Gabriel Martinez Asthma Shadow Health Assignment

Gabriel Martinez Asthma Shadow health Experience Overview

Patient: Gabriel Martinez

Digital Clinical Experience Score

100%

This score measures your performance on the Student Performance Index in relation to other students in comparable academic programs. Your instructor has chosen to scale your Student Performance Index score so that the average score on the index is a 80.0%. This score may not be your final grade if your instructor chooses to include additional components, such as documentation or time spent Gabriel Martinez Asthma Shadow health.

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Student Performance Index

44.6 out of 46

Proficiency Level:

Proficient

Gabriel Martinez Asthma Shadow health. Students rated as “proficient” demonstrate entry-level expertise in nursing competencies and clinical reasoning skills. In c omparable nursing programs, the top 25% of students perform at the level of a proficient nurse.Gabriel Martinez Asthma Shadow Health Assignment

Subjective Data CollectionGabriel Martinez Asthma Shadow Health Assignment

31

out of

31

Objective Data Collection

9.6

out of

11

Education and Empathy

4

out of

4

Time

223 minutes total spent in assignment

Interaction with patient

185 minutes

Post-exam activities

38 minutes

.

.

.

Why did you throw away the inhaler?	Question 01/23/21 7:32 PM PST
	I hate the way that inhaler makes me all . . . shaky. It makes my heart beat too fast. That’s why, when my mom told me to clean out my backpack, I threw it in the trash. Gabriel Martinez Asthma Shadow health
	Sorry about that	Empathize 01/23/21 7:32 PM PST
	Oh wow, thanks.
	Those are side effects of the medication but they soon fade away. You should not throw away the medication	Educate 01/23/21 7:33 PM PST
	Yeah, you’re right.
	Have you experienced the side effects before?	Question 01/23/21 7:33 PM PST
	The emergency inhaler makes my heart beat fast and makes me all shaky.
	Do you exercises?	Question 01/23/21 7:34 PM PST
	My mom says I can’t play sports because of my asthma.
	Sorry about that	Empathize 01/23/21 7:34 PM PST
	Ok, thanks.
	What happens when you play sport? (No matching questions found.) Gabriel Martinez Asthma Shadow health	Question 01/23/21 7:34 PM PST
	What happens when you exercise? (Clarified to What happens when you have an asthma attack?.)	Question 01/23/21 7:35 PM PST
	When my asthma attacks it’s kind of scary. It gets hard to breathe because I’m coughing and wheezing . . . I feel a lot better now though. My chest isn’t as tight as it was. (Clarified to to tell you about my asthma attacks.)
	Sorry about that	Empathize 01/23/21 7:35 PM PST
	Thanks, that makes me feel better.
	Who do you live with?	Question 01/23/21 7:35 PM PST
	Me and my mom live in a apartment.
	Where do you live?	Question 01/23/21 7:36 PM PST
	I live in a apartment with my mom in Shadowville.
	Do you smoke?	Question 01/23/21 7:36 PM PST
	No way. Those things will kill you..

.

.

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Past Medical History Guardian

• 
  

  Finding:

  Asked about patient’s general allergies

• 
  

  Finding:

  Denies patient has food allergies

  (Found)

  Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

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  Example Question:

  What allergies does your son have?
• 
  

  Finding:

  Denies patient has a latex allergy

  (Found)

  Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

  Example Question:

  What allergies does your son have?
• 
  

  Finding:

  Denies patient has medication allergies

  (Found)

  Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

  Example Question:

  What allergies does your son have?
• 
  

  Finding:

  Reports environmental allergies

  (Found)

  Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Gabriel Martinez Asthma Shadow Health Assignment

  Example Question:

  What allergies does your son have?

• 
  

  Finding:

  Followed up on environmental allergies

• 
  

  Finding:

  Reports patient has allergies to tree pollen, pet dander, and dust mites

  (Found)

  Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Gabriel Martinez Asthma Shadow health.

  Example Question:

  What environmental allergies does your son have?

• 
  

  Finding:

  Followed up on impact of allergies on asthma

• 
  

  Finding:

  Reports allergies have caused previous exacerbations

  (Found)

  Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Gabriel Martinez Asthma Shadow health

  Example Question:

  How do your son’s environmental allergies impact his asthma?
• 
  

  Finding:

  Reports high pollen count traditionally worsens asthma symptoms

  (Found)

  Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

  Example Question:

  How do your son’s environmental allergies impact his asthma?

• 
  

  Finding:

  Asked about previous hospitalizations

• 
  

  Finding:

  Reports one previous hospitalization for moderate asthma exacerbation Gabriel Martinez Asthma Shadow health

  (Found)

  Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

  Example Question:

  Has your son been hospitalized before?
• 
  

  Finding:

  Reports hospitalization was one year ago

  (Found)

  Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

  Example Question:

  Has your son been hospitalized before?

• 
  

  Finding:

  Followed up on factors leading to prior hospitalization

• 
  

  Finding:

  Reports patient had been exposed to smoke the night before hospitalization

  (Found)

  Pro Tip: Gabriel Martinez Asthma Shadow health Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

  Example Question:

  Why was your son last hospitalized?
• 
  

  Finding:

  Reports rescue inhaler was not effective in managing symptoms

  (Found)

  Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Gabriel Martinez Asthma Shadow health

  Example Question:

  Why was your son last hospitalized?

Social History Guardian

• 
  

  Finding:

  Asked about patient’s activity level

• 
  

  Finding:

  Reports preventing patient from performing aerobic exercise

  (Found)

  Pro Tip: A patient’s and their guardian’s social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient’s social history can also unveil the influence of their present illnesses on their social lives.

  Example Question:

  Gabriel Martinez Asthma Shadow health How does exercise impact your son’s asthma?

• 
  

  Finding:

  Asked about patient’s exposure to secondhand smoke

• 
  

  Finding:

  Denies using tobacco products

  (Found)

  Pro Tip: A patient’s and their guardian’s social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient’s social history can also unveil the influence of their present illnesses on their social lives. Gabriel Martinez Asthma Shadow Health Assignment

  Example Question:

  Does anyone in your family use tobacco?

• 
  

  Finding:

  Asked about childcare

• 
  

  Finding:

  Reports working around 55 hours per week

  (Found)

  Pro Tip: A patient’s and their guardian’s social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. Gabriel Martinez Asthma Shadow health These factors can influence their current health and wellness. Asking a guardian about a pediatric patient’s social history can also unveil the influence of their present illnesses on their social lives.

  Example Question:

  What is your childcare situation?
• 
  

  Finding:

  Reports utilizing after-school programs during the school year

  (Found)

  Pro Tip: A patient’s and their guardian’s social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient’s social history can also unveil the influence of their present illnesses on their social lives.

  Example Question:

  What is your childcare situation?
• 
  

  Finding:

  Reports patient’s maternal grandparents care for him once a weekend

  (Found)

  Pro Tip: A patient’s and their guardian’s social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Gabriel Martinez Asthma Shadow health Asking a guardian about a pediatric patient’s social history can also unveil the influence of their present illnesses on their social lives.

  Example Question:

  What is your childcare situation?

Family Medical History Guardian

• 
  

  Finding:

  Asked about relevant family medical history

• 
  

  Finding:

  Denies family history of respiratory illness

  (Found)

  Pro Tip: A patient’s family medical history can indicate if the patient is at a higher risk for certain illnesses and disorders. Gathering this information from a guardian can contextualize a pediatric patient’s current complaint and how their family’s health history might be influencing it.

  Example Question:

  What health problems run in your family?

Review of Relevant Systems Guardian

• 
  

  Finding:

  Followed up on patient’s integumentary system

• 
  

  Finding:

  Reports patient is diagnosed with eczema

• Gabriel Martinez Asthma Shadow health

NRNP 6665 Discussion: Comprehensive Integrated Psychiatric Assessment

Discussion: Comprehensive Integrated Psychiatric Assessment

Assessment of children and adolescents, like adults, share some similarities, but overall will be somewhat different. The classical approach to making a comprehensive psychiatric evaluation will be age-dependent when it comes to younger age groups. Furthermore, the difficulty is enhanced when you take into consideration the contextual complexities including culture and environment. Therefore, with regard to the vignette 5 video, this post will attempt to highlight some of these aspects of a comprehensive integrated psychiatric assessment.

What The Practitioner Did Well

The practitioner is using nonverbal cues such as nodding and making eye contact with the patient at good measure. These are desirable traits for a psychiatric interview. Additionally, she practices active listening. This is seen when she gives a summary of the pertinent findings from the patient history back to the patient to help them both in breaking down the situation.

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What The Practitioner Can Improve Upon

The provider starts off with the wrong line of questioning when you consider the patient’s age and gender. Males have been considered to be more likely to relate to questions concerning rage and irritability as opposed to sadness and hopelessness as symptomatic of depression. In addition, the interview could benefit from better rapport cultivated by the provider as this does not seem to be the case with the patient on close observation. NRNP 6665 Discussion: Comprehensive Integrated Psychiatric Assessment

Compelling Concerns and The Next Question

Suicidality and the risk of self-harm appear to be the most compelling issues in the patient with a background of anxiety and depressive symptomatology. The next question to be asked would therefore assess the risk of follow-through. It would be pertinent to know if there have been any suicide attempts and if so, how many. This is extremely helpful in determining an appropriate management plan (Oquendo & Bernanke, 2017).

Why A Thorough Psychiatric Assessment of a Child/Adolescent Is Important

A thorough psychiatric assessment of a child is important because most of the time children do not have insight into their issues. It may be required that the health care provider dig a little deeper to bring these issues to the forefront. Moreover, children and adolescents suffer many mental conditions that may not be present in adults.

Symptom Rating Scales That Would Be Appropriate to Use During the Psychiatric Assessment of A Child/Adolescent

Two appropriate symptom rating scales include The Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) scales. As part of the Achenbach System of Empirically Based Assessment, these tools provide assistance in the quantification and qualification of many mental health conditions of childhood that are represented in the DSM V. Consequently, these scales provide useful information to the clinical assessment of children and adolescents (Sisteré et al., 2014).

Psychiatric Treatment Options for Children and Adolescents That May Not Be Used When Treating Adults

Children and adolescents may benefit from relationship-based therapies such as parenting interventions and attachment-orientated interventions. These types of interventions depend on their developmental stage and the level of maturity attained at that time of the illness. For instance, attachment interventions will involve enhancing parental sensitivity to the child’s emotions and behavior whereas parental interventions aim to change parental practices that may be harmful (Macdonald et al., 2016). NRNP 6665 Discussion: Comprehensive Integrated Psychiatric Assessment

The Role Parents/Guardians Play in Assessment

parents can provide insight into the child’s or adolescent’s current problem. They can also be a guide in enhancing the efficacy and communication during the evaluation interview. Parental participation in the process also creates an environment where the child feels safe and protected making them amenable to getting the help they need (Haine-Schlagel & Walsh, 2015).

References

Haine-Schlagel, R., & Walsh, N. E. (2015). A review of parent participation engagement in child and family mental health treatment. Clinical Child and Family Psychology Review, 18(2), 133–150. https://doi.org/10.1007/s10567-015-0182-x
Macdonald, G., Livingstone, N., Hanratty, J., McCartan, C., Cotmore, R., Cary, M., Glaser, D., Byford, S., Welton, N. J., Bosqui, T., Bowes, L., Audrey, S., Mezey, G., Fisher, H. L., Riches, W., & Churchill, R. (2016). Types of interventions. In The effectiveness, acceptability, and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: An evidence synthesis. NIHR Journals Library. https://www.ncbi.nlm.nih.gov/books/NBK385382/
Oquendo, M. A., & Bernanke, J. A. (2017). Suicide risk assessment: Tools and challenges. World Psychiatry, 16(1), 28–29. https://doi.org/10.1002/wps.20396
Sisteré, M., Massons, J., Granero, R., & Ascaso, L. (2014). Validity of the DSM-Oriented Scales of the Child Behavior Checklist and Youth Self-Report. Psicothema, 26, 364–371. https://doi.org/10.7334/psicothema2013.342. NRNP 6665 Discussion: Comprehensive Integrated Psychiatric Assessment

Solution    

 Response to my colleague NO 2-Discussion Post

Hello Bridgette. I find your discussion quite engaging with adequate incorporation of information from different literature covering the question at hand. Concerning the provided video, you have mentioned the use of non-verbal cues and active listening tactics, which are effective communication strategies that must be adopted by all practitioners to promote the patient’s interest and engagement during the psychiatric interview. However, I disagree with the notion that the provider would have used a gender-specific approach to engage the male client (Rafferty et al., 2018). I believe that she did an excellent job giving the client clues of what she wanted to know. However, she should have given the client more time to further explain how he was feeling based on his terms, rather than the practitioner’s terms (Tillmann et al., 2018). Following up with questions relating to suicide and self-harm is however necessary just like you have pointed out.

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Conducting a thorough psychiatric examination is crucial among children given their increased interaction with numerous triggers to psychiatric complications. You have accurately identified and elaborated the two main symptoms rating scales for children and adolescents such as the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) scales. An additional scale would be the Conners’ Rating Scales-Revised (CRS-R), which is effective in rating behavioral symptoms displayed by children (Guerrera et al., 2019). Furthermore, I do not think relationship-based therapies are specific for children. Studies show that adults can also benefit from this kind of therapy. You should have explored children-specific therapeutic interventions such as play therapy which help equip young people with resilient and coping skills to promote their mental health (Guerrera et al., 2019). It is however true that parents and guardians play a significant role in providing more insight regarding the health problems their children are suffering from. NRNP 6665 Discussion: Comprehensive Integrated Psychiatric Assessment

References

Guerrera, S., Menghini, D., Napoli, E., Di Vara, S., Valeri, G., & Vicari, S. (2019). Assessment of psychopathological comorbidities in children and adolescents with autism spectrum disorder using the child behavior checklist. Frontiers in psychiatry, 10, 535.https://doi.org/10.3389/fpsyt.2019.00535

Rafferty, J., Yogman, M., Baum, R., Gambon, T. B., Lavin, A., Mattson, G., … & Committee on Psychosocial Aspects of Child and Family Health. (2018). Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents. Pediatrics, 142(4).https://doi.org/10.1542/peds.2018-2162

Tillmann, S., Tobin, D., Avison, W., & Gilliland, J. (2018). Mental health benefits of interactions with nature in children and teenagers: A systematic review. J Epidemiol Community Health, 72(10), 958-966.http://dx.doi.org/10.1136/jech-2018-210436

Nsg5003 Advanced Pathophysiology

Sample Question 1

Mom is a carrier for hemophilia but does not have the disease. Dad does not have hemophilia . 1) In Cystic Fibrosis, how would the responses be different to the questions in the Post? Give a detailed explanation supporting your response.

Response # 2 Down Syndrome is another genetic disorder. Why is the Punnett Square not a good tool for predicting if offspring will have Down Syndrome? Why does the risk for Down’s Syndrome increase with maternal age?

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Sample Question 2

1) List the additional questions you would need to ask this patient. Explain.

2) What is the safety profile of Lisinopril-hydrochlorothiazide and bismuth subsalicylate in pregnant women? What are the possible complications to the pregnant woman and her fetus?

3) What is the importance of assessing laboratory values when prescribing medications? How might the laboratory values, in this case, impact your treatment plan? Nsg5003 Advanced Pathophysiology

4) Would you make any changes to Ms. BD’s blood pressure and GERD medications? Explain. If yes, what would you prescribe? Discuss the medications safety in pregnancy, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings.

5) How does ethnopharmacology apply to this patient if she were NOT pregnant? Explain.

6) What health maintenance or preventive education do you provide in this client case based on your choice of medications/treatment?

7) Would you treat this patient or refer her? Explain. If you refer, where would you refer this patient?

Sample Question 3

1) Describe the pathophysiology of depression.

2) Discuss the phenomenon of depression effects on appetite. Describe from a pathophysiologic basis why some people with depression experience a lack of appetite resulting in weight loss while others will experience increased food intake and have weight gain. Nsg5003 Advanced Pathophysiology

3) Discuss two additional clinical findings of depression and present the pathophysiologic basis of these symptoms.

Sample Question 4

1)Summarize the pathophysiology of Peptic Ulcer Disease as compared to GERD and explain which one his symptoms most closely represent. Support with evidence. 2) Explain the body’s natural protection against peptic ulcers from a pathophysiology standpoint. 3) What diagnostic testing may be used to further evaluate the symptoms and what might this test tell the healthcare provider? Nsg5003 Advanced Pathophysiology

Discussion Board Of Advanced Pathophysiology

(There are two discussions. Please write one page each for each discussion.)
Prompt 1
Select one of the following discussion prompts to address:

• Consider the long-term effects of hyperglycemia as seen in poorly controlled diabetes. Consider factors that lead to good or poor compliance in regimens designed to decrease hyperglycemia and improve health outcomes in diabetics. Review this article (Links to an external site.) https://diabetesjournals.org/clinical/article/24/2/71/1610/Improving-Patient-Adherenceand identify the key factors that can interfere with compliance. Discussion Board Of Advanced Pathophysiology
• Describe the pathophysiology, clinical manifestations, evaluation, and treatment of two diseases of the posterior pituitary–syndrome of inappropriate antidiuretic hormone secretion (SIADH) and diabetes insipidus (DI).
• Discuss Grave’s Disease and the systemic manifestations and treatment of hyperthyroidism. Describe the pathophysiology, clinical manifestations, evaluation, and treatment of hypothyroidism.

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Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.

Prompt 2
Select one of the following discussion prompts to address:
• Describe the pathophysiology, clinical manifestations, evaluation, and treatment of polycystic ovary syndrome (PCOS).
• Discuss common causes of galactorrhea and describe the pathophysiology, clinical manifestations, evaluation, and treatment of galactorrhea.
• Describe benign prostatic hypertrophy (BPH) and discuss the pathogenesis, clinical manifestations, evaluation, and treatment of BPH.
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas. Discussion Board Of Advanced Pathophysiology

Textbook:
Pathophysiology: The Biologic Basis for Disease in Adults and Children
• Author: Kathryn L. McCance and Sue E. Huether
• Publisher: Elsevier
• Edition: 7th (2014)
Chapter 21-26