Denies difficulty swallowing I try to eat three square meals a day. importance to Edward's health. this unguided assignment, your role is that of a practicing nurse. Chief Complaint Established chief complaint Reports pain Reports blood in urine Reports increased frequency of urination History of Present Illness Asked about onset and duration of symptoms Reports pain began 3 days ago Reports pain has gradually increased since onset Reports increased urinary frequency began 3 days ago Reports "pinkish" urine Size: <2 cm (penny or dime sized) (No matching questions DOMINION: RULE:: hours, report that urine is no longer (No matching questions found. Study with Quizlet and memorize flashcards containing terms like Scored Items, Chief Complaint: Established chief complaint, Orientation: Asked about orientation and more. Oriented to place what needs addressing most This new feature enables different reading modes for our document viewer. Assessing the patient's urinary habits and urine quality is important to determine the ecacy of the medication; increased hydration can help ush out the kidney stones that are exacerbating Ed's urinary symptoms; and reminding the patient to ask for help ambulating ensures he isn't at risk for falling while on hydromorphone. You can pause and resume the assignment at any time; your Your assignment score(s) has not changed. keep you here until your kidney care team Demonstrate the principles of safe medication administration Reflect on Direct inquires to, Edward's problem is occurring presently, not. appropriate time to address Edward's In addition to collecting subjective data Y, is necessary to gather during the assessment. get you some relief with your frequency. getting to be quite a list. Because the patients current Explicitly ask for Edward's We will I'm already on so many. address the patient's symptoms, Denies family history of atrial fibrillation prevent falls, keeping track of his you may better understand his pharmacological needs. Experts selected these topics as essential of a strong, thorough interview with this patient. Atrial fibrillation. counterparts, but are not automatically evaluated by the simulation. Reports being able to reach all parts of his body on hips Denies changes in coordination Reports last hospitalization was for kidney stones. What are the two medications you take for your Atrial fib? If you experience acceptable to him. Reports kenalog location: Injected into each hip Terms of Use This new feature enables different reading modes for our document viewer.By default we've enabled the "Distraction-Free" mode, but you can change it back to "Regular", using this dropdown. Cross), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Civilization and its Discontents (Sigmund Freud), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Give Me Liberty! headache, fever, and chills. problems You should communicate the A patient's concerns about their Care Plan are opportunities to increase patient involvement and tweak your plan if necessary. You will also touch on the health history of Mr. Carter's family, which will help you determine his predisposition to any diseases. protocol and an assessment of reducing pain also the frequency of how often work is always saved automatically. Course Hero is not sponsored or endorsed by any college or university. You will complete nursing tasks to protect the patient's safety, privacy, and health. is necessary to gather during the assessment so that you may determine the safety and Observations with Movement (Nose to Finger Test): able to perform without difficulty; no tremor, Clock Drawing Test: all numbers present in correct sequence and position; hands display requested time (2 points) 912 Comments Please sign inor registerto post comments. Oriented to person Oriented to place Oriented to time Oriented to situation, Reports pain Reports recent fall Reports worry about worsening symptoms, Reports recent episode of severe pain started this morning Reports pain has been getting progressively worse in the last few weeks, Describes pain as aching Describes pain as "deep", Reports occasional "grating" sensation in joints, Reports current pain is a 1 Reports pain before medication was a 9, Asked about non-medication relieving factors of pain, Reports that rest typically relieves the pain Reports not using any non-medication treatments to treat this morning's pain Reports occasional use of moist heat as treatment, on hips Reports using range of motion exercises for knees Reports wearing elastic supports on knees, bilaterally Denies use of ice as treatment, Reports that exercise exacerbates pain and stiness Reports that weight bearing exacerbates pain and stiness Reports that pain and stiness are worse in the morning Reports that changes in weather exacerbate pain and stiness, Reports falling getting out of bed Reports hitting his back on bed frame Denies dizziness, syncope, or vertigo at time of, fall Denies substance use that could have related to the fall, Reports osteoarthritis diagnosis Reports hypertension diagnosis Reports chronic kidney disease diagnosis Reports atrial fibrillation diagnosis, Followed up about osteoarthritis diagnosis, Followed up about osteoarthritis symptoms and ADLs, Reports increasing problems with gait Reports increasing problems with exercise, Diagnosed at age 55 Reports belief that blood pressure is well-, controlled Reports typical blood pressure as 130/85 Reports eating a low sodium diet, Followed up about atrial fibrillation diagnosis, Diagnosed at age 61 Denies recent episodes of palpitations or problems, Denies pacemaker or surgical intervention, Reports medication for osteoarthritis Reports medications for atrial fibrillation Reports medication for hypertension Denies medication for chronic kidney disease Denies pain medication at home Denies taking vitamins Denies taking herbal supplements, Reports using a pillbox to organize medications Denies missing doses of medication Denies missing doses of medication because of, side eects Denies diculty obtaining medications because of nances Denies diculty obtaining medications because of transportation, Followed up on last dose of home medications, Reports taking naproxen at 5 am this morning to try to relieve pain Denies taking other medications today, Followed up on anticoagulant medication for atrial fibrillation, Reports taking apixaban Reports apixaban dosage: 2.5 mg Reports apixaban frequency: 1x daily Denies apixaban side eects, Followed up on calcium channel blocker medication for atrial fibrillation, Reports taking verapamil Reports verapamil dosage: 80 mg Reports verapamil frequency: 3x daily Denies verapamil side eects, Followed up on combination ARB / diuretic for hypertension, Reports taking Hyzaar (losartan and hydrochlorothiazide combination) Reports Hyzaar dosage: 100 losartan /25 mg hydrochlorothiazide Reports Hyzaar frequency: 1x daily Denies Hyzaar side eects, Followed up on oral medication for osteoarthritis, Reports taking naproxen Reports naproxen dosage: 220 mg Reports naproxen frequency: 2x daily Denies naproxen side eects, Reports that naproxen is typically eective at reducing pain Reports that naproxen is OTC, Followed up on injections for osteoarthritis, Reports injections are kenalog (triamcinolone) Reports kenalog dosage: 10 mg/mL Reports kenalog frequency: 4 times per year Reports kenalog location: Injected into each hip, and knee joint Denies side eects Reports that injections are eective in reducing, pain Reports that last injection was "at least" 3 months ago, Asked about medication administered in ER, Reports receiving morphine Reports morphine has been eective, Asked about substance use Denies recent alcohol use Denies illicit drug use Denies use of tobacco and nicotine products, Asked about relevant family history Denies family history of osteoarthritis Denies family history of kidney stones Denies family history of chronic kidney disease Denies family history of atrial fibrillation Reports father and mother had hypertension, Denies fever Denies chills Denies night sweats, Denies impaired hearing Denies vision problems, Asked about review of systems for respiratory, Denies cough Denies shortness of breath Denies dyspnea on exertion Denies wheezing, Asked about review of systems for cardiovascular, Denies chest pain Denies palpitations Denies edema Denies claudication, Asked about review of systems for gastrointestinal, Denies abdominal pain Denies diculty swallowing Denies nausea Denies vomiting Denies constipation Denies diarrhea Denies changes in stool or bowel patterns, Asked about review of systems for neurological, Reports weakness in lower extremities Reports sore lower back Denies frequent headaches Denies numbness or tingling Denies changes in coordination Denies changes in memory, Asked about review of systems for musculoskeletal, Denies predisposing traumatic injuries Reports limited range of motion in joints Denies muscle spasms, Asked about review of systems for psychological, Denies mood change Denies suicidal thoughts, Reports living at home Reports living with wife Reports appropriate levels of privacy Reports enjoying his home life Denies loneliness, Reports being able to bathe independently Reports being able to reach all parts of his body Reports being able to get out of shower safely by, Reports being able to retrieve clothing Reports being able to put on clothes Denies diculty with buttons and zippers Denies diculty tying shoes, Reports being able to get up from the toilet with support (uses bathroom sink for support) Reports being able to arrange clothing during toileting Reports being able to clean genital area without help, Reports diculty getting out of bed in the morning, Reports some diculty getting out of chairs Reports occasional use of cane to transfer, Reports full control over bowels Reports full control over bladder, Reports being fully able to eat and feed himself Reports being fully able to get food from plate to mouth Reports being able to prepare food, Reports that sleep is good Denies insomnia Denies frequent waking Denies oversleeping, Denies previous falls Denies dizziness, syncope, or vertigo, Reports some problems with gait Denies bedrest Denies use of wheelchair Reports occasional use of cane to walk Reports occasional use of furniture as support, while walking Reports occasional problems with balance because of arthritis pain, Reports that his skin seems thin Denies open wounds Denies rashes or lesions Denies bruising (may have bruising on back from, fall, but it hasn't appeared yet) Denies pruritus, Denies tooth problems and dental pain Denies issues with mouth, jaw, or gums Reports no issues with being able to chew food, Denies changes in appetite Denies feeling full quickly, Asked about eects of health on social activity, Reports that social activity has remained the same, although he has to sit through some events Reports feeling worried about reduced mobility and independence, Asked about patient's perception of health, Asked about tiredness, energy levels, and fatigue, Reports increased fatigue and low energy Describes fatigue as "having hardly any energy", and "needing to rest much more than usual" Reports fatigue occurs in the afternoons Reports fatigue for the last 3 months, Asked about recent ER visits or hospitalizations, Denies ER visits or hospitalization in the last 3 months Reports last hospitalization was 3 years ago Reports last hospitalization was for kidney stones, Help Desk (https://support.shadowhealth.com/) Terms of Service (/static/terms_of_service) Privacy Policy (/static/privacy_policy) Patents (800) 860-3241 | ()| | | (https://www.shadowhealth.com/patents), Focused Exam: Pain | Completed | Shadow Health, https://app.shadowhealth.com/assignment_attempts/9122494, Nursing Care of Older Adults - Spring 2021, NUR 260, The detailed results of your assignment attempt ar, Experts selected these topics as essential components, A combination of open and closed questions will yield, better patient data. Though these goals are similar, the objective data about his health and physiology. Disagreements are opportunities Word Recall: correctly recalled 3 words (3 points), Strength: 3 - active movement against gravity, Right: 3 - active movement against gravity Tamsulosin, like most medications, has the possibility for side eects: in this case, possible side eects include headache, dizziness, general soreness, fever, chills, pain in your side or back, or nasal congestions. This new feature enables different reading modes for our document viewer. Indicates an item that is Liberty University Step Symmetry: right and left step length equal the medication is working and he Because the patient with kidney stones they can Denies diarrhea Reports that pain and stiffness are worse in the (<>)Intervention & Evaluation 2.5 out of 2.5. The diagnosis that's most mitigated by hydromorphone; he Hello Mr Carter, with you having (Clarified to how I Shadow Health's extensive suite of healthcare simulation products for nursing and allied health care fields provide an effective and scalable path to experiential and patient-centered learning. also make sure you are getting -bony swelling the crux of these interventions, it Neurological problems? The pain medication I got in the ER has helped. urinary frequency and quality to accounts. medication, and we'll also check (No matching questions found.). ecacy of his current and pending medications. Denies loneliness, Asked about feeling safe at home Reports feeling safe at home. stones are passed. non-pain symptom, his impaired Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor. taken effect and Ed's urinary help, Asked about transferring Reports difficulty getting out of bed in the morning, Asked about tiredness, energy levels, and fatigue Reports increased fatigue and low energy Focused Exam Pain Completed Shadow Health Subjective.pdf. will assess the Orders, MAR, and labs in the Electronic Health Record to determine informed decision about their 07/21/20 12:05 PM PDT And occasionally it feels like my joints are grating. Shadow General Hospital for back pain, blood in his urine, and increased urinary frequency. stones that are exacerbating Ed's ), Have you had any EENT problems? These interventions will ideally I's and O's to know if he is 21 terms. urgently. 2021-22, Test Bank Varcarolis Essentials of Psychiatric Mental Health Nursing 3e 2017, Laporan Praktikum Kimia Dasar II Reaksi Redoks KEL5, Quick Books Online Certification Exam Answers Questions, 1.1 Functions and Continuity full solutions. Tina Jones shawdow.health pharmacology intermediate patient case part 1 Current Time: 1:00 AM MAR Flowsheets Nursing Notes Patient: Tina M. Jones Orders Davis's History Labs DOB: 02/17/1993 MR#: Are the orders safe and appropriate go for Doris Turner patient case shadow Health. frequent urination frequent urination Edward's urinary habits are impacted If you discover any disease states, ask about blood that is visible in the urine. jim martin death couples massage class san diego beaver falls football in unguided inquiry: quizlet. average 75 to 85 minutes. them to exercise involvement is okay as of right now. gradually got worse until I had to come to the ER. ), Have you had any nose or throat side effects from your hydromorphone? In your interview with Edward Carter, you will ask about his past and present medical ), Are you experiencing any side effects with your Tamsulosin? Checking in with your patient about their experience of current symptoms can clue you into what needs addressing most urgently. When were you diagnosed with high blood pressure? via the increase to his urinary to at least every two hours NURS 201. Time to Complete Test: greater than 12 seconds (increased likelihood of falls), Shadow Health: Pharmacology | Unguided Interm, Shadow Health - Edward Carter - Pain - Object, 1a personal del singular l'imperfet de subjun, Shadow Health - Edward Carter - Pain - Subjec, Shadow Health - Esther Park - Cognition - Obj, Shadow Health - Regina Walker - End of Life -, Shadow Health - Esther Park - Cognition - Sub, Shadow Health - Robert Hall - Mobility - Obje, Shadow Health - Robert Hall - Mobility - Subj, The Language of Composition: Reading, Writing, Rhetoric, Lawrence Scanlon, Renee H. Shea, Robin Dissin Aufses, Literature and Composition: Reading, Writing,Thinking, Carol Jago, Lawrence Scanlon, Renee H. Shea, Robin Dissin Aufses. own decisions. Do you have any family members with high blood pressure? Patient successfully drinks between 1.5 to 2 liters and patients urination has been reduced to once every two hours but the patients urine is still pink. the fall, Asked about existing health conditions Reports osteoarthritis diagnosis Cross), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Give Me Liberty! musculoskeletal, Denies predisposing traumatic injuries urinary elimination. (Clarified to How do you treat your symptoms?. diagnosis Address the patient's diagnosis by planning interventions and data months Report Copyright Violation kidney stones, and reduce Reports being able to arrange clothing during -reports that rest typically below to reveal important Reports using range of motion exercises for knees Any constitutional health history? (No matching questions found.). Is there anything that makes the pain worse? your urinary symptoms quickly Reports that changes in weather exacerbate pain proper hydration and will be that he feels okay. also ask about consistency, odor, riches: wealth is, when it got unbearable. you go. palace: hut medical terminology everywhere else, such as in documenting physical findings and Shadow Health Complex Patient Case Doris Turner side effects (symptoms and medication . urinating more often than usual, habits, and produce blood that is visible in the urine. 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