Brian Foster Chest Pain Shadow Health Assessment
Brian Foster Chest Pain Shadow Health Assessment
Explain the clinical reasoning behind your decisions and tasks.2. Explain the tasks you undertook to complete this exam. 3. What data did you base your decisions on for this patient assessment?
Digital Clinical Experience
Digital Clinical Experience (DCE) is a digital standardized patient that allows students to practice and refine their assessment skills. Students will replicate patient education, empathy, and communication found in real-life patient interaction.
DCE allows students to engage in interactions with their patients that are meaningful and educational. The student will then be able to reflect on the interaction and develop clinical reasoning skills. Brian Foster Chest Pain Shadow Health Assessment
Assignment
Approximate Time
Due Dates
Respiratory (Tina Jones)
2.5 hours
2/16/15
Focused Exam: Cough (Danny Rivera)
1 hour
2/16/15
Cardiovascular (Tina Jones)
2.5 hours
2/16/15
Chest Pain-Focused Exam (Brian Foster)
1 hour
2/16/15
Abdominal (Tina Jones)
2.5 hours
2/16/15
Abdominal Pain-Focused Exam (Esther Park)
1 hour
2/16/15
Musculoskeletal (Tina Jones)
2 hours
2/16/15
Neurological (Tina Jones)
2.5 hours
2/16/15
Brian Foster Chest Pain Shadow Health Assessment Assignment
Digital Clinical Experiences strengthen your understanding of different body systems and help refine your assessment skills. The most value with this program will be achieved if the assignment is done shortly after you have had the content area.
Please keep this in mind when completing the assignments. You will receive 5pts for each assignment if completed by the due date with a 75% or greater. The final due date for this experience is at the end of the PN 127 course. Brian Foster Chest Pain Shadow Health Assessment
Requirements for Completion
You will receive 5pts for each assignment. These points are only achieved if you complete the assignment, prep sheet, and submit your lab pass on time.
All assignments are due by 8 am on the date assigned above. No exceptions will be made for points if the assignment is late.
All assignments must be completed to pass the course.
What do I need to do the complete each assignment
Complete the prep sheet (no questions left blank)
Complete the DCE Module from start to finish.
Review your exam report. You must achieve a 75% or redo it until you do achieve a 75%. –so don’t wait until the last minute to do these.
You need to review your transcript. You must have used all three communication techniques – Ask, Educate, & Empathize.
Finally, submit your prep sheet and lab pass into the assigned drop box.
Contributor Lake Area Technical Institute, Watertown, SD
Consortium for Healthcare Education Online project material by CHEO Project TAACCCT Round 2 is licensed under a Creative Commons Attribution 4.0 International License. “This product was funded by a grant awarded by the U.S. Department of Labor’s Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor.
The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership.” Brian Foster Chest Pain Shadow Health Assessment
Brian Foster Chest Pain Shadow Health Assessment
Introduction and Pre-brief
This assignment provides the opportunity to conduct a focused exam on Brian Foster, who presents with recent episodes of chest pain in a non-emergency setting. Interview Mr. Foster and thoroughly assess the cardiovascular system and related body systems to compile a list of differential diagnoses.
This case study allows you to evaluate Mr. Foster’s family history of heart disease and identify lifestyle risk factors. During the physical examination, thoroughly examine the cardiovascular system and carefully evaluate and document the patient’s heart sounds.
Tips and Tricks
The sounds in the Shadow Health Concept Labs and Physical Assessment Assignments are medically accurate.
Distinguishing normal from abnormal heart sounds requires practice and carefully listening for sometimes subtle and easily missed sounds. Before beginning this assignment, take advantage of the Cardiovascular Concept Lab to sharpen your skills. Brian Foster Chest Pain Shadow Health Assessment
Optimize your listening experience by using headphones with your computer and listening to both normal and abnormal sounds multiple times to improve your proficiency in recognizing subtle differences.
Often patients present with a specific complaint or problem. However, a new problem may be discovered during the history and physical examination that takes precedence during the visit. Be alert to such a situation with this case study assignment.
Purposes
The purposes of the Shadow Health Physical Assessment Assignments are to:
Increase knowledge and understanding of advanced practice physical assessment skills and techniques, Conduct focused and comprehensive histories and physical assessments for various patient populations, Adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient
Apply assessment skills and techniques to gather subjective and objective data
Differentiate normal from abnormal physical examination findings
Summarize, organize, and appropriately document findings using correct professional terminology
Practice developing primary and differential diagnoses
Practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning
Analyze and reflect on own performance to gain insight and foster knowledge. Brian Foster Chest Pain Shadow Health Assessment.
Subjective Data Collection: 30 of 30 (100.0%)
Hover To Reveal…
Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions.
Indicates an item that you found.
Indicates an item that is available to be found.
Category
Scored Items
Experts selected these topics as essential components of a 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 sporadic chest pain
(Found)
Pro Tip: Chest pain can be a sign of many serious and less serious health problems. It is important to follow up with the discovery of chest pain by asking about its characteristics and severity. Brian Foster Chest Pain Shadow Health Assessment.
Example Question:
Brian Foster Chest Pain Shadow Health Assessment – History of Present Illness
Finding: Asked about the onset of pain
Finding:
Reports chest pain started appearing in the past month
(Found)
Pro Tip: Establishing the onset of a patient’s pain is essential in diagnosing its severity as well as the comfort of the patient.
Example Question:
When did your chest pain start?
Finding: Asked about the location of the pain
Finding:
Reports pain is in the center of the chest
(Found)
Pro Tip: Identifying the location of a patient’s pain is essential in determining which body systems are affected, the underlying cause, and how best to treat it. Brian Foster Chest Pain Shadow Health Assessment. Brian Foster Chest Pain Shadow Health Assessment
Example Question:
Where is the pain?
Finding:
Reports pain does not radiate
(Found)
Pro Tip: Pain radiation is an important symptom that can be helpful in understanding the cause of pain and narrowing the diagnosis.
Example Question:
Does the pain radiate?
Finding:
Denies arm pain
(Found)
Pro Tip: When combined with chest pain, arm pain can be a sign that the complaint may be cardiac.
Example Question:
Finding:
Denies shoulder pain
(Found)
Pro Tip: When combined with chest pain, shoulder pain can be a sign that the complaint may be cardiac.
Example Question:
Are you experiencing shoulder pain?
Finding:
Denies back pain
(Found)
Pro Tip: When combined with chest pain, back pain can be a sign that the complaint may be cardiac. Brian Foster Chest Pain Shadow Health Assessment
Example Question:
Are you experiencing back pain?
Finding:
Denies neck pain
(Found)
Pro Tip: When combined with chest pain, neck pain can be a sign that the complaint may be cardiac.
Example Question:
Are you experiencing neck pain?
Finding: Asked about the duration of pain episodes
Finding:
Reports each episode lasted “several” minutes
(Found)
Pro Tip: Knowing the duration of a patient’s pain gives you a complete picture of its severity and potential impact on their health.
Example Question:
How long does your chest pain last?
Finding: Asked about the frequency of pain
Finding:
Reports 3 episodes in the past month
(Found)
Pro Tip: Establishing a timeline for a patient’s symptoms can help you to diagnose his condition better and most effectively treat him.
Example Question:
How many times in the last month have you had chest pain?
Finding:
Reports that episodes did not seem related
(Available)
Example Question:
Finding:
Asked about the severity of the pain
Finding:
Reports current pain is 0 out of 10
(Found)
Example Question:
Finding:
Reports pain severity at its worst is 5 out of 10
(Found)
Example Question:
Finding: Asked about the character of pain
Finding:
Describes pain as tight and uncomfortable
(Found)
Pro Tip: Asking Brian to describe his pain helps identify his discomfort’s cause and severity. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning. Brian Foster Chest Pain Shadow Health Assessment
Example Question:
Can you describe your pain?
Finding:
Denies crushing pain
(Found)
Pro Tip: Asking Brian to describe his pain helps identify his discomfort’s cause and severity. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning.
Example Question:
Is the pain crushing?
Finding:
Denies gnawing pain
(Found)
Example Question:
Is the pain gnawing?
Finding:
Denies burning pain
(Found)
Pro Tip: Asking Brian to describe his pain helps identify his discomfort’s cause and severity. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning. Brian Foster Chest Pain Shadow Health Assessment
Example Question:
Is the pain burning?
Finding:Asked about aggravating factors
Finding:
Reports pain is aggravated by activity
(Found)
Pro Tip: Aggravating factors reveal further information about the nature of the pain and the body systems affected.
Example Question:
What makes the pain worse?
Finding:
Pain occurred with yard work and taking stairs
(Found)
Pro Tip: Determining the activity that may have caused the patient’s complaint is crucial because it may reveal the root cause of the complaint.
Example Question:
What activity triggered the pain?
Finding:
Pain does not worsen with eating
(Available)
Pro Tip: It is important to ask about the patient’s diet and its impact on his complaint because cardiac complaints and gastrointestinal pain can be very similar and are frequently conflated. Ruling out one or the other can assist your diagnosis.
Example Question:
Is the pain worse when you eat?
Finding:
Pain does not worsen after spicy foods
(Available)
Pro Tip: It is important to ask about the patient’s diet and its impact on his complaint because cardiac complaints and gastrointestinal pain can be very similar and are frequently conflated. Ruling out one or the other can assist your diagnosis.
Example Question:
Is the pain worse after you eat spicy food?
Finding:
Pain does not worsen after high-fat foods
(Found)
Pro Tip: It is important to ask about the patient’s diet and its impact on his complaint because cardiac complaints and gastrointestinal pain can be very similar and are frequently conflated. Ruling out one or the other can assist your diagnosis.
Example Question:
Is the pain worse after you eat high-fat foods?
Finding: Asked about relieving factors
Finding:
Reports pain relief with a brief periods of rest
(Found)
Pro Tip: It’s important to assess the nature of pain by asking about relief. Relieving factors can help narrow the body system and assist in a more accurate diagnosis. Brian Foster Chest Pain Shadow Health Assessment.
Example Question:
What relieves your pain?
Finding:
Reports no medication to treat chest pain
(Found)
Example Question:
Brian Foster Chest Pain Shadow Health Assessment – Medical History
Finding: Confirmed use of medications
Finding:
Confirms medications
(Found)
Pro Tip: Determining what, if any, medications a patient is taking is a crucial element of a thorough health history and will help you avoid unwanted drug interactions.
Example Question:
What medications do you take?
Finding:
Reports taking hypertension 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 hypertension?
Finding:
Reports taking hyperlipidemia 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 hyperlipidemia?
Finding:
Reports occasional ibuprofen use
(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:
Do you take over the counter medications?
Finding:
Reports taking fish oil
(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 or supplements will help you to treat your patient.
Example Question:
Do you take any supplements?
Finding:
Denies aspirin regimen
(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:
Do you take aspirin?
ORDER HERE FOR CUSTOM ESSAY SOLUTIONS – Brian
Foster Chest Pain Shadow Health Assessment
Finding: Followed up on hypertension treatment
Finding:
Medication is Lopressor
(Found)
Pro Tip: Discovering which specific medications a patient takes helps you assess his health conditions, effectiveness of treatment, and guards against unwanted medication interactions.
Example Question:
What medication do you take for hypertension?
Finding:
Lopressor dose is 100mg
(Found)
Pro Tip: The current dose of any patient’s prescription medications is important to learn about because it provides useful information about the patient’s treatment plan as well as potential medication interactions.
Example Question:
What dose of medication do you take for hypertension?
Finding:
Takes Lopressor once daily
(Found)
Example Question:
How frequently do you take medication for hypertension?
Finding: Followed up on hypertension treatment
Finding:
Medication is Lopressor
(Found)
Pro Tip: Discovering which specific medications a patient takes helps you assess his health conditions, effectiveness of treatment, and guards against unwanted medication interactions.
Example Question:
What medication do you take for hypertension?
Finding: Followed up on hyperlipidemia treatment
Finding:
Medication is Lipitor
(Found)
Pro Tip:Discovering which specific medications a patient takes helps you assess his health conditions, effectiveness of treatment, and guards against unwanted medication interactions. Brian Foster Chest Pain Shadow Health Assessment
Example Question:
What medication do you take for hyperlipidemia?
Finding:
Lipitor dose is 20mg
(Found)
Pro Tip: The current dose of any patient’s prescription medications is important to learn about because it provides useful information about the patient’s treatment plan as well as potential medication interactions.
Example Question:
What dose of medication do you take for hyperlipidemia?
Finding:
Takes Lipitor once daily
(Found)
Pro Tip: The frequency with which a patient takes his medications is an essential element of the complete picture of his medication treatment plan.
Example Question:
How frequently do you take medication for hyperlipidemia?
Finding:
Takes Lipitor at bedtime
(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 information, like at what time of day Brian takes Lipitor, will help you to treat your patient. Brian Foster Chest Pain Shadow Health Assessment
Example Question:
What time of day do you take your lipitor?
Finding:
Has taken Lipitor for 1 year
Brian Foster Chest Pain Shadow Health Assessment – Objective Data Collection: 30 of 33 (90.91%)
Correct
Partially correct
Incorrect
Missed
Inspected face 1 of 1 point
No visible abnormal findings
Rash or lesion
Cyanosis
Pallor
Redness or flushing
Evidence of trauma (scar, laceration, or bruising)
Inspected for jugular venous distension 1 of 1 point
4 cm or less above the sternal angle
More than 4 cm above the sternal angle
Inspected chest 1 of 1 point
Symmetric
Asymmetric
No visible abnormal findings
Rash or lesion
AP diameter abnormal
Intercostal retraction while breathing
Excessive use of accessory muscles while breathing
Pectus excavatum
Skin growths (freckles or moles)
Evidence of skin trauma (scar, laceration, or bruising)
Inspected abdomen 0.67 of 1 point
Inspected hands and fingernails 1 of 1 point
No visible abnormal findings
Redness
Moles or skin tags
Masses (warts, cysts, or tumors)
Freckles, birthmark, or other discoloration
Excessive dry or flaking skin
Purpura
Scarring
Laceration, lesion, or wound
Bruising
Rash
No visible abnormal findings
Pallor
Cyanosis
Splinter hemorrhages
Clubbing
No visible abnormal findings
Redness
Moles or skin tags
Masses (warts, cysts, or tumors)
Freckles, birthmark, or other discoloration
Excessive dry or flaking skin
Purpura
Scarring
Laceration, lesion, or wound
Bruising
Rash
No visible abnormal findings
Pallor
Cyanosis
Splinter hemorrhages
Clubbing
Inspected lower extremities and toenails 1 of 1 point
Tested capillary refill time 1 of 1 point
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 Brian Foster Chest Pain Shadow Health Assessment
Followed Up
Followed Up
Followed Up
Followed Up
Not Encountered
Followed Up
Document: Vitals
Vitals
Blood Pressure
Left Arm BP 146/88; Right Arm BP 146/90
O2 Sat
98%
Pulse
104 BPM
Resp. Rate
19
Temperature
36.7C
T
The patient reports to the clinic because of chest pains xxxxx. He reports experiencing xxxxx. He describes the chest pain xxxxx. . He denies heartburn xxxx
Return to Canvas to complete your SOAP note for this assignment.
Objective
General Survey:
Respiratory: Breathing is xxx.
Gatrointestital: Round, xx. No xxxx. Tymphanic throughout. xxx palpable xxxx. Neuro: Alert and oriented. xxxx all extremities. Skin: Warm, pink, xxx tenting. EKG: Regular
Return to Canvas to complete your SOAP note for this assignment.
Assessment
Diagnosis; 1. Angina basal pectori xxx
Explain the clinical reasoning behind your decisions and tasks.
Student Response: xxxthe xxx
Explicitly describe the tasks you undertook to complete this exam.
Student Response: xx used xxx