Tag: Clinical-Nursing

  • tina jones HEENT shadow health assessment transcript

    Transcript

    Hello. My name is xxx. I will be interviewing you today and then conduct a physical exam.

    Greet

    05/29/20 6:31 PM EDT

    Hey.

    May i know your name please?

    Question

    05/29/20 6:31 PM EDT

    Tina Jones.

    What brings you the the Clinic today Tina?

    Question

    05/29/20 6:31 PM EDT

    My throat has been sore… and itchy. And my nose won’t stop running. These symptoms are driving me nuts.

    Am sorry to hear that

    Empathize

    05/29/20 6:32 PM EDT

    I appreciate you telling me that.

    How long have you had these symptoms?

    Question

    05/29/20 6:32 PM EDT

    My itchy eyes, runny nose, and sore throat all started a week ago. [AUDIO COMING SOON]

    Have you ever had these symptoms before?

    Question

    05/29/20 6:33 PM EDT

    No.

    How severe is your sore throat?

    Question

    05/29/20 6:36 PM EDT

    It’s not… terrible. I mean, it hurts a little. Like, mild to moderate. The main thing is that it won’t go away.

    Is the sore throat constant

    GET SHADOW HEALTH HELP HERE

    Question

    05/29/20 6:36 PM EDT

    Yeah, it’s sore pretty much all the time.

    can you describe the pain?

    Question

    05/29/20 6:38 PM EDT

    It’s really sore, and it itches a lot, like in the back.

    how would you rate te pain on a scale of 0 to 10 ?

    Question

    05/29/20 6:38 PM EDT

    It’s like a 4 out of 10, maybe.

    Does the pain radiate?

    Question

    05/29/20 6:38 PM EDT

    No, it’s just in my throat.

    What do you think is casing the sore throat?

    Question

    05/29/20 6:39 PM EDT

    At first I thought I was getting sick, or a cold or something, but now it doesn’t seem like that. My throat hasn’t gotten worse, but it’s not going away either.

    Does anything make the throat feel better?

    Question

    05/29/20 6:40 PM EDT

    All I’ve done is suck on some throat drops. And I’ve been drinking more water, which helps.

    Does anything make the pain worse?

    Question

    05/29/20 6:41 PM EDT

    It’s a little worse in the morning, but that’s really the only pattern I’ve noticed.

    Do you have any other symptoms associated with the sore throat? (No matching questions found.)

    Question

    05/29/20 6:43 PM EDT

    do you have any nasal discharge?

    Question

    05/29/20 6:43 PM EDT

    Yes, it won’t stop running!

    Do you take any over the counter medications?

    Question

    05/29/20 6:50 PM EDT

    I’ve been trying throat drops lately. In general, I take Tylenol for a headache sometimes, or Advil for cramps, but not often.

    How often do you get headaches?

    Question

    05/29/20 6:51 PM EDT

    Maybe once a week? I usually do a lot of my school work at once, so I’ll study for like, 5 or 6 hours. I usually end up with a headache by the end of the night.

    How would you rate these headaches?

    Question

    05/29/20 6:51 PM EDT

    Not too bad. . . I’d say about 3. Or a 4 if I really push it.

    What helps your headache?

    Question

    05/29/20 6:51 PM EDT

    I just take some acetaminophen. The gel kind, 500 mg. [AUDIO COMING SOON]

    Does anything make your headache worse?

    Question

    05/29/20 6:52 PM EDT

    Usually they get worse if I don’t stop
    studying
    . I try to take a break when they start most of the time, but if I have a test or something coming up, I just have to try and ignore it.

    How long have you had these headaches?

    Question

    05/29/20 6:52 PM EDT

    I’m not sure — Maybe over the last year or so.

    Do you take any herbal supplements?

    Question

    05/29/20 6:53 PM EDT

    No, I don’t take anything herbal.

    Do you take any prescription medications?

    Question

    05/29/20 6:53 PM EDT

    Do you take vitamins?

    Question

    05/29/20 7:21 PM EDT

    No, I don’t take any vitamins.

    Are your immunizations up to date?

    Question

    05/29/20 7:22 PM EDT

    I’m pretty sure I am, yeah.

    What side effects did you have with metformin?

    Question

    05/29/20 7:23 PM EDT

    I felt sick and gassy all the time. It was really uncomfortable.

    When you get side effects that you cannot tolerate, you should speak to your doctor for alternatives and also confirm if they react with other medicatiobs

    Educate

    05/29/20 7:25 PM EDT

    Alright, thanks for letting me know.

    Are you allergic to medications?

    Question

    05/29/20 7:28 PM EDT

    Yeah, I’m allergic to penicillin.

    Do you have seasonal allergies?

    Question

    05/29/20 7:28 PM EDT

    Well, no. I mean, I never had allergies to pollen or anything outdoors like that. . . But my nose is acting just like my sister’s right now, and she’s always had hay fever. I’m starting to think that this is allergies.

    Do you have food allergies? Are you allergic to latex? (Clarified to Do you have food allergies?.)

    Question

    05/29/20 7:29 PM EDT

    Nope, no food allergies that I know of. (Clarified to if I have food allergies.)

    Do you smoke cigarettes?

    Question

    05/29/20 7:32 PM EDT

    No, I’ve never smoked a cigarette in my life.

    Do you take alcohol? (No matching questions found.)

    Question

    05/29/20 7:32 PM EDT

    Do you drink alcohol?

    Question

    05/29/20 7:33 PM EDT

    I do sometimes, yeah, when I go out with my friends.

    How many drinks do you take when you go out? (Clarified to How many drinks do you have when you go out at night?.)

    Question

    05/29/20 7:33 PM EDT

    Like, two or three drinks. If I have more than two or three drinks, I feel like hell the next day, so I stop at three. (Clarified to how many alcoholic drinks I have when I go out.)

    Thats moderate drinking which is ok.

    Educate

    05/29/20 7:34 PM EDT

    Thanks for telling me.

    What type of alcohol do you take?

    Question

    05/29/20 7:34 PM EDT

    I usually get rum and diet Coke. I don’t know why that matters.

    Different drinks have different alcohol levels, thats why i asked.

    Educate

    05/29/20 7:35 PM EDT

    OK, I understand.

    How is your family medical history?

    Question

    05/29/20 7:35 PM EDT

    My mom has some issues, and I think some of my grandparents did, too.

    What health issues does your mother have?

    Question

    05/29/20 7:35 PM EDT

    Mom has high cholesterol and blood pressure, I think. She seems to be doing okay though.

    What medical issues does your father have? (Clarified to Tell me about your dad’s health?.)

    Question

    05/29/20 7:36 PM EDT

    He passed last year. (Clarified to what health issues my dad has.)

    Am sorry to hear that

    Empathize

    05/29/20 7:36 PM EDT

    Thanks for understanding.

    did your father have any medical conditions?

    Question

    05/29/20 7:37 PM EDT

    He had high blood pressure and cholesterol, and diabetes too…the same kind as me.

    What health issues does your maternal grandmother have?

    Question

    05/29/20 7:37 PM EDT

    Nana had high blood pressure and cholesterol, I think.

    What issues does you maternal grandfather have?

    Question

    05/29/20 7:38 PM EDT

    Poppa died of a heart attack when he was 80. . . he had some blood pressure and cholesterol issues when he was alive, too.

    What health issues does you paternal grand mother have?

    Question

    05/29/20 7:38 PM EDT

    Granny’s doing good. She’s still living on her own. She’s slowing down, but we help her out. She lives down the street from us, and she gets around okay. I think she takes some pills, maybe for blood pressure? She might have high cholesterol too. She seems happy.

    What health issues does your paternal grandfather have?

    Question

    05/29/20 7:39 PM EDT

    Grandpa Jones had colon cancer, and that caused all kinds of problems for him. Plus, he had high blood pressure, and…I’m pretty sure he had diabetes.

    how did you cope with your fathers death?

    Question

    05/29/20 7:39 PM EDT

    Well, right after he died, after the funeral and everything, I just tried to get through that. Mom was having such a hard time, crying a lot, everything made her sad, she was kinda depressed. So I guess at first I just focused on getting things done–groceries, laundry, insurance papers and stuff. Knowing that Mom needed me kinda helped me get through day by day. There was about a month where it was hard for us to get to church. Even getting up and ready for church was too overwhelming. But our church family helped us out, and gave us rides to church and brought meals and all that, so they really helped build us back up. Things were only hard like that for a few months.

    Seems you have a strong support system which is great.

    Empathize

    05/29/20 7:40 PM EDT

    Thanks.

    What health conditions does your sister have?

    Question

    05/29/20 7:41 PM EDT

    She’s pretty healthy. She has asthma too, but she almost never has attacks.

    what health conditions does your brother have?

    Question

    05/29/20 7:41 PM EDT

    None that I know of. He’s got some extra weight on him, I guess.

    Anyone one with an obesity problem in your family?

    Question

    05/29/20 7:45 PM EDT

    No, I don’t think so. My brother and my dad are kind of big, but I wouldn’t say they were obese or anything.

    Any one with alcoholism problem in the family?

    Question

    05/29/20 7:46 PM EDT

    One person in the family, my dad’s brother, has an alcohol problem, but we never see him.

    What work do you do?

    Question

    05/29/20 7:47 PM EDT

    I’m a supervisor at Mid-American Copy & Ship. I’ve been working there since high school, and I’ve just kept moving up.

    Am happy to hear that your job is fine and you are doing well

    Empathize

    05/29/20 7:47 PM EDT

    Thanks for understanding.

    What is your highest level of education?

    Question

    05/29/20 7:48 PM EDT

    Well, I’m finishing up my Bachelor’s degree right now.

    What is your Major?

    Question

    05/29/20 7:48 PM EDT

    I’m going to get my bachelor’s in accounting.

    I really haven’t travelled that much…I’ve always wanted to go to France but I’ve never even been out of the country. I’m always busy with work or school anyway though. We used to go on some family vacations when I was younger, but they were usually just to see some family in other states.

    Am sure when you get less busy, you will travel more

    Empathize

    05/29/20 7:52 PM EDT

    I appreciate you saying that.

    Have you been wheezing?

    Question

    05/29/20 7:52 PM EDT

    No, I haven’t been wheezing this week.

    Please let me examine you now. (No matching questions found.)

    Question

    05/29/20 7:53 PM EDT

    Please let me examine you now.

    Educate

    05/29/20 7:53 PM EDT

    Sure, I think I understand what you mean.

    Inspected general face

    Exam Action

    05/29/20 7:57 PM EDT

    Inspected forehead and scalp

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected nose and mouth

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected left side of face

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected back of head

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected right side of face

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected general face

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected right side of face

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected general face

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected nose and mouth

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected forehead and scalp

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected nose and mouth

    Exam Action

    05/29/20 7:58 PM EDT

    Inspected right orbital area and sclera

    Exam Action

    05/29/20 7:59 PM EDT

    Inspected lower conjunctiva

    Exam Action

    05/29/20 7:59 PM EDT

    Inspected upper conjunctiva

    Exam Action

    05/29/20 8:00 PM EDT

    Inspected upper conjunctiva

    Exam Action

    05/29/20 8:00 PM EDT

    Inspected left orbital area and sclera

    Exam Action

    05/29/20 8:00 PM EDT

    Performed otoscopic examination of right naris

    Exam Action

    05/29/20 8:00 PM EDT

    Performed otoscopic examination of left naris

    Exam Action

    05/29/20 8:01 PM EDT

    Performed otoscopic examination of right ear

    Exam Action

    05/29/20 8:02 PM EDT

    Performed otoscopic examination of left ear

    Exam Action

    05/29/20 8:02 PM EDT

    Inspected mouth

    Exam Action

    05/29/20 8:03 PM EDT

    Inspected mouth: pushed tongue left with tongue blade

    Exam Action

    05/29/20 8:04 PM EDT

    Inspect mouth: pushed tongue right with tongue blade

    Exam Action

    05/29/20 8:04 PM EDT

    Inspect mouth: lifted tongue with tongue blade

    Exam Action

    05/29/20 8:04 PM EDT

    Inspected mouth: depressed tongue with tongue blade

    Exam Action

    05/29/20 8:04 PM EDT

    Inspected front of neck

    Exam Action

    05/29/20 8:06 PM EDT

    Inspected left side of neck

    Exam Action

    05/29/20 8:06 PM EDT

    Inspected back of neck

    Exam Action

    05/29/20 8:06 PM EDT

    Inspected right side of neck

    Exam Action

    05/29/20 8:06 PM EDT

    Inspected back of neck

    Exam Action

    05/29/20 8:06 PM EDT

    Inspected right side of neck

    Exam Action

    05/29/20 8:07 PM EDT

    Inspected front of neck

    Exam Action

    05/29/20 8:07 PM EDT

    Inspected right side of neck

    Exam Action

    05/29/20 8:07 PM EDT

    Inspected front of neck

    Exam Action

    05/29/20 8:07 PM EDT

    Palpated scalp: No balding or thinning hair distribution, no masses, no tenderness reported

    Exam Action

    05/29/20 8:07 PM EDT

    Palpated maxillary sinuses: No tenderness reported

    Exam Action

    05/29/20 8:08 PM EDT

    Palpated frontal sinuses: No tenderness reported

    Exam Action

    05/29/20 8:08 PM EDT

    Palpated temporal arteries bilaterally: Right: no thrill, 2+ / Left: no thrill, 2+

    Exam Action

    05/29/20 8:08 PM EDT

    Palpated right carotid artery: No thrill, 2+

    Exam Action

    05/29/20 8:10 PM EDT

    Palpated left carotid artery: No thrill, 2+

    Exam Action

    05/29/20 8:10 PM EDT

    Palpated jaw: Full range of motion, no popping or clicking

    Exam Action

    05/29/20 8:11 PM EDT

    Palpated axillary lymph nodes: Not palpable

    Exam Action

    05/29/20 8:11 PM EDT

    Palpated supraclavicular lymph nodes: Not palpable

    Exam Action

    05/29/20 8:12 PM EDT

    Palpated lymph nodes of head and neck: Not palpable

    Exam Action

    05/29/20 8:12 PM EDT

    Palpated thyroid gland: No nodules, not enlarged, no irregularities, no tenderness reported

    Exam Action

    05/29/20 8:12 PM EDT

    Auscultated breath sounds in anterior right lower lobe

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in anterior right middle lobe

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in anterior right upper lobe

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in anterior left upper lobe

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in anterior left mid-chest (upper lobe)

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in anterior left lower lobe

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in posterior left upper lobe

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in posterior left mid-back (lower lobe)

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in posterior left lower lobe

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in posterior left lower lobe on side

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in posterior left lower lobe near spine

    Exam Action

    05/29/20 8:13 PM EDT

    Auscultated breath sounds in posterior right lower lobe near spine

    Exam Action

    05/29/20 8:14 PM EDT

    Auscultated breath sounds in posterior right lower lobe on side

    Exam Action

    05/29/20 8:14 PM EDT

    Auscultated breath sounds in posterior right lower lobe

    Exam Action

    05/29/20 8:14 PM EDT

    Auscultated breath sounds in posterior right mid-back (lower lobe)

    Exam Action

    05/29/20 8:14 PM EDT

    Auscultated breath sounds in posterior right upper lobe

    Exam Action

    05/29/20 8:14 PM EDT

    Auscultated right temporal pulse

    Exam Action

    05/29/20 8:14 PM EDT

    Auscultated left temporal pulse

    Exam Action

    05/29/20 8:14 PM EDT

    Auscultated right carotid pulse

    Exam Action

    05/29/20 8:15 PM EDT

    Auscultated left carotid pulse

    Exam Action

    05/29/20 8:15 PM EDT

    Tested left pupillary reaction with penlight

    Exam Action

    05/29/20 8:16 PM EDT

    Tested right pupillary reaction with penlight

    Exam Action

    05/29/20 8:16 PM EDT

    Follow my finger with just your eyes

    Question

    05/29/20 8:17 PM EDT

    Ok.

    Tested EOM to the upper right

    Exam Action

    05/29/20 8:17 PM EDT

    Tested EOM to the lower right

    Exam Action

    05/29/20 8:17 PM EDT

    Tested EOM to the lower center

    Exam Action

    05/29/20 8:17 PM EDT

    Tested convergence to the center

    Exam Action

    05/29/20 8:17 PM EDT

    Tested EOM to the upper center

    Exam Action

    05/29/20 8:17 PM EDT

    Tested EOM to the upper left

    Exam Action

    05/29/20 8:17 PM EDT

    Tested EOM to the lower left

    Exam Action

    05/29/20 8:17 PM EDT

    Tell me when you can no loner see

    Question

    05/29/20 8:18 PM EDT

    Ok, I will.

    Tested peripheral vision

    Exam Action

    05/29/20 8:18 PM EDT

    Now.

    Examined fundus of right eye with ophthalmoscope

    Exam Action

    05/29/20 8:20 PM EDT

    Examined fundus of left eye with ophthalmoscope

    Exam Action

    05/29/20 8:21 PM EDT

    F P

    Is the volume the same in both ears or louder in one ear

    Question

    05/29/20 8:24 PM EDT

    Ok.

    Same in both ears.

    Performed Weber test with tuning fork

    Exam Action

    05/29/20 8:25 PM EDT

    Tell me when you no longer hear the ringing

    Question

    05/29/20 8:25 PM EDT

    Ok, I will.

    Now.

    F.

    Question

    05/29/20 8:26 PM EDT

    F.

    Eight

    Question

    05/29/20 8:26 PM EDT

    Eight.

    W.

    Question

    05/29/20 8:26 PM EDT

    W.

    Performed whisper test in right ear

    Exam Action

    05/29/20 8:26 PM EDT

    Four

    Question

    05/29/20 8:26 PM EDT

    Four.

    R.

    Question

    05/29/20 8:26 PM EDT

    R.

    Nine.

    Question

    05/29/20 8:26 PM EDT

    Nine.

    Performed whisper test in left ear

    Exam Action

    05/29/20 8:27 PM EDT

    Tested gag reflex with tongue blade

    Exam Action

    05/29/20 8:27 PM EDT

  • NRS 493 – professional capstone and practicum

    Planning is the key to successful completion of this course and program-related objectives. The Individual Success Plan (ISP) assignment requires early collaboration with the course faculty and your course preceptor. Students must establish a plan for successful completion of

    The required 50 community direct clinical practice experience hours, 50 leadership direct clinical practice hours, and 25 indirect clinical experience hours.

    Completion of work associated with program competencies.

    Work associated with completion of the student’s capstone project change proposal.

    Students will use the “Individual Success Plan” to develop an individual plan for completing practice hours and course objectives. As a part of this process, students will identify the number of hours set aside to meet course goals.

    Student expectations and instructions for completing the ISP document are provided in the “NRS-493 Individual Success Plan” resource, located in the Study Materials and in the assignment instructions.

    Students should apply concepts from prior courses to critically examine and improve their current practice. Students are expected to integrate scholarly readings to develop case reports that demonstrate increasingly complex and proficient practice.

    After the ISP has been developed by the student and approved by the course faculty, students will initiate a preconference with the faculty and preceptor to review the ISP.

    You are not required to submit this assignment to LopesWrite.

     

    NRS-493 Individual Success Plan

    REQUIRED PRACTICE HOURS: 100 Direct Clinical Experience (50 hours community/50 hours leadership) – 25 Indirect Clinical Experience Hours.

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    Complete Contact Information

    Student Information

    GCU

    Name:

     

    E-mail:

     

     

    Phone Number:

     

     

    Course Faculty Information

    GCU

    Name:

     

    E-mail:

     

     

    Phone Number:

     

     

    Practicum Preceptor Information

    Practice Setting

    Name:

     

    E-mail:

     

     

    Phone Number:

     

     

     

     

     

    ISP Instructions

    Use this form to develop your Individual Success Plan (ISP) for NRS-493, the Professional Capstone and Practicum course. An individual success plan maps out what you, the RN-to-BSN student, needs to accomplish in order to be successful as you work through this course and complete your overall program of study. You will also share this with your preceptor at the beginning and end of this course so that he or she will know what you need to accomplish.

    In this ISP, you will identify all of the objectives and assignments relating to the 100 direct clinical practice experience hours and the 25 indirect clinical practice hours you need to complete by the end of this course. Use this template to specify the date by which you will complete each assignment. Your plan should include a self-assessment of how you met all applicable GCU RN-to-BSN Domains & Competencies (see Appendix A).

    General Requirements

    Use the following information to ensure successful completion of each assignment as it pertains to deliverables due in this course:

    Use the Individual Success Plan
    to develop a personal plan for completing your clinical practice experience hours and self-assess how you will meet the GCU RN-to-BSN University Mission Critical Competencies
    and
    the Programmatic Domains & Competencies (Appendix A) related to that course.

    Show all of the major deliverables in the course, the topic/course objectives that apply to each deliverable, and lastly, align each deliverable to the applicable University Mission Critical Competencies and the course-specific Domains and Competencies (see Appendix A).

    Completing your ISP does not earn clinical practice experience hours, nor does telephone conference time, or time spent with your preceptor.

    Within the Individual Success Plan,
    ensure you identify all graded course assignments and indirect clinical assignments listed in the table on the next page.

     

     

     

     

     

     

    Topic

    Graded Assignment

    Indirect Clinical Assignments

    Topic 1

    1.      Individual Success Plan

    2.      Reflection Journal Entry

    1.      List of potential topics for the change proposal

    Topic 2

    1.      Topic Selection Approval Paper

    2.      Reflection Journal Entry

    1.      Search the literature for supporting journal articles

    2.      Summary of topic category; community or leadership

    Topic 3

    1.      PICOT Question Paper

    2.      Reflection Journal Entry

    1.      List of objectives

    Topic 4

    1.      Literature Evaluation Table

    2.      Reflection Journal Entry

    1.      List of measurable outcomes

    Topic 5

    1.      Reflection Journal Entry

    1.      Summary of the strategic plan

    2.      Midterm Evaluation Tool

    Topic 6

    1.      Literature Review Table

    2.      Reflection Journal Entry

    1.      List of resources

    Topic 7

    1.      Reflection Journal Entry

    1.      Summary of the evaluation plan

    2.      Remediation-if required

    Topic 8

    1.      Benchmark Written Capstone Project Change Proposal

    2.      Reflection Journal Entry

     

    Topic 9

    1.      Reflection Journal Entry

    1.      Professional Presentation

    Topic 10

    1.      Finalized ISP

    2.      Scholarly Activity Summary

    3.      Benchmark-Reflection Journal Summary

    1.      Summary of presentation

    2.      Final Clinical Evaluation Tool

    3.      Practice Clinical Evaluation Tool-Agency

    4.      Practice Clinical Evaluation Tool-Preceptor

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Application-based Learning Course Assignments

    List of Current Course Objectives

    Assignment

    Date Due

    Self-Assessment:

    Programmatic Domains & Competencies

    (see Appendix A)

    Self-Assessment:

    GCU RN-to-BSN

    University Mission Critical Competencies

     (see Appendix A)

    Date

    Assignment

    Completed

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    By typing in his/her signature below, the student agrees to have read, understood, and be accountable for the instructions, assignments, and hours shown above and that all questions have been satisfactorily answered by the faculty.

    Preceptors will sign upon initial receipt and at the end of the course to confirm that assignments have been complete with your guidance.

     

    Student Signature

    Name:

     

    Date:

     

    Preceptor Signature [Upon Initiation of Course]

    Name:

     

    Date:

     

    Preceptor Signature [Upon Completion of Course]

    Name:

     

    Date:

     

     

    APPENDIX A:

    GCU RN-to-BSN Domains & Competencies

    University’s Mission Critical Competencies

    How does this Individual Success Plan support the GCU Mission?

    MC1: Effective Communication:
    Therapeutic communication is central to baccalaureate nursing practice. Students gain an understanding of their ethical responsibility and how verbal and written communication affects others intellectually and emotionally. Students begin to use nursing terminology and taxonomies within the practice of professional and therapeutic communication. Courses require students to write scholarly papers, prepare presentations, develop persuasive arguments, and engage in discussion that is clear, assertive, and respectful.

    MC2: Critical Thinking:
    Courses require students to use critical thinking skills by analyzing, synthesizing, and evaluating scientific evidence needed to improve patient outcomes and professional practice.

    MC3: Christian Worldview:
    Students will apply a Christian worldview within a global society and examine ethical issues from the framework of a clearly articulated system of professional values. Students will engage in discussion of values-based decisions made from a Christian perspective.

    MC4:

    Global Awareness, Perspectives, and Ethics:
    The concept of global citizenship is introduced to baccalaureate students in the foundational curriculum. Some courses will focus on the human experience across the world health continuum. The World Health Organization (WHO) definitions of health, health disparities, and determinants of health are foundational to nursing practice.

    MC5: Leadership:
    Students are required to develop skills and knowledge associated with their professional role. Courses require students to develop self-leadership skills such as time management, setting priorities, self-control, and evaluation of their abilities and performance.

     

    Domains and Competencies

    How does this Individual Success Plan support the Program Domains and Competencies?

    Domain 1: Professional Role

    Graduates of Grand Canyon University’s RN-BSN program will be able to incorporate professional values to advance the nursing profession through leadership skills, political involvement, and life-long learning.

    Competencies:

    1.1:
          Exemplify professionalism in diverse health care settings.

    1.2:
          Manage patient care within the changing environment of the health care system.

    1.3:
          Exercise professional nursing leadership and management roles in the promotion of patient safety and quality care.

    1.4:
          Participate in health care policy development to influence nursing practice and health care.

    1.5:
          Advocate for autonomy and social justice for individuals and diverse populations.

     

    Domain 2: Theoretical Foundations of Nursing Practice

    Graduates of Grand Canyon University’s RN-BSN program will have acquired a body of nursing knowledge built on a theoretical foundation of liberal arts, science, and nursing concepts that will guide professional practice.

    Competencies:

    2.1:
          Incorporate liberal arts and science studies into nursing knowledge.

    2.2:
          Comprehend nursing concepts and health theories.

    2.3:
          Understand and value the processes of critical thinking, ethical reasoning, and decision making.

    Domain 3: Nursing Practice

    Graduates of Grand Canyon University’s RN-BSN program will be able to utilize the nursing process to provide safe quality care based on nursing best practices.

    Competencies:

    3.1:
          Utilize the nursing process to provide safe and effective care for patients across the lifespan

    3.2:
          Implement patient care decisions based on evidence-based practice.

    3.3:
          Provide individualized education to diverse patient populations in a variety of health care settings.

    3.4:
          Demonstrate professional standards of practice.

    Domain 4: Communication/Informatics

    Graduates of Grand Canyon University’s RN-BSN program will be able to manage information and technology to provide safe quality care in a variety of settings. In addition, graduates will be able to communicate therapeutically and professionally to produce positive working relationships with patients and health care team members.

    Competencies:

    4.1:
          Utilize patient care technology and information management systems.

    4.2:
          Communicate therapeutically with patients.

    4.3:
          Promote interprofessional collaborative communication with health care teams to provide safe and effective care.

    Domain 5: Holistic Patient Care

    Graduates of Grand Canyon University’s RN-BSN program will be able to provide holistic individualized care that is sensitive to cultural and spiritual aspects of the human experience.

    Competencies:

    5.1:
          Understand the human experience across the health-illness continuum.

    5.2:
          Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups.

    5.3:
          Provide culturally sensitive care.

    5.4:
          Preserve the integrity and human dignity in the care of all patients.

     

     

     

    Practice Experience Conference Form (Pre-Conference)

     

    Pre-/mid-/ and post- conference or evaluation between students, faculty, and preceptors are
    mandatory
    for students enrolled in the RN-BSN Capstone and Practicum course. Conferences may be conducted face-to-face or via synchronous technology.

     

    Overall Course Objectives
    :

    This course provides students the opportunity to integrate what they have learned in the program in a practicum experience. Students are expected to integrate nursing knowledge, knowledge gained throughout the program, leadership, and advanced critical-thinking and problem-solving skills in the development of a comprehensive and professional capstone project change proposal.

     

    Student Specific Objectives:
    Students are responsible for completing all experiences as mandated for program.

     

    A
    pre-conference
    will occur prior to the start of the clinical practice experience. This meeting is intended for the student and preceptor to review course and student-specific learning objectives:  the roles, responsibilities, and expectations of student and preceptor during this practicum experience.  All faculty and preceptor contact information will be given to each party per the student.  Any course or program information requested by the preceptor will be provided by the student. Faculty will review submitted document.

     

    A
    mid-conference/evaluation
    will occur at the mid-point of the course. This meeting is intended for the student, faculty, and preceptor to discuss student progress toward meeting the competencies in the clinical evaluation tool (CET).  Progress toward completing the written capstone project change proposal will also be discussed with faculty recommendations for project development

     

    A
    post-conference/evaluation will
    occur at the end of the practicum experience. This is intended for the student and preceptor to review and evaluate all competencies and validate that all areas are “at meets expectations” prior to progression. Faculty will provide final review and evaluation after conferring with preceptor.

     

    Proposed Practicum Experience (Brief Description of Experience Identified by Student), Practicum goals/objectives reviewed in pre-meeting.

    Preceptor contact information (email or phone): _______________________________________

     

    Preceptor Signature
    : __________________________________                          Date: _______________

     

    Student Signature
    : ____________________________________                         Date: _______________

     

    Review progress towards meeting goals/ objectives with rationales provided to student at mid-term conference.

     

    Preceptor Signature
    : __________________________________                          Date: _______________

     

    Student Signature
    : ____________________________________                         Date: _______________

     

    Review progress towards meeting goals/ objectives with rationales provided to student at end of rotation.

     

    Preceptor Signature
    : __________________________________                          Date: _______________

     

    Student Signature
    : ____________________________________                         Date: _______________

     

     

    Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

    This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).

    In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below.  In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

    New practice approaches

    Interprofessional collaboration

    Health care delivery and clinical systems

    Ethical considerations in health care

    Practices of culturally sensitive care

    Ensuring the integrity of human dignity in the care of all patients

    Population health concerns

    The role of technology in improving health care outcomes

    Health policy

    Leadership and economic models

    Health disparities

    While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

     

    NRS-493 Professional Capstone and Practicum Reflective Journal

    No of Criteria: 
    13
     
    Achievement Levels: 
    5

    Criteria

    Achievement Levels

    Description

    Percentage

    1: Unsatisfactory

    0.00 %

    2: Less Than Satisfactory

    75.00 %

    3: Satisfactory

    79.00 %

    4: Good

    89.00 %

    5: Excellent

    100.00 %

    Group 1

    100.0

    New Practice Approaches

    8.0

    New practice approaches are not present.

    New practice approaches are present, but they are incomplete or otherwise lacking in required detail.

    New practice approaches are present. Some minor details or elements are missing, but the omissions do not impede understanding.

    New practice approaches are present and complete. The submission provides the basic information required.

    New practice approaches are present, complete, and incorporate additional relevant details and critical thinking to engage the reader.

    Interprofessional Collaboration (C4.3)

    8.0

    Interprofessional collaboration information is not present.

    Interprofessional collaboration information is present, but it is incomplete or otherwise lacking in required detail.

    Interprofessional collaboration information is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Interprofessional collaboration information is present and complete. The submission provides the basic information required.

    Interprofessional collaboration information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Health Care Delivery and Clinical Systems

    8.0

    Health care delivery and clinical systems information is not present.

    Health care delivery and clinical systems information is present, but it is incomplete or otherwise lacking in required detail.

    Health care delivery and clinical systems information is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Health care delivery and clinical systems information is present and complete. The submission provides the basic information required.

    Health care delivery and clinical systems information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Ethical Considerations In Health Care (C2.3)

    8.0

    Information regarding ethical considerations in health care is not present.

    Information regarding ethical considerations in health care is present, but it is incomplete or otherwise lacking in required detail.

    Information regarding ethical considerations in health care is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information regarding ethical considerations in health care is present and complete. The submission provides the basic information required.

    Information regarding ethical considerations in health care is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Practice of Culturally Sensitive Care (C5.3)

    8.0

    Information regarding the practice of culturally sensitive care is not present.

    Information regarding the practice of culturally sensitive care is present, but it is incomplete or otherwise lacking in required detail.

    Information regarding the practice of culturally sensitive care is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information regarding the practice of culturally sensitive care is present and complete. The submission provides the basic information required.

    Information regarding the practice of culturally sensitive care is present and complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Preservation of Integrity of Human Dignity in the Care of All Patients (C5.4)

    8.0

    Information regarding the preservation of integrity and human dignity in the care of all patients is not present.

    Information regarding the preservation of integrity and human dignity in the care of all patients is present, but it is incomplete or otherwise lacking in required detail.

    Information regarding the preservation of integrity and human dignity in the care of all patients is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information regarding the preservation of integrity and human dignity in the care of all patients is present and complete. The submission provides the basic information required.

    Information regarding the preservation of integrity and human dignity in the care of all patients is present and complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Population Health Concerns

    8.0

    Information regarding population health concerns is not present.

    Information regarding population health concerns is present, but it is incomplete or otherwise lacking in required detail.

    Information regarding population health concerns is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information regarding population health concerns is present and complete. The submission provides the basic information required.

    Information regarding population health concerns is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Role of Technology in Improving Health Care Outcomes (C4.1)

    8.0

    Information on the role of technology in improving health care outcomes is not present.

    Information on the role of technology in improving health care outcomes is present, but it is incomplete or otherwise lacking in required detail.

    Information on the role of technology in improving health care outcomes is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information on the role of technology in improving health care outcomes is present and complete. The submission provides the basic information required.

    Information on the role of technology in improving health care outcomes is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Health Policy

    8.0

    Health policy information is not present.

    Health policy information is present, but it is incomplete or otherwise lacking in required detail.

    Health policy information is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Health policy information is present and complete. The submission provides the basic information required.

    Health policy information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Leadership and Economic Models

    8.0

    Information on leadership and economic models is not present.

    Information on leadership and economic models is present, but it is incomplete or otherwise lacking in required detail.

    Information on leadership and economic models is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information on leadership and economic models is present and complete. The submission provides the basic information required.

    Information on leadership and economic models is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Health Disparities

    8.0

    Information on health disparities is not present.

    Information on health disparities is present, but it is incomplete or otherwise lacking in required detail.

    Information on health disparities is present Some minor details or elements are missing, but the omissions do not impede understanding.

    Information on health disparities is present and complete. The submission provides the basic information required.

    Information on health disparities is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Outline of Overall Personal Discovery

    8.0

    Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is not present

    Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present, but it is incomplete or otherwise lacking in required detail.

    Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present and complete. The submission provides the basic information required.

    Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present and complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    4.0

    Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

    Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

    Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

    Writer is clearly in command of standard, written, academic English.

    Total Percentage  
    100

    In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The student may also choose to work with an interprofessional collaborative team.

    Students should select a topic that aligns to their area of interest as well as the clinical practice setting in which practice hours are completed.

    Write a 500-750 word description of your proposed capstone project topic. Include the following:

    The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal.

    The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed.

    A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.

    Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.

    Significance of the topic and its implications for nursing practice.

    A proposed solution to the identified project topic with an explanation of how it will affect nursing practice.

    You are required to cite to a minimum of eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. Plan your time accordingly to complete this assignment.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    You are required to submit this assignment to LopesWrite. Refer to the 
    LopesWrite Technical Support articles
     for assistance.

    RUBRIC

    Attempt Start Date:
     
    25-May-2020 at 12:00:00 AM

    Due Date:
     
    31-May-2020 at 11:59:59 PM

    Maximum Points: 
    60.0

    Topic 2 Rubric: Capstone Project Topic Selection and Approval

    No of Criteria: 
    12
     
    Achievement Levels: 
    5

    Criteria

    Achievement Levels

    Description

    Percentage

    Unsatisfactory

    0.00 %

    Less Than Satisfactory

    75.00 %

    Satisfactory

    79.00 %

    Good

    89.00 %

    Excellent

    100.00 %

    Content

    80.0

    Project Topic for Focus of Change Proposal

    5.0

    The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal is omitted.

    The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal is presented but is largely incomplete.

    The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal is summarized. There are some omissions or inaccuracies. Some support is needed.

    The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal is presented. Minor aspects are unclear or require support.

    The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal is clearly and logically presented. Support and rationale are evident.

    Setting or Context Where Project Topic Is Observed

    10.0

    The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed is omitted.

    The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed is presented but is largely incomplete.

    The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed is summarized. There are some omissions or inaccuracies. Some support is needed.

    The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed is presented. Minor aspects are unclear or require support.

    The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed is logically presented. Support and rationale are evident.

    Detailed Description of Project Topic

    15.0

    A description of the project topic is omitted.

    A description of the project topic is presented but is largely incomplete.

    A description of the project topic is presented. There are some omissions or inaccuracies. Some support is needed.

    A description of the project topic is presented. Minor aspects are unclear or require support.

    A detailed description of the project topic is clearly and logically presented. Support and rationale are evident.

    Effect of Identified Problem or Issue

    15.0

    Effect of the identified problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project is omitted.

    Effect of the identified problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project is presented but is largely incomplete.

    Effect of the identified problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project is summarized. There are some omissions or inaccuracies. Some support is needed.

    Effect of the identified problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project is presented. Minor aspects are unclear or require support.

    Effect of the identified problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project is clearly and logically presented. Support and rationale are evident.

    Topic Significance and Implications for Nursing Practice

    15.0

    Significance of topic and its implications for nursing practice is omitted.

    Topic is presented but criteria are incomplete.

    Topic and most criteria are presented. There are some omissions or inaccuracies. Some support is needed.

    Topic and criteria are presented. Minor aspects are unclear or require support.

    Topic and criteria are clearly and logically presented. Support and rationale are evident.

    Proposed Solution for Identified Project Topic and Implications for Nursing Practice

    15.0

    A proposed solution to the identified project topic with an explanation of how it will affect nursing practice is omitted.

    Topic is presented but criteria are incomplete.

    Topic and most criteria are presented. There are some omissions or inaccuracies. Some support is needed.

    Topic and criteria are presented. Minor aspects are unclear or require support.

    Topic and criteria are clearly and logically presented. Support and rationale are evident.

    Peer-Reviewed Articles

    5.0

    Fewer than six peer-reviewed articles are presented.

    Fewer than seven peer-reviewed articles are presented. Overall, only five articles meet the assignment criteria.

    Eight peer-reviewed articles are presented. Overall, only six articles meet the assignment criteria.

    Eight peer-reviewed articles are presented. Overall, only seven articles meet the assignment criteria.

    Eight peer-reviewed articles are presented, and each article clearly meets the assignment criteria.

    Organization, Effectiveness, and Format

    20.0

    Thesis Development and Purpose

    5.0

    Paper lacks any discernible overall purpose or organizing claim.

    Thesis is insufficiently developed or vague. Purpose is not clear.

    Thesis is apparent and appropriate to purpose.

    Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

    Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

    Argument Logic and Construction

    5.0

    Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

    Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

    Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

    Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

    Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

    Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    5.0

    Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

    Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

    Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

    Writer is clearly in command of standard, written, academic English.

    Paper Format (use of appropriate style for the major and assignment)

    2.0

    Template is not used appropriately, or documentation format is rarely followed correctly.

    Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

    Template is used, and formatting is correct, although some minor errors may be present.

    Template is fully used; There are virtually no errors in formatting style.

    All format elements are correct.

    Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

    3.0

    Sources are not documented.

    Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

    Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

    Sources are documented, as appropriate to assignment and style, and format is mostly correct.

    Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

    Total Percentage  
    100

  • USW1_NURS_6050_Global Health Comparison Grid Template

    Global Health Comparison

    Grid Template

    Global Health Comparison Grid Template

     

    Use this document to complete the Module 6 Assessment
    Global Healthcare Comparison Matrix and Narrative Statement

     

     

     

    Global Healthcare Issue

     

     

    Description

     

     

     

    Country

    United States

     

     

    Describe the policy in each country related to the identified healthcare issue

     

     

     

     

     

     

     

     

     

     

    What are the strengths of this policy?

     

     

     

     

     

     

     

     

     

     

     

    What are the weaknesses of this policy?

     

     

     

     

     

     

     

     

     

     

     

     

    Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)

     

     

     

    How has each country’ government addressed cost, quality, and access to the selected global health issue?

     

     

     

     

     

     

     

     

     

     

     

     

    How has the identified health policy impacted the health of the global population? (Be specific and provide examples)

     

     

     

     

     

     

     

     

     

     

     

    Describe the potential impact of the identified health policy on the role of nurse in each country.

     

     

     

     

     

     

     

     

     

     

     

    Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)

     

     

     

     

     

     

     

     

     

     

     

     

     

    General Notes/Comments

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    USW1_NURS_6050_Global Health Comparison Grid Template

  • NRS-493 Professional Capstone and Practicum Reflective Journal

    Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

    This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).

    In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below.  In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

    New practice approaches

    Interprofessional collaboration

    Health care delivery and clinical systems

    Ethical considerations in health care

    Practices of culturally sensitive care

    Ensuring the integrity of human dignity in the care of all patients

    Population health concerns

    The role of technology in improving health care outcomes

    Health policy

    Leadership and economic models

    Health disparities

    While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

     

    NRS-493 Professional Capstone and Practicum Reflective Journal

    No of Criteria: 
    13
     
    Achievement Levels: 
    5

    Criteria

    Achievement Levels

    Description

    Percentage

    1: Unsatisfactory

    0.00 %

    2: Less Than Satisfactory

    75.00 %

    3: Satisfactory

    79.00 %

    4: Good

    89.00 %

    5: Excellent

    100.00 %

    Group 1

    100.0

    New Practice Approaches

    8.0

    New practice approaches are not present.

    New practice approaches are present, but they are incomplete or otherwise lacking in required detail.

    New practice approaches are present. Some minor details or elements are missing, but the omissions do not impede understanding.

    New practice approaches are present and complete. The submission provides the basic information required.

    New practice approaches are present, complete, and incorporate additional relevant details and critical thinking to engage the reader.

    Interprofessional Collaboration (C4.3)

    8.0

    Interprofessional collaboration information is not present.

    Interprofessional collaboration information is present, but it is incomplete or otherwise lacking in required detail.

    Interprofessional collaboration information is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Interprofessional collaboration information is present and complete. The submission provides the basic information required.

    Interprofessional collaboration information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Health Care Delivery and Clinical Systems

    8.0

    Health care delivery and clinical systems information is not present.

    Health care delivery and clinical systems information is present, but it is incomplete or otherwise lacking in required detail.

    Health care delivery and clinical systems information is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Health care delivery and clinical systems information is present and complete. The submission provides the basic information required.

    Health care delivery and clinical systems information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Ethical Considerations In Health Care (C2.3)

    8.0

    Information regarding ethical considerations in health care is not present.

    Information regarding ethical considerations in health care is present, but it is incomplete or otherwise lacking in required detail.

    Information regarding ethical considerations in health care is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information regarding ethical considerations in health care is present and complete. The submission provides the basic information required.

    Information regarding ethical considerations in health care is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Practice of Culturally Sensitive Care (C5.3)

    8.0

    Information regarding the practice of culturally sensitive care is not present.

    Information regarding the practice of culturally sensitive care is present, but it is incomplete or otherwise lacking in required detail.

    Information regarding the practice of culturally sensitive care is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information regarding the practice of culturally sensitive care is present and complete. The submission provides the basic information required.

    Information regarding the practice of culturally sensitive care is present and complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Preservation of Integrity of Human Dignity in the Care of All Patients (C5.4)

    8.0

    Information regarding the preservation of integrity and human dignity in the care of all patients is not present.

    Information regarding the preservation of integrity and human dignity in the care of all patients is present, but it is incomplete or otherwise lacking in required detail.

    Information regarding the preservation of integrity and human dignity in the care of all patients is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information regarding the preservation of integrity and human dignity in the care of all patients is present and complete. The submission provides the basic information required.

    Information regarding the preservation of integrity and human dignity in the care of all patients is present and complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Population Health Concerns

    8.0

    Information regarding population health concerns is not present.

    Information regarding population health concerns is present, but it is incomplete or otherwise lacking in required detail.

    Information regarding population health concerns is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information regarding population health concerns is present and complete. The submission provides the basic information required.

    Information regarding population health concerns is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Role of Technology in Improving Health Care Outcomes (C4.1)

    8.0

    Information on the role of technology in improving health care outcomes is not present.

    Information on the role of technology in improving health care outcomes is present, but it is incomplete or otherwise lacking in required detail.

    Information on the role of technology in improving health care outcomes is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information on the role of technology in improving health care outcomes is present and complete. The submission provides the basic information required.

    Information on the role of technology in improving health care outcomes is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Health Policy

    8.0

    Health policy information is not present.

    Health policy information is present, but it is incomplete or otherwise lacking in required detail.

    Health policy information is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Health policy information is present and complete. The submission provides the basic information required.

    Health policy information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Leadership and Economic Models

    8.0

    Information on leadership and economic models is not present.

    Information on leadership and economic models is present, but it is incomplete or otherwise lacking in required detail.

    Information on leadership and economic models is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Information on leadership and economic models is present and complete. The submission provides the basic information required.

    Information on leadership and economic models is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Health Disparities

    8.0

    Information on health disparities is not present.

    Information on health disparities is present, but it is incomplete or otherwise lacking in required detail.

    Information on health disparities is present Some minor details or elements are missing, but the omissions do not impede understanding.

    Information on health disparities is present and complete. The submission provides the basic information required.

    Information on health disparities is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Outline of Overall Personal Discovery

    8.0

    Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is not present

    Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present, but it is incomplete or otherwise lacking in required detail.

    Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present. Some minor details or elements are missing, but the omissions do not impede understanding.

    Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present and complete. The submission provides the basic information required.

    Outline of what student discovered about professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and how the student met the competencies aligned to this course is present and complete, and incorporates additional relevant details and critical thinking to engage the reader.

    Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    4.0

    Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

    Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

    Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

    Writer is clearly in command of standard, written, academic English.

    Total Percentage  
    100

  • NURS_6050 Healthcare Program/Policy Evaluation Analysis Template

    Healthcare Program/Policy Evaluation Analysis  

    Template

    Healthcare Program/Policy Evaluation Analysis Template

     

    Use this document to complete the Module 5 Assessment
    Assessing a Healthcare Program/Policy Evaluation

     

     

     

    Healthcare Program/Policy Evaluation

     

     

    Description

     

     

     

    How was the success of the program or policy measured?

     

     

     

     

     

     

     

     

     

     

    How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?

     

     

     

     

     

     

     

     

     

     

     

    What data was used to conduct the program or policy evaluation?

     

     

     

     

     

     

     

     

     

     

     

     

    What specific information on unintended consequences were identified?

     

     

    What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.

     

     

     

     

     

     

     

     

     

     

     

     

    Did the program or policy meet the original intent and objectives? Why or why not?

     

     

     

     

     

     

     

     

     

     

     

    Would you recommend implementing this program or policy in your place of work? Why or why not?

     

     

     

     

     

     

     

     

     

     

     

    Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation.

     

     

     

     

     

     

     

     

     

     

     

     

     

    General Notes/Comments

     

     

     

     

     

     

     

     

     

     

     

     

     

    USW1_NURS_6050_Healthcare Program-Policy Evaluation Analysis Template

  • Sophia Haddad Pediatric GAS Pharyngitis shadow health transcript

    Transcript

    Started:
    Mar 10, 2020 |
    Total Time:
    60 min

    Hi, Sophia. My name is Danielle and I will be your provider today.

    Greet

    03/10/20 1:45 AM CDT

    Hi there.

    Hi Omar, My name is Danielle, and I will be your provider today

    Question

    03/10/20 1:46 AM CDT

    Hello.

    What brings you and Sophia in today? (Clarified to What brings you to the office today?.)

    Question

    03/10/20 1:46 AM CDT

    My daughter’s sick. A high fever and a sore throat. (Clarified to what brings me to the office.)

    What brings you in to the office

    Question

    03/10/20 1:48 AM CDT

    I’m here because they sent me home at school because I was cold and tired and the teacher sent me to the nurse, and when I told her my throat had been hurting all morning she called my Baba. He’s the guy over there.

    I am sorry you are not feeling well, i hope i can help

    Empathize

    03/10/20 1:49 AM CDT

    Thank you.

    Where is the pain?

    Question

    03/10/20 1:50 AM CDT

    It hurts in the back of my throat. AND my head hurts.

    Why are you sick?

    Question

    03/10/20 1:51 AM CDT

    My throat hurts, and I’m all cold and tired.

    When did you notice the pain?

    Question

    03/10/20 1:51 AM CDT

    I was eating breakfast this morning and it hurt to swallow and I realized my throat hurt all the time.

    When did your fever start?

    Question

    03/10/20 1:52 AM CDT

    I started feeling all chilly and achy at school, during science class.

    How bad does your throat hurt?

    Question

    03/10/20 1:52 AM CDT

    Uh. Bad. It hurts kinda bad.

    Do you have problems talking?

    Question

    03/10/20 1:53 AM CDT

    My throat hurts worse when I talk.

    Are you able to swallow?

    Question

    03/10/20 1:53 AM CDT

    I can swallow, but it hurts my throat really bad.

    Do you drink water?

    Question

    03/10/20 1:53 AM CDT

    I like drinking water. I had some already today.

    Do you take any medications?

    Question

    03/10/20 1:54 AM CDT

    Only when Baba makes me. Medicine tastes so bad.

    Im sorry you feel that way

    Empathize

    03/10/20 1:55 AM CDT

    OK. Thanks.

    Medicines can help us feel better

    Educate

    03/10/20 1:55 AM CDT

    Hmm . . . OK.

    How long has sophia been sick?

    Question

    03/10/20 1:56 AM CDT

    The school called me about 2 hours ago saying Sophia had a fever of 102 and a sore throat.

    What was your daughters fever at school?

    Question

    03/10/20 1:57 AM CDT

    The school said her fever was 102. I feel so bad she has that on top of a sore throat.

    Did she have a fever at home? (Clarified to When did your daughter’s fever start?.)

    Question

    03/10/20 1:57 AM CDT

    I’m not sure, to be honest. I didn’t realize she had a fever this morning, but I do know her temperature was 102 this morning at the school clinic. (Clarified to when my daughter’s fever started.)

    When did the pain start?

    Question

    03/10/20 1:58 AM CDT

    I didn’t notice the sore throat or the fever this morning. I feel pretty bad for missing it.

    Its okay

    Empathize

    03/10/20 1:58 AM CDT

    OK, thanks.

    Are you daughters classmates sick? (No matching questions found.)

    Question

    03/10/20 1:59 AM CDT

    Are your daughters classmates sick?

    Question

    03/10/20 1:59 AM CDT

    The school nurse said that strep throat is going around at her school. I think a few of her classmates are out sick right now.

    Is anyone sick in your family?

    Question

    03/10/20 1:59 AM CDT

    No one at home has had strep. My wife and I are both healthy.

    What have you done for your daughter’s throat/

    Question

    03/10/20 2:00 AM CDT

    I gave Sophia some ibuprofen for her fever. She also drank a little bit of cold water, which I think helped her throat.

    Did you give your daughter medication recently?

    Question

    03/10/20 2:01 AM CDT

    I gave her the ibuprofen on our way here, as we were leaving school.

    Does sophia take any home medications

    Question

    03/10/20 2:01 AM CDT

    Sophia doesn’t take any regular medications, thankfully. She really doesn’t handle it well.

    How much ibuprofen did sophia receive?

    Question

    03/10/20 2:02 AM CDT

    I gave her children’s ibuprofen, the liquid kind. The strength was . . . 100 mg per 5 mL.

    how does your daughter handle taking medications?

    Question

    03/10/20 2:03 AM CDT

    Sophia doesn’t handle taking medicine well. She’s been pretty stubborn about it for a long time.

    How does you daughter handle swallowing pills? (No matching questions found.)

    Question

    03/10/20 2:04 AM CDT

    How does you daughter swallow pills? (No matching questions found.)

    Question

    03/10/20 2:04 AM CDT

    What happened when you tried to give sophia the medication?

    Question

    03/10/20 2:05 AM CDT

    When I try to give Sophia medication . . . well, life isn’t great. It’s hard to convince her to do it, and when Sophia doesn’t want to do something, she’s really headstrong about it. For example, before we got here, I gave Sophia some ibuprofen. Sophia took the medicine eventually, but she started crying when I told her that she needed to take it. She used to spit medication out, but she doesn’t do that much anymore.

    Is your daughter up to date on vaccines?

    Question

    03/10/20 2:06 AM CDT

    Yes, Sophia’s up to date on her vaccinations.

    Has sophia had any surgeries in the past

    Question

    03/10/20 2:07 AM CDT

    Sophia had ear tubes put in when she was two, but no surgeries other than that.

    did you daughter have a tonsillectomy? (No matching questions found.)

    Question

    03/10/20 2:07 AM CDT

    did your daughter have a tonsillectomy?

    Question

    03/10/20 2:07 AM CDT

    No, Sophia’s never had her tonsils removed.

    When is the last time your daughter had a sore throat?

    Question

    03/10/20 2:08 AM CDT

    I don’t know the last time Sophia had a sore throat . . . she’s never had strep before.

    When was your daughters last ear infection?

    Question

    03/10/20 2:08 AM CDT

    It’s been a long time. A few years. They stopped shortly after she got her ear tubes put in, when she was two.

    What medications is your daughters allergic to

    Question

    03/10/20 2:09 AM CDT

    Sophia isn’t allergic to any medications.

    Does your head hurt/

    Question

    03/10/20 2:10 AM CDT

    Yes. I have a headache right now. It feels kind of achy and heavy.

    Does your chest feel tight?

    Question

    03/10/20 2:10 AM CDT

    No, my chest doesn’t feel tight.

    Have you been coughing a lot?

    Question

    03/10/20 2:10 AM CDT

    No, I haven’t been coughing at all.

    Are you vomiting?

    Question

    03/10/20 2:11 AM CDT

    I haven’t thrown up.

    Do you have any lumps or bumps on your skin?

    Question

    03/10/20 2:11 AM CDT

    Yes, I have these red bumps on my chest.

    Does you daughter have a runny nose? (No matching questions found.)

    Question

    03/10/20 2:12 AM CDT

    Does your daughter have a runny nose?

    Question

    03/10/20 2:12 AM CDT

    Sophia’s nose hasn’t been runny.

    Does your daughter have a cough?

    Question

    03/10/20 2:12 AM CDT

    Sophia doesn’t have a cough.

    When did you notice your daughter’s rash/

    Question

    03/10/20 2:13 AM CDT

    The school nurse told me about the rash when I picked Sophia up from school a few hours ago. I didn’t notice it before that.

    Can i take a look at sophias throat and rash/

    Question

    03/10/20 2:14 AM CDT

    Yes, I suppose. Go ahead.

    can I look at the rash?

    Question

    03/10/20 2:14 AM CDT

    OK, you can look at my rash . . . but I’m warning you, it’s NOT pretty.

    Can I please look at your throat? (Clarified to Can I look at your throat?.)

    Question

    03/10/20 2:14 AM CDT

    Yeah, you can look at my throat. (Clarified to if I can look at your throat.)

    Sophia’s test came back positive.

    Question

    03/10/20 2:17 AM CDT

    Alright. Thank you.

    Follow the instructions on the medication

    Question

    03/10/20 2:17 AM CDT

    I’ll be sure to do that.

    Keep medication in safe place, out of children reach

    Question

    03/10/20 2:18 AM CDT

    Good call. I don’t think she’d pour it out or something, butoh, you mean she might drink it. Right, that too.

    Check to be sure the dose is correct

    Question

    03/10/20 2:18 AM CDT

    I bet it’s really dangerous to give a kid too much medicine. Better be careful.

    Symptoms should improve in a couple of days

    Question

    03/10/20 2:19 AM CDT

    That’s really good to hear. I hate to see her like this.

    Sophia will be able to return to school in 3 days

    Question

    03/10/20 2:19 AM CDT

    Yeah, I can do that. Make sure Sophia takes all of her medicine. No matter how much she doesn’t want to. Make her do the thing she doesn’t want to do. I got it.

    Looks for a rash in here mouth

    Question

    03/10/20 2:19 AM CDT

    Oh, thrush is terrible. I’ll let you know right away if I see any signs of it.

    Stop the medication of you see any signs of an allergic reaction, like difficulty breathing

    Question

    03/10/20 2:20 AM CDT

    Sophia already has some of those things because of the strep. How do I know if she’s also having a reaction to the amoxicillin?

    Hives and if your daughter cant breathe

    Question

    03/10/20 2:21 AM CDT

    Understood.

    change the toothbrush

    Question

    03/10/20 2:21 AM CDT

    She’s pretty attached to her butterfly toothbrush, but I’m sure we can find another one . . . probably . . .

    she can return to school in 3 days

    Question

    03/10/20 2:21 AM CDT

    That’s good to know. Thanks.

    She can drink plenty of water

    Question

    03/10/20 2:22 AM CDT

    Sophia’s pretty good about drinking water. Normally I’d go for tea, but I don’t think I need a caffeinated Sophia stuck at home from school. Bad times for everybody.

    Have a good day

    Question

    03/10/20 2:22 AM CDT

    Ok. See you later.

  • tina jones Cardiovascular shadowhealth Objective Data

    Objective Data Collection: 23 of 23 (100%)

    Correct

    Partially correct

    Incorrect

    Missed

    Inspected chest

    1 of 1 point

    Symmetry
    (1/2 point)

    Symmetric

    Asymmetric

    Appearance
    (1/2 point)

    No visible abnormal findings

    Prominent pulsation

    Abnormal apical impulse

    Heaves or lifts

    Inspected for jugular venous distention

    1 of 1 point

    Height Of Venous Pressure
    (1/1 point)

    4 cm or less above the sternal angle

    More than 4 cm above the sternal angle

    Inspected hands and fingernails

    1 of 1 point

    Right: Nail Changes
    (1/3 point)

    No visible abnormal findings

    Pallor

    Cyanosis

    Splinter hemorrhages

    Clubbing

    Left: Nail Changes
    (1/3 point)

    No visible abnormal findings

    Pallor

    Cyanosis

    Splinter hemorrhages

    Clubbing

    Capillary Refill Time
    (1/3 point)

    3 seconds or less

    Greater than 3 seconds

    Inspected lower extremities and toenails

    1 of 1 point

    Right: Edema
    (1/9 point)

    No edema

    Pitting

    Non-pitting

    Right: Severity Of Edema
    (1/9 point)

    No edema

    1+ Slight pitting

    2+ Deeper pit, disappears in 10 to 15 seconds

    3+ Noticeably deep pit that lasts more than a minute

    4+ Very deep pit that lasts 2 to 5 minutes

    Right: Appearance
    (1/9 point)

    No visible abnormal findings

    Visible distortion or swelling

    Discoloration

    Skin thickening

    Ulceration

    Varicose veins

    Right: Nail Changes
    (1/9 point)

    No visible abnormal findings

    Pallor

    Cyanosis

    Splinter hemorrhages

    Clubbing

    Left: Edema
    (1/9 point)

    No edema

    Pitting

    Non-pitting

    Left: Severity Of Edema
    (1/9 point)

    No edema

    1+ Slight pitting

    2+ Deeper pit, disappears in 10 to 15 seconds

    3+ Noticeably deep pit that lasts more than a minute

    4+ Very deep pit that lasts 2 to 5 minutes

    Left: Appearance
    (1/9 point)

    No visible abnormal findings

    Visible distortion or swelling

    Discoloration

    Skin thickening

    Ulceration

    Varicose veins

    Left: Nail Changes
    (1/9 point)

    No visible abnormal findings

    Pallor

    Cyanosis

    Splinter hemorrhages

    Clubbing

    Capillary Refill Time
    (1/9 point)

    3 seconds or less

    Greater than 3 seconds

    Palpated temporal arteries

    1 of 1 point

    Right: Vibration
    (1/4 point)

    No thrill

    Thrill

    Right: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Left: Vibration
    (1/4 point)

    No thrill

    Thrill

    Left: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Palpated carotid arteries

    1 of 1 point

    Right: Vibration
    (1/4 point)

    No thrill

    Thrill

    Right: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Left: Vibration
    (1/4 point)

    No thrill

    Thrill

    Left: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Palpated PMI

    1 of 1 point

    Location
    (1/3 point)

    Present at midclavicular line and 5th intercostal space

    Displaced laterally

    Amplitude
    (1/3 point)

    Brisk and tapping

    Increased amplitude (hyperkinetic)

    Diameter
    (1/3 point)

    Less than 3 cm

    Greater than 3 cm

    Palpated radial arteries

    1 of 1 point

    Right: Vibration
    (1/4 point)

    No thrill

    Thrill

    Right: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Left: Vibration
    (1/4 point)

    No thrill

    Thrill

    Left: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Palpated brachial arteries

    1 of 1 point

    Right: Vibration
    (1/4 point)

    No thrill

    Thrill

    Right: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Left: Vibration
    (1/4 point)

    No thrill

    Thrill

    Left: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Palpated femoral arteries

    1 of 1 point

    Right: Vibration
    (1/4 point)

    No thrill

    Thrill

    Right: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Left: Vibration
    (1/4 point)

    No thrill

    Thrill

    Left: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Palpated popliteal arteries

    1 of 1 point

    Right: Vibration
    (1/4 point)

    No thrill

    Thrill

    Right: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Left: Vibration
    (1/4 point)

    No thrill

    Thrill

    Left: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Palpated tibial arteries

    1 of 1 point

    Right: Vibration
    (1/4 point)

    No thrill

    Thrill

    Right: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Left: Vibration
    (1/4 point)

    No thrill

    Thrill

    Left: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Palpated dorsalis pedis arteries

    1 of 1 point

    Right: Vibration
    (1/4 point)

    No thrill

    Thrill

    Right: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Left: Vibration
    (1/4 point)

    No thrill

    Thrill

    Left: Amplitude
    (1/4 point)

    0 Absent

    1+ Diminished or barely palpable

    2+ Expected

    3+ Increased

    4+ Bounding pulse

    Auscultated temporal arteries

    1 of 1 point

    Right
    (1/2 point)

    No bruit

    Bruit

    Left
    (1/2 point)

    No bruit

    Bruit

    Auscultated carotid arteries

    1 of 1 point

    Right
    (1/2 point)

    No bruit

    Bruit

    Left
    (1/2 point)

    No bruit

    Bruit

    Auscultated breath sounds

    1 of 1 point

    Breath Sounds
    (1/3 point)

    Present in all areas

    Diminished in some areas

    Absent in some areas

    Adventitious Sounds
    (1/3 point)

    No adventitious sounds

    Wheezing

    Fine crackles

    Stridor

    Rhonchi

    Rales

    Location
    (1/3 point)

    All areas clear

    Adventitious sounds in anterior right upper lobe

    Adventitious sounds in anterior right middle lobe

    Adventitious sounds in anterior right lower lobe

    Adventitious sounds in anterior left upper lobe

    Adventitious sounds in anterior left lower lobe

    Adventitious sounds in posterior right upper lobe

    Adventitious sounds in posterior right lower lobe

    Adventitious sounds in posterior left upper lobe

    Adventitious sounds in posterior left lower lobe

    Auscultated heart sounds

    1 of 1 point

    Heart Sounds
    (1/2 point)

    S1 and S2 audible

    S1, S2, and S3 audible

    S1, S2, and S4 audible

    S1, S2, S3, and S4 audible

    Extra Heart Sounds
    (1/2 point)

    No extra sounds

    Gallops

    Murmur

    Friction rub

    Valve clicks

    Auscultated abdominal aorta

    1 of 1 point

    Sounds
    (1/1 point)

    No bruit

    Bruit

    Auscultated renal arteries

    1 of 1 point

    Right
    (1/2 point)

    No bruit

    Bruit

    Left
    (1/2 point)

    No bruit

    Bruit

    Auscultated iliac arteries

    1 of 1 point

    Right
    (1/2 point)

    No bruit

    Bruit

    Left
    (1/2 point)

    No bruit

    Bruit

    Auscultated femoral arteries

    1 of 1 point

    Right
    (1/2 point)

    No bruit

    Bruit

    Left
    (1/2 point)

    No bruit

    Bruit

    Performed ankle-brachial index test

    1 of 1 point

    Abi
    (1/1 point)

    > 1.40 (noncompressable)

    1.00 – 1.40 (normal)

    0.90 – 0.99 (borderline ischemia)

    < 0.90 (abnormal) Performed EKG 1 of 1 point Sinus Rhythm (1/2 point) Regular Irregular St Changes (1/2 point) No ST changes ST changes present

  • Cardiovascular tina jones shadow health Transcript

    Transcript

    Started:
    Jun 27, 2020 |
    Total Time:
    109 min

    Hello my name is Danielle I will be your provider today

    Greet

    06/27/20 3:27 PM CDT

    Hey.

    Can you verify your name

    Question

    06/27/20 3:27 PM CDT

    Tina Jones.

    Your date of birth

    Question

    06/27/20 3:27 PM CDT

    February 17th.

    Thank you

    Question

    06/27/20 3:27 PM CDT

    You’re welcome.

    What brings you in today

    Question

    06/27/20 3:27 PM CDT

    I’ve been noticing my heart seems to be beating too fast every once in a while lately, and it started to worry me. My mom said I should make an appointment. You don’t want to ignore heart stuff, I guess.

    I’m sorry to hear you’re experiencing those symptoms, they can be very uncomfortable. I’ll ask you some questions to learn more about your symptoms, and we will try to determine what’s causing you to feel this way

    Empathize

    06/27/20 3:29 PM CDT

    Thanks for saying that.

    When did you first notice these symptoms

    Question

    06/27/20 3:30 PM CDT

    I think the first time was about a month ago.

    What were you doing when you noticed these symptoms (Clarified to What were you doing when you got the palpitations?.)

    Question

    06/27/20 3:30 PM CDT

    I usually notice them on my way to class in the mornings. My schoolwork has really been picking up and I’ve been drinking energy drinks to help keep me focused during the day, so maybe the caffeine or whatever else is in those things has something to do with it. (Clarified to what I was doing when the palpitations occured.)

    How many energy drinks do you drink per day

    Question

    06/27/20 3:31 PM CDT

    Usually just one in the morning, kind of like some people have a cup of coffee. Some mornings lately I’ve had two, though.

    Drinking high levels of caffeine can make you feel stressed or anxious, and can dehydrate you. over time, lots of caffeine can make you experience “crashes” during the day, too. let’s talk about healthy alternatives

    Educate

    06/27/20 3:33 PM CDT

    Sure, I think I understand what you mean.

    How often were you experiencing these symptoms

    Question

    06/27/20 3:33 PM CDT

    No.

    How often do you notice your heart racing fast (Clarified to How often does your heart beat fast?.)

    Question

    06/27/20 3:33 PM CDT

    It’s been about once a week for the past month. (Clarified to how often my heart beats fast.)

    Can you describe it for me (Clarified to What is your heartbeat like?.)

    Question

    06/27/20 3:34 PM CDT

    It’s usually normal, but it’s way faster during these episodes I’ve been having. (Clarified to what my heartbeat is like.)

    How do you feel when your heart is racing fast

    Question

    06/27/20 3:34 PM CDT

    Well, when my heart starts beating really fast, it just feels like a thumping in my chest. It makes me anxious and uncomfortable.

    Is there anything that relieves the fast heartbeat (Clarified to Does anything relieve your symptoms?.)

    Question

    06/27/20 3:35 PM CDT

    I haven’t tried anything specific, other than just trying to relax and breathe deep. (Clarified to if anything relieves my symptoms.)

    Do you take any medications to help you with your symptoms

    Question

    06/27/20 3:35 PM CDT

    Nope.

    What medications are you taking

    Question

    06/27/20 3:35 PM CDT

    I have a daily inhaler and a rescue inhaler for my asthma.

    Are you taking any new medications

    Question

    06/27/20 3:36 PM CDT

    Yeah, I have a daily inhaler now that I’ve been using.

    What’s the name of the medication

    Question

    06/27/20 3:36 PM CDT

    The daily inhaler is Flovent, and the rescue inhaler is Proventil.

    Do you have any new allergies

    Question

    06/27/20 3:36 PM CDT

    No, not that I know of.

    Do you have a history of hypertension

    Question

    06/27/20 3:37 PM CDT

    …I’ve never been diagnosed with blood pressure problems. But I think it can be on the high side sometimes.

    Do you check your blood pressure

    Question

    06/27/20 3:37 PM CDT

    Only when I’m here at the clinic.

    Do you have any health history that would contribute to hypertension (No matching questions found.)

    Question

    06/27/20 3:38 PM CDT

    Do you have diabetes

    Question

    06/27/20 3:38 PM CDT

    Yeah, I was diagnosed a few years ago.

    Do you have high cholesterol

    Question

    06/27/20 3:38 PM CDT

    I’ve never had it tested. My family has problems with high cholesterol, but I don’t think I do.

    Any history of a heart murmur

    Question

    06/27/20 3:38 PM CDT

    No.

    Do you have health insurance

    Question

    06/27/20 3:39 PM CDT

    I have health insurance through work. To be honest, though, I’m not exactly sure what it covers.

    Are you able to afford your Medications

    Question

    06/27/20 3:41 PM CDT

    It wasn’t the cost that was a problem. I just didn’t like taking it.

    What is your access to healthcare

    Question

    06/27/20 3:42 PM CDT

    I have health insurance through my job, so I can go to the doctor if I need to. It’s always a hassle though, so I try to avoid it unless I really have to like right now.

    Do you have anything that stresses you out (Clarified to Are you stressed out?.)

    Question

    06/27/20 3:44 PM CDT

    Yeah, I’ve been pretty stressed lately. (Clarified to if I am stressed out.)

    What are you stressed about

    Question

    06/27/20 3:44 PM CDT

    School is really busy right now, like I have a lot of projects due all around the same time. And on top of that, I’ve had to cover more at work lately, and I’m in charge of a big project at work, too.

    Sounds like you’re working really hard. I’m sorry you’re dealing with so much stress.

    Empathize

    06/27/20 3:45 PM CDT

    Thanks for understanding.

    Tell me about your diet (Clarified to What is your diet like?.)

    Question

    06/27/20 3:46 PM CDT

    It’s pretty good, I think. I’m not a huge health nut or anything. (Clarified to what my diet is like.)

    What are usually eat in a typical day

    Question

    06/27/20 3:46 PM CDT

    Let’s see . . . a muffin or pumpkin bread for breakfast, a sandwich for lunch, and some kind of meat with a veggie for dinner.

    Do you have snacks

    Question

    06/27/20 3:46 PM CDT

    Yeah, I usually have some snacks during the day.

    What type of snacks

    Question

    06/27/20 3:46 PM CDT

    I try to eat snacks that are kind of healthy like pretzels–sometimes if I’ll treat myself and get french fries, but I try not to do that too often.

    Do you exercise

    Question

    06/27/20 3:47 PM CDT

    I’m pretty exhausted by the end of the day, so I don’t have the energy to do any extra exercise. 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.

    I understand being busy and having very little free time. however, exercise is healthy for you, and can even relieve stress. even small amounts of exercise, such as taking a short walk, can improve your health

    Educate

    06/27/20 3:49 PM CDT

    Thanks for telling me.

    Do you use any recreational drugs

    Question

    06/27/20 3:49 PM CDT

    No.

    Do you use tobacco products

    Question

    06/27/20 3:49 PM CDT

    No. I think it’s gross.

    Do you drink alcohol

    Question

    06/27/20 3:50 PM CDT

    I do sometimes, yeah, when I go out with my friends.

    How often do you drink alcohol

    Question

    06/27/20 3:50 PM CDT

    No more than once or twice a week, sometimes less.

    How much do you drink when you go out

    Question

    06/27/20 3:50 PM CDT

    Just a few. I’m not a big drinker.

    How do you feel overall

    Question

    06/27/20 3:51 PM CDT

    I’m feeling fine right now, but I wanted to make sure there’s nothing serious going on with my heart.

    Do you have any other symptoms

    Question

    06/27/20 3:51 PM CDT

    I guess when it happens I feel a bit worried, like anxious, but that’s all.

    Do you experience any fatigue

    Question

    06/27/20 3:51 PM CDT

    Yeah, most days I feel pretty exhausted by the end of the day.

    Do you have any nausea vomiting

    Question

    06/27/20 3:51 PM CDT

    I haven’t had thrown up, or even had an upset stomach, in a long time.

    Have you noticed any swelling in your legs

    Question

    06/27/20 3:52 PM CDT

    No, not that I have noticed.

    Do you have a family history of heart problems

    Question

    06/27/20 3:52 PM CDT

    Um, none that I know of. Wait, my Poppa–that’s Mom’s dad–died of a heart attack.

    Do you have a family history of heart disease

    Question

    06/27/20 3:52 PM CDT

    Um, none that I know of. Wait, my Poppa–that’s Mom’s dad–died of a heart attack.

    Any family history of high cholesterol

    Question

    06/27/20 3:53 PM CDT

    Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.

    Family history of obesity

    Question

    06/27/20 3:53 PM CDT

    No, I don’t think so. My brother and my dad are kind of big, but I wouldn’t say they were obese or anything.

    Family history of a stroke

    Question

    06/27/20 3:53 PM CDT

    Yeah, that’s how my Nana died.

    Any family history of hypertension

    Question

    06/27/20 3:53 PM CDT

    We’ve got high blood pressure in our family for sure. Granny, Mom, and Dad had it…and honestly I think my other three grandparents might’ve had issues with that, too.

    A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs

    Educate

    06/27/20 3:55 PM CDT

    Alright, thanks for letting me know.

    I am going to examine you now

    Question

    06/27/20 3:56 PM CDT

    Alright.

    Inspected anterior chest wall

    Exam Action

    06/27/20 3:56 PM CDT

    Inspected right side chest wall

    Exam Action

    06/27/20 3:56 PM CDT

    Inspected anterior chest wall

    Exam Action

    06/27/20 3:56 PM CDT

    Inspected left side chest wall

    Exam Action

    06/27/20 3:56 PM CDT

    Inspected anterior chest wall

    Exam Action

    06/27/20 3:56 PM CDT

    Inspected for jugular venous distention: JVP 1 cm above sternal angle

    Exam Action

    06/27/20 3:56 PM CDT

    Inspected fingernails of right hand

    Exam Action

    06/27/20 3:57 PM CDT

    Checked capillary refill in fingernails

    Exam Action

    06/27/20 3:57 PM CDT

    Checked capillary refill in fingernails

    Exam Action

    06/27/20 3:57 PM CDT

    Checked capillary refill in fingernails

    Exam Action

    06/27/20 3:57 PM CDT

    Checked capillary refill in fingernails

    Exam Action

    06/27/20 3:57 PM CDT

    Inspected fingernails of left hand

    Exam Action

    06/27/20 3:57 PM CDT

    Checked capillary refill in fingernails

    Exam Action

    06/27/20 3:58 PM CDT

    Checked capillary refill in fingernails

    Exam Action

    06/27/20 3:58 PM CDT

    Checked capillary refill in fingernails

    Exam Action

    06/27/20 3:58 PM CDT

    Checked capillary refill in fingernails

    Exam Action

    06/27/20 3:58 PM CDT

    Inspected fingernails of right hand

    Exam Action

    06/27/20 3:58 PM CDT

    Inspected legs

    Exam Action

    06/27/20 3:59 PM CDT

    Inspected right leg

    Exam Action

    06/27/20 3:59 PM CDT

    Inspected legs

    Exam Action

    06/27/20 3:59 PM CDT

    Inspected left leg

    Exam Action

    06/27/20 3:59 PM CDT

    Inspected legs

    Exam Action

    06/27/20 3:59 PM CDT

    Inspected right leg for edema: No edema

    Exam Action

    06/27/20 3:59 PM CDT

    Inspected toenails

    Exam Action

    06/27/20 3:59 PM CDT

    Checked capillary refill in toenails

    Exam Action

    06/27/20 3:59 PM CDT

    Checked capillary refill in toenails

    Exam Action

    06/27/20 3:59 PM CDT

    Checked capillary refill in toenails

    Exam Action

    06/27/20 4:00 PM CDT

    Checked capillary refill in toenails

    Exam Action

    06/27/20 4:00 PM CDT

    Checked capillary refill in toenails

    Exam Action

    06/27/20 4:00 PM CDT

    Checked capillary refill in toenails

    Exam Action

    06/27/20 4:00 PM CDT

    Checked capillary refill in toenails

    Exam Action

    06/27/20 4:00 PM CDT

    Checked capillary refill in toenails

    Exam Action

    06/27/20 4:00 PM CDT

    Checked capillary refill in toenails

    Exam Action

    06/27/20 4:00 PM CDT

    Checked capillary refill in toenails

    Exam Action

    06/27/20 4:00 PM CDT

    Inspected legs

    Exam Action

    06/27/20 4:00 PM CDT

    Inspected left leg for edema: No edema

    Exam Action

    06/27/20 4:00 PM CDT

    Palpated temporal arteries: No thrill on either side, 2+ on both sides

    Exam Action

    06/27/20 4:02 PM CDT

    Palpated temporal arteries: No thrill on either side, 2+ on both sides

    Exam Action

    06/27/20 4:03 PM CDT

    Palpated right carotid pulse: No thrill, 2+

    Exam Action

    06/27/20 4:03 PM CDT

    Palpated left carotid pulse: No thrill, 2+

    Exam Action

    06/27/20 4:03 PM CDT

    Palpated chest at PMI: Present at midclavicular line and 5th intercostal space, brisk and tapping, diameter 2 cm

    Exam Action

    06/27/20 4:04 PM CDT

    Palpated right radial pulse: No thrill, 2+

    Exam Action

    06/27/20 4:05 PM CDT

    Palpated left radial pulse: No thrill, 2+

    Exam Action

    06/27/20 4:05 PM CDT

    Palpated right brachial pulse: No thrill, 2+

    Exam Action

    06/27/20 4:05 PM CDT

    Palpated left brachial pulse: No thrill, 2+

    Exam Action

    06/27/20 4:05 PM CDT

    Palpated right femoral pulse: No thrill, 2+

    Exam Action

    06/27/20 4:06 PM CDT

    Palpated left femoral pulse: No thrill, 2+

    Exam Action

    06/27/20 4:06 PM CDT

    Palpated right popliteal pulse: No thrill, 2+

    Exam Action

    06/27/20 4:06 PM CDT

    Palpated left popliteal pulse: No thrill, 2+

    Exam Action

    06/27/20 4:06 PM CDT

    Palpated right tibial pulse: No thrill, 2+

    Exam Action

    06/27/20 4:07 PM CDT

    Palpated left tibial pulse: No thrill, 2+

    Exam Action

    06/27/20 4:07 PM CDT

    Palpated right dorsalis pedis pulse: No thrill, 2+

    Exam Action

    06/27/20 4:07 PM CDT

    Palpated left dorsalis pedis pulse: No thrill, 2+

    Exam Action

    06/27/20 4:07 PM CDT

    Auscultated right temporal pulse

    Exam Action

    06/27/20 4:08 PM CDT

    Auscultated left temporal pulse

    Exam Action

    06/27/20 4:08 PM CDT

    Auscultated right temporal pulse

    Exam Action

    06/27/20 4:08 PM CDT

    Auscultated right carotid pulse

    Exam Action

    06/27/20 4:12 PM CDT

    Auscultated left carotid pulse

    Exam Action

    06/27/20 4:12 PM CDT

    Auscultated right carotid pulse

    Exam Action

    06/27/20 4:12 PM CDT

    Auscultated breath sounds in posterior left upper lobe

    Exam Action

    06/27/20 4:13 PM CDT

    Auscultated right temporal pulse

    Exam Action

    06/27/20 4:13 PM CDT

    Auscultated breath sounds in anterior left upper lobe

    Exam Action

    06/27/20 4:13 PM CDT

    Auscultated breath sounds in anterior right upper lobe

    Exam Action

    06/27/20 4:13 PM CDT

    Auscultated breath sounds in anterior right middle lobe

    Exam Action

    06/27/20 4:13 PM CDT

    Auscultated breath sounds in anterior left mid-chest (upper lobe)

    Exam Action

    06/27/20 4:13 PM CDT

    Auscultated breath sounds in anterior right lower lobe

    Exam Action

    06/27/20 4:13 PM CDT

    Auscultated breath sounds in anterior left lower lobe

    Exam Action

    06/27/20 4:14 PM CDT

    Auscultated breath sounds in posterior left lower lobe on side

    Exam Action

    06/27/20 4:14 PM CDT

    Auscultated breath sounds in posterior left lower lobe near spine

    Exam Action

    06/27/20 4:14 PM CDT

    Auscultated breath sounds in posterior right lower lobe near spine

    Exam Action

    06/27/20 4:14 PM CDT

    Auscultated breath sounds in posterior right lower lobe on side

    Exam Action

    06/27/20 4:14 PM CDT

    Auscultated breath sounds in posterior right lower lobe

    Exam Action

    06/27/20 4:14 PM CDT

    Auscultated aortic area with the bell

    Exam Action

    06/27/20 4:14 PM CDT

    Auscultated aortic area with the diaphragm

    Exam Action

    06/27/20 4:14 PM CDT

    Auscultated pulmonic area with the diaphragm

    Exam Action

    06/27/20 4:15 PM CDT

    Auscultated Erb’s point with the diaphragm

    Exam Action

    06/27/20 4:15 PM CDT

    Auscultated tricuspid area with the diaphragm

    Exam Action

    06/27/20 4:15 PM CDT

    Auscultated mitral area with the diaphragm

    Exam Action

    06/27/20 4:15 PM CDT

    Auscultated aorta in abdomen

    Exam Action

    06/27/20 4:15 PM CDT

    Auscultated right renal pulse

    Exam Action

    06/27/20 4:15 PM CDT

    Auscultated left renal pulse

    Exam Action

    06/27/20 4:15 PM CDT

    Auscultated right iliac pulse

    Exam Action

    06/27/20 4:16 PM CDT

    Auscultated left iliac pulse

    Exam Action

    06/27/20 4:16 PM CDT

    Auscultated right femoral pulse

    Exam Action

    06/27/20 4:16 PM CDT

    Auscultated left femoral pulse

    Exam Action

    06/27/20 4:16 PM CDT

    Tested ABI: 141/145 = 0.972

    Exam Action

    06/27/20 4:16 PM CDT

    Performed EKG: Regular sinus rhythm, no ST changes

    Exam Action

    06/27/20 4:17 PM CDT

    Tested ABI: 141/145 = 0.972

    Exam Action

    06/27/20 4:17 PM CDT

    Any family history of high cholesterol

    Question

    06/27/20 5:40 PM CDT

    Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.

    A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs

    Educate

    06/27/20 5:40 PM CDT

    That makes sense.

    Any family history of high cholesterol

    Question

    06/27/20 5:41 PM CDT

    Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.

    A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs

    Empathize

    06/27/20 5:42 PM CDT

    Thanks for understanding.

    Do you know your family history of high blood pressure is a risk for heart disease

    Question

    06/27/20 5:45 PM CDT

    Yeah, I know.

    A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs

    Educate

    06/27/20 5:45 PM CDT

    Alright, thanks for letting me know.

    A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs

    Empathize

    06/27/20 5:45 PM CDT

    Thanks for saying that.

  • tina jones mental health shadow health assessment transcript

    Transcript

    Started:
    Jun 14, 2020 |
    Total Time:
    71 min

    Hi Ms. Jones, my name isXXX. I will be you Health care provider today

    Greet

    06/14/20 7:26 PM CDT

    Hey.

    What brings you in today?

    Question

    06/14/20 7:26 PM CDT

    I decided to come in because I’m tired all the time now. . . I have this really important exam coming up, and I’m stressed and too foggy to study most of the time. I really need help sleeping so I can focus on preparing for my exam.

    I’m sorry to hear about your trouble sleeping and stress. I’m glad you came in today. let me learn more about what you’re experiencing, and i will try to help

    Empathize

    06/14/20 7:31 PM CDT

    I appreciate you saying that.

    when did you start have trouble sleeping?

    Question

    06/14/20 7:33 PM CDT

    This all started almost a month ago. . . it’s been happening regularly for about three and a half weeks, I’d say.

    How often do you have difficulty sleeping?

    GET SHADOW HEALTH HELP HERE

    Question

    06/14/20 7:33 PM CDT

    It’s happening most nights, I’d say. Four. . . more like five nights a week.

    What are factors that prevent you from sleeping? (No matching questions found.)

    Question

    06/14/20 7:34 PM CDT

    What prevents you from sleeping? (Clarified to What were you thinking about when you couldn’t sleep?.)

    Question

    06/14/20 7:34 PM CDT

    Mostly I start out worrying about this exam I have coming up, and how much I need to study, and then I start thinking about what happens if I don’t pass the exam, and even if I do, whether I’ll actually be able to find an accounting job once I graduate, and then if I do find a job, what if I’m bad at it. . . it just sort of builds on itself like that, just, like, worry upon worry. (Clarified to what I was thinking about when I could not sleep.)

    Do you drink coffee

    Question

    06/14/20 7:35 PM CDT

    Never. I don’t like it. Too bitter for my taste.

    ORDER EXAMS, iHUMAN, ASSIGNMENTS HERE

    Do you take naps during the day?

    Question

    06/14/20 7:36 PM CDT

    I’m not really a big nap person–if I fall asleep, I want to sleep for hours, not wake up in twenty minutes feeling groggy. Plus I don’t have time for them, anyway.

    Is there anything preventing you from falling asleep (Clarified to Is there anything that helps you fall asleep?.)

    Question

    06/14/20 7:36 PM CDT

    Basically the only way I get to sleep easily is if I manage to feel less stressed out–sometimes I can sort of turn my thoughts away from what I’m worried about by distracting myself with something, like thinking about what I’m going to wear the next day or something like that. I’d rather avoid having to take medication if possible. Taking deep breaths can help a little, too. (Clarified to if I anything helps me sleep.)

    Do you exercise

    Question

    06/14/20 7:37 PM CDT

    I just don’t have time to exercise, honestly.

    Do you drift off during the day?

    Question

    06/14/20 7:38 PM CDT

    No, though I do feel groggy during the day.

    Are you tired during the day?

    Question

    06/14/20 7:38 PM CDT

    I’m pretty much tired all the time. I just really need more sleep.

    do you have anxiety?

    Question

    06/14/20 7:39 PM CDT

    I’ve never been diagnosed with anxiety or anything. . . I think usually I’m a pretty relaxed person. At least until recently.

    Do you have a history of panic attacks

    Question

    06/14/20 7:40 PM CDT

    I’ve never had a panic attack, no.

    How does anxiety affect daily life (Clarified to How does your anxiety interfere with your daily life?.)

    Question

    06/14/20 7:41 PM CDT

    Being anxious is mostly just interfering with my sleep, and then not being able to get enough sleep is interfering with my life. (Clarified to how my anxiety interferes with my daily life.)

    how is you quality of sleep (Clarified to Do you sleep ok?.)

    Question

    06/14/20 7:41 PM CDT

    Lately I haven’t been getting enough sleep at all. It takes me so long to fall asleep at night–it’s really frustrating. (Clarified to if I sleep well.)

    what are you sleep habits?

    Question

    06/14/20 7:42 PM CDT

    Well. . . I usually get into bed around midnight, but at that point I feel too nervous to sleep, so I’ll read to try and wind down for maybe an hour, sometimes longer. Then I turn out the light and try to sleep. If it takes a really long time, then sometimes I’ll turn the light back on and read a little more until I feel sleepier.

    how are you coping with stress

    Question

    06/14/20 7:42 PM CDT

    Usually I try to stay organized, you know, make to-do lists, plan my time, that kind of thing. Sometimes I’ll talk to friends or family. . . going to church usually helps, too. Lately, though, none of that is really helping like it should.

    What is causing the stress

    Question

    06/14/20 7:43 PM CDT

    I’m stressed now because I can’t sleep, but I can’t sleep because I keep worrying about all this other stuff, like graduating, and passing this exam that’s coming up, and getting a job, and finding my own place to live. . . it’s a lot.

    It sounds like you have a lot on your plate. I am sorry you are dealing with so much stress

    Empathize

    06/14/20 7:44 PM CDT

    I appreciate you telling me that.

    What were you thinking about when you couldn’t sleep?

    Question

    06/14/20 7:46 PM CDT

    Mostly I start out worrying about this exam I have coming up, and how much I need to study, and then I start thinking about what happens if I don’t pass the exam, and even if I do, whether I’ll actually be able to find an accounting job once I graduate, and then if I do find a job, what if I’m bad at it. . . it just sort of builds on itself like that, just, like, worry upon worry.

    what are your sleep patterns (Clarified to What are your sleep habits?.)

    Question

    06/14/20 7:47 PM CDT

    Well. . . I usually get into bed around midnight, but at that point I feel too nervous to sleep, so I’ll read to try and wind down for maybe an hour, sometimes longer. Then I turn out the light and try to sleep. If it takes a really long time, then sometimes I’ll turn the light back on and read a little more until I feel sleepier. (Clarified to what my sleep habits are.)

    It”s hard to function at our best when we don’t get enough sleep. I know you are busy with work and school, but let’s talk about some strategies to help you get more sleep and make sure you’re getting good quality sleep.

    Empathize

    06/14/20 7:49 PM CDT

    Thanks.

    Tell me more about “feeling put of it”

    Question

    06/14/20 7:49 PM CDT

    I don’t know what you want to know. . . mostly, it’s that I can’t get to sleep at a reasonable time, but I also feel like the quality of my sleep is worse in general.

    what do you mean by “feeling out of it”

    Question

    06/14/20 7:50 PM CDT

    It’s like. . . I just feel slowed down and tired all the time from not sleeping. It’s harder to focus, or get things done efficiently. . . I’m just generally less sharp.

    Tell me about your medical history

    Question

    06/14/20 7:50 PM CDT

    I’ve had asthma since I was little, and I have sugar diabetes, too.

    Do you take any medications?

    Question

    06/14/20 7:51 PM CDT

    All I have is a Proventil inhaler and a Flovent inhaler for my asthma.

    Do you take any medications for sleep

    Question

    06/14/20 7:51 PM CDT

    I haven’t tried taking anything to sleep–I would really rather avoid having to take medication if possible.

    Do you have any new allergies

    Question

    06/14/20 7:52 PM CDT

    Nope.

    Do you have a history of sleeping problems?

    Question

    06/14/20 7:52 PM CDT

    Well. . . the only other time I’ve had sleep problems was right after Dad died. It felt a little like this, with my
    mind racing, but honestly, not as bad
    . Other than that month or two, I’ve always been a really good sleeper. I could fall asleep right away, and then I’d sleep like a log.

    DO you have a history of depression

    Question

    06/14/20 7:53 PM CDT

    I was pretty sad after Dad died, but I wouldn’t say it was, like, true depression. I definitely wasn’t diagnosed with it or anything.

    Do you have difficulty making decisions?

    Question

    06/14/20 7:53 PM CDT

    Only in the sense that, like, everything I do is a little harder because I’m out of it from not sleeping.

    Do you feel hopeless

    Question

    06/14/20 7:54 PM CDT

    I don’t feel hopeless, just frustrated and stressed out.

    Do you have thoughts of wanting to hurt yourself

    Question

    06/14/20 7:54 PM CDT

    No, I’ve never wanted to hurt myself.

    Do you have suicidal thought?

    Question

    06/14/20 7:54 PM CDT

    No, never.

    Do you have any past traumas

    Question

    06/14/20 7:55 PM CDT

    No, not really.

    Do you have a history of violence

    Question

    06/14/20 7:55 PM CDT

    No, never.

    Are you employed

    Question

    06/14/20 7:55 PM CDT

    I’m a supervisor at Mid-American Copy & Ship. I’ve been working there since high school, and I’ve just kept moving up.

    Are you in school

    Question

    06/14/20 7:56 PM CDT

    Yeah, I’m about to get my B.A. in Accounting.

    Do you have an hobbies

    Question

    06/14/20 7:56 PM CDT

    I
    read a lot
    , especially since I bought one of those e-book readers. My friends and I have thought about starting a book club actually. Oh, and there’s these free talks at church that I like to go to if I have time. I watch TV, but usually on DVD or streaming. I like to marathon the shows I really like. I’m really interested in documentaries, too.

    Have you been in the military

    Question

    06/14/20 7:56 PM CDT

    No, I’ve never been in the military.

    Do you have a legal history

    Question

    06/14/20 7:57 PM CDT

    No way.

    What is you current living situation

    Question

    06/14/20 7:57 PM CDT

    I’m living back at my mom’s house with her and my sister. It’s the house I grew up in–we each have our own bedroom, and there’s also a kitchen and a living room. It’s all one story. It can be kind of weird, being my age and living with my family again, but I’ve enjoyed spending time with my family, and I’m happy to help out. I’m
    looking forward to getting my own place soon
    , though.

    Do you get along with your family

    Question

    06/14/20 7:57 PM CDT

    Things are pretty good between all of us–we’re a tight knit family. I think we’re pretty special, the way we all get along.

    Do you have religious preference?

    Question

    06/14/20 7:58 PM CDT

    Yeah. We go to First Baptist, and we do a lot with our church community. We socialize before and after church, and I go to Bible study on Wednesdays, too.

    does your family support you

    Question

    06/14/20 7:59 PM CDT

    Yeah, definitely. We’re all pretty tight knit. I think we’re a pretty special family, the way we all get along. My brother moved in with his fiance, but we still see him once a week at least, and I eat dinner with my mom and sister as much as possible, plus they always go to church with me on Sundays.

    It sounds like you have a healthy support system through your family and friends which is great. it sounds like you work hard to manage your time effectively, too. remember to take out to relax or take a walk

    Empathize

    06/14/20 8:04 PM CDT

    Thanks for understanding.

    Do you use illicit drugs?

    Question

    06/14/20 8:05 PM CDT

    No.

    Have you used marijuana

    Question

    06/14/20 8:06 PM CDT

    Well, I used to smoke pot. . . but I don’t do that anymore.

    when was the last time you smoked marijuana

    Question

    06/14/20 8:06 PM CDT

    I haven’t smoked pot since I was twenty or twenty-one.

    Do you drink alcohol

    Question

    06/14/20 8:06 PM CDT

    I do sometimes, yeah, when I go out with my friends.

    how often do you drink

    Question

    06/14/20 8:06 PM CDT

    No more than once or twice a week. . . a lot of time less than that.

    how much do you drink

    Question

    06/14/20 8:07 PM CDT

    Not often–a couple times a month I’ll go out for a few drinks with friends.

    how many drink do you drink per month (Clarified to How many times a month do you drink?.)

    Question

    06/14/20 8:07 PM CDT

    Not much. I go out for drinks with friends maybe a couple times a month. (Clarified to how many times a month I drink alcohol.)

    how many drink do you drink in a month (Clarified to How many drinks do you have per month?.)

    Question

    06/14/20 8:07 PM CDT

    Oh, I don’t know. Let’s see. . . I might go out every few weeks, so twice a month. . . and I maybe have 2 or 3 drinks at a time, so that’s like 6 drinks a month.
    I guess if I’m free to go out more than that
    , it might be up to 12 drinks in a month, but that’s pretty rare. (Clarified to how many alcoholic drinks I have a month.)

    do you drink and drive

    Question

    06/14/20 8:08 PM CDT

    We usually take a cab when we go out.

    so you use tobacco products

    Question

    06/14/20 8:08 PM CDT

    No, never.

    do you vape

    Question

    06/14/20 8:08 PM CDT

    I don’t vape. Ew. [AUDIO COMING SOON]

    Do you

    Question

    06/14/20 8:09 PM CDT

    No! I don’t know

    What is your

    Question

    06/14/20 8:09 PM CDT

    I’m

    how long have you

    Question

    06/14/20 8:09 PM CDT

    I

    Are you

    Question

    06/14/20 8:10 PM CDT

    No, I haven’t

    have anyone

    Question

    06/14/20 8:10 PM CDT

    No, never.

    do you have any family members with a history of mental illness

    Question

    06/14/20 8:11 PM CDT

    No. They’re crazy, but nobody’s diagnosed with anything.

  • mental health shadow health assessment Education & Empathy

    Education & Empathy
    : 4 of 4 (100.0%)

    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

    1 Symptoms

    Followed Up

    Description:
    Tina describes problems sleeping and stress-symptoms like racing thoughts.

    What brings you in today?

    Question

    07:26 PM CDT

    I decided to come in because I’m tired all the time now. . . I have this really important exam coming up, and I’m stressed and too foggy to study most of the time. I really need help sleeping so I can focus on preparing for my exam.

    I’m sorry to hear about your trouble sleeping and stress. I’m glad you came in today. let me learn more about what you’re experiencing, and i will try to help

    Empathize

    07:31 PM CDT

    I appreciate you saying that.

    Model Statement:
    “I’m sorry to hear about your trouble sleeping and stress. I’m glad you came in. Let me learn more about what you’re experiencing, and I will try to help.”

    2 Stress

    Followed Up

    Description:
    Tina describes how busy she is with school and work.

    What is causing the stress

    Question

    07:43 PM CDT

    I’m stressed now because I can’t sleep, but I can’t sleep because I keep worrying about all this other stuff, like graduating, and passing this exam that’s coming up, and getting a job, and finding my own place to live. . . it’s a lot.

    It sounds like you have a lot on your plate. I am sorry you are dealing with so much stress

    Empathize

    07:44 PM CDT

    I appreciate you telling me that.

    Model Statement:
    “It sounds like you have a lot on your plate. I’m sorry you’re dealing with so much stress.”

    3 Sleep

    Followed Up

    Description:
    Tina describes her sleep hygiene and routine.

    What is causing the stress

    Question

    07:43 PM CDT

    I’m stressed now because I can’t sleep, but I can’t sleep because I keep worrying about all this other stuff, like graduating, and passing this exam that’s coming up, and getting a job, and finding my own place to live. . . it’s a lot.

    It sounds like you have a lot on your plate. I am sorry you are dealing with so much stress

    Empathize

    07:44 PM CDT

    I appreciate you telling me that.

    What were you thinking about when you couldn’t sleep?

    Question

    07:46 PM CDT

    Mostly I start out worrying about this exam I have coming up, and how much I need to study, and then I start thinking about what happens if I don’t pass the exam, and even if I do, whether I’ll actually be able to find an accounting job once I graduate, and then if I do find a job, what if I’m bad at it. . . it just sort of builds on itself like that, just, like, worry upon worry.

    what are your sleep patterns (Clarified to: What are your sleep habits?)

    Question

    07:47 PM CDT

    Well. . . I usually get into bed around midnight, but at that point I feel too nervous to sleep, so I’ll read to try and wind down for maybe an hour, sometimes longer. Then I turn out the light and try to sleep. If it takes a really long time, then sometimes I’ll turn the light back on and read a little more until I feel sleepier. (Clarified to: what my sleep habits are)

    It”s hard to function at our best when we don’t get enough sleep. I know you are busy with work and school, but let’s talk about some strategies to help you get more sleep and make sure you’re getting good quality sleep.

    Empathize

    07:49 PM CDT

    Thanks.

    Model Statement:
    “It’s hard to function at our best when we don’t get enough sleep. I know you’re very busy with work and school, but let’s talk about some strategies to help you get more sleep and make sure you’re getting good quality sleep.”

    4 Coping and Support Systems

    Followed Up

    Description:
    Tina describes her coping mechanisms and support systems.

    Do you get along with your family

    Question

    07:57 PM CDT

    Things are pretty good between all of us–we’re a tight knit family. I think we’re pretty special, the way we all get along.

    Do you have religious preference?

    Question

    07:58 PM CDT

    Yeah. We go to First Baptist, and we do a lot with our church community. We socialize before and after church, and I go to Bible study on Wednesdays, too.

    does your family support you

    Question

    07:59 PM CDT

    Yeah, definitely. We’re all pretty tight knit. I think we’re a pretty special family, the way we all get along. My brother moved in with his fiance, but we still see him once a week at least, and I eat dinner with my mom and sister as much as possible, plus they always go to church with me on Sundays.

    It sounds like you have a healthy support system through your family and friends which is great. it sounds like you work hard to manage your time effectively, too. remember to take out to relax or take a walk

    Empathize

    08:04 PM CDT

    Thanks for understanding.

    Model Statement:
    “It sounds like you have healthy support systems through your family and friends, which is great. It sounds like you work hard to manage your time effectively, too. Remember to take time out to relax or take a walk.”