possibilities. Though caffeine helps Tina to stay alert, drinking too much caffeine could interfere with her sleep. Example Question: Do you drink caffeine?  Finding: Reports stopping caffeine use after 4 P.M. (Available) Pro Tip: This follow­up question is needed to assess how likely it is that caffeine consumption is interfering with sleep. If Tina were drinking caffeine late in the afternoon or at night, it would very likely be aggravating, or even causing, her sleep disturbance. Example Question: When do you usually have your last caffeinated drink?  Finding: Denies alcohol use before bed (Available) Pro Tip: A closed question about factors that are known to aggravate the complaint will help you to eliminate the most salient possibilities. Alcohol consumption before bed has been shown to interfere with homeostasis, which regulates sleep, and can even lead to insomnia, so it is important to know if Tina is drinking it to fall asleep. Example Question: Do you drink alcohol before bed?