Shadow Health Focused Exams
Shadow Health Focused Exams
- Complete the ShadowHealth© Focused Exams – Special Populations: Chest Pain, Cough and Abdominal Pain assignments
After you have achieved at least 80% on the assignment(s) download, save and upload your LabPass document to the dropbox.
Professional Development
- Write a 500-word APA reflection essay of your experience with the Shadow Health virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:
- What went well in your assessment?
- What did not go so well? What will you change for your next assessment?
- What findings did you uncover?
- What questions yielded the most information? Why do you think these were effective?
- What diagnostic tests would you order based on your findings?
- What differential diagnoses are you currently considering?
- What patient teaching were you able to complete? What additional patient teaching is needed?
- Would you prescribe any medications at this point? Why or why not? If so, what?
- How did your assessment demonstrate sound critical thinking and clinical decision making? Shadow Health Focused Exams
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Focused Exam: Chest Pain Results | Turned In Advanced Physical Assessment – March 2020, advanced_physical_assessment__td8__031720__sect1
Return to Assignment (/assignments/313481/)
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Documentation / Electronic Health Record
Document: Provider Notes
Student Documentation Model Documentation
Subjective
Brain is a 58 you caucasian Male who presents with C/o chest pain in the middle of his chest over his heart, 3 times this month. His pain is 5/10 when the pain arises, no chest pain currently. Chest pain does not radiate to his arm, shoulder or neck. Aggravated chest pain when walking up the steps, and is relieved when he rests. Denies any heartburn, difficult breathing. No change in appetite but mentioned he gained some weight when his bike was stolen. Rare exercise at this moment, desires clearance for exercise since the onset of his chest pain. Never been seen for chest pain, and has not taken anything for chest pain. Medical history: HTN on Lopressor 100 mg/daily x1 year Hyperlipedmia on lipitor 20 mg daily x1 year Omega 3 daily No surgical history Family Medical hx: Father: htn/hyperlipdemia, obesity, died of colon cancer @ 75yo MGF: heart attack died @ 54 yo Sister: HTN and Diabetes type 2 Social hx: beer 3 drinks in a weekend denies tobacco or drug use
Pt. reports “I have been having some troubling chest pain in my chest now and then for the past month.” Experiencing periodic c pain with exertion such as yard work as well as with overeating. Points to midsternum as location. Describes pain as “tight and uncomfortable.” Denies radiation. Pain lasts for “a few” minutes goes away when he rests. Most recent episode was three days a after eating a large restaurant dinner. States “It has never gotten ‘really bad’” so didn’t think it was an emergency, but is concerne after three episodes in one month and wants his heart checked o Reports mild cramping in legs with activity. Denies shortness of breath, indigestion, heartburn. Denies chest pain at this time. Shadow Health Focused Exams
Your Results Lab Pass (/assignment_attempts/6701636/lab_pass.pd
Overview
Transcript
Subjective Data Collection
Objective Data Collection
Education & Empathy
Documentation
Document: Vitals Document: Provider Notes
Student Documentation Model Documentation
Objective
Brian is a 58 year old Caucasian male appears to be well-groomed, is pleasant and answers questions clearly and appropriately. He maintains eye contact throughout the exam. He appears in no distress VSS: Bp 146/90 Skin warm to touch, dry, pink and intact. no tenting Heart: S1, s2, s3 and S4 with murmur Carotid pulse: positive Thrill, +3 on right: PMI: displaced laterally, briks and tapping, <3cm Breath sounds: clear in upper lobes, posterior lower lobes with crackles bilaterally. GI: no tenderness, no masses, guarding or distension. BS present at all quads, WNL Liver is palpable and nontender: spleen and kidneys are not palpable Extremties: No edema, Brachial and radial pulse neg for thrill at 2+ popliteal, tibal and dorsalis pedis pulse diminised at 1+. capillary refill less than 3 seconds on extremiteis. EKG: Regular sinus rhythm. No ST changes
• General Survey: 58 year old male is alert and oriented, with clea speech and in no acute distress. • Cardiac: S1, S2, without murmurs or rubs. PMI displaced latera S3 noted at mitral area. • Peripheral Vascular: Right side carotid bruit. JVP 3cm above ste angle. Right carotid pulse with thrill, 3+. Left carotid pulse withou thrill, 2+. Brachial, radial, femoral pulses without thrill, 2+. Poplite tibial, and dorsalis pedis pulses without thrill, 1+. Cap refill less t 3 seconds – 4 extremities. • Respiratory: Breathing is quiet and unlabored. Breath sounds a clear to auscultation in upper lobes and RML. Fine crackles/rales posterior bases of L/R lungs. • Gastrointestinal: Round, soft, non-tender with normoactive bow sounds in 4 quadrants; no abdominal bruits. No tenderness to lig or deep palpation. Tympanic throughout. Liver is 7 cm at the MC and 1 cm below the right costal margin. Spleen and bilateral kidn are not palpable. • Neuro: Alert and oriented x 3, follows commands, moves all extremities. • Skin: Warm, dry, pink, and intact. No tenting. • EKG (interpretation): Regular sinus rhythm. No ST changes. Shadow Health Focused Exams
Assessment
Coronary Artery disease Stable angina Carotid disease pericarditis Aortic aneurysm r/o GERD R/O Sarcodosis
Based on the abnormal findings during cardiovascular and respiratory auscultation, my differentials include coronary artery disease with stable angina; congestive heart failure; carotid disea aortic aneurysm; pericarditis; or GERD.
Plan
Blood work for cardiac enzyme, electrolytes, CBC, Lipid profile, liver function test, cxr, 12 lead EKG Consult with cardiologist Echocardiogram Exercise stress test Dopplers for carotid Patient should be tested with results on labs at the least, and not discharged home. Baby Asa upon arrival Ntiroglycerin if chest pain is present again Warning signs of when to seek medical help like another onset of chest pain, SOB, shoulder or arm pain
Mr. Foster should receive a 12-lead ECG, chest x-ray, and lab workup (cardiac enzymes, electrolytes, CBC, BNP, CMP, Hgb A1 lipid profile, and liver function tests) to confirm a diagnosis. He should be referred for an echocardiogram, exercise stress test, a carotid dopplers as well as a consult with a vascular surgeon for carotid evaluation. Mr. Foster should be prescribed diltiazem and diuretic in addition to his daily Lopressor and Lipitor. If needed, an ACE inhibitor to manage his hypertension and PRN nitroglycerin for chest pain that does not subside with rest.
Comments
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Focused Exam: Abdominal Pain Results | Turned In Advanced Physical Assessment – March 2020, advanced_physical_assessment__td8__031720__sect1
Return to Assignment (/assignments/313482/)
Documentation / Electronic Health Record
Document: Provider Notes
Student Documentation Model Documentation
Subjective
Miss Park is a pleasant Korean 78 year old woman who presents to the clinic with complaints of abdominal pain for the past 5 days. She is oriented to person place and time. She answers the questions appropriately and maintains eye contact during the interview and exam. This with her daughter who assist with her Care at home. Pains are described as crampy, dull at her lower abdomen, with a pain scale of 6/10, mostly constant. Has had difficulty using the bathroom this past 5 days, which has affected her daily activites. She has been feeling more tired than usual, denies feeling fever chills or rectal pain. She drinks two glasses of water a day and eats well, although has had a decrease in appetite since her abdominal pain started. Her abominal pain Is aggravated with food and activity, pain is relieved with rest. Her stool is soft and brown, no current diarrhea. She has history of colonoscopy that was negative. She denies any vaginal bleeding or urinary difficulty. She denies any GERD, colon cancer or stomach issues. PMHx: HTN on accupril 10 mg daily Immunizations: updated: declines flu vaccination today. Surgical hx: choleystectomy at 42yo Cesarean delivery at 40yo: OB/GYN: G3P3L2: one stillbirth for cord accident. No hx of STI. Pap WNL 2010 Social hx: has a friend who she is intimate with, no tobacco use, no illicit drugs. Drinks once a week with white wine. Has stong family support. Visits her Son in Houston occasionally. Family Hx: Mother: DM and HTN: Deceased @ 88yo Father: HTN and hypercholestremia: deceased at 82yo MGP: HTN PGM: HTN/ CVA/obesity Brothers: HTN SOn: healthy daughter: Healthy
Ms. Park reports that she is “having pain in her belly.” She experienced mild diarrhea three days ago and has not had a bow movement since. She reports that she has been feeling some abdominal discomfort for close to a week, but the pain has increased in the past 2-3 days. She now rates her pain at 6 out o 10, and describes it as dull and crampy. She reports her pain lev the onset at 3 out of 10. She is also experiencing bloating. She d not feel her symptoms warranted a trip to the clinic but her daug insisted she come. She describes her symptoms primarily as generalized discomfort in the abdomen, and states that her lowe abdomen is the location of the pain. She denies nausea and vomiting, blood or mucus in stool, rectal pain or bleeding, or rece fever. She denies vaginal bleeding or discharge. Reports no histo of inflammatory bowel disease or GERD. Denies family history of disorders. Her appetite has decreased over the last few days and she is taking small amounts of water and fluids. Previously she reports regular brown soft stools every day to every other day. Shadow Health Focused Exams
Your Results Lab Pass (/assignment_attempts/6709886/lab_pass.pd
Overview
Transcript
Subjective Data Collection
Objective Data Collection
Education & Empathy
Documentation
Student Survey
Document: Vitals Document: Provider Notes
Student Documentation Model Documentation
Objective
Alert and oriented x3: Some discomfort due to abdominal pain HEENT: moist mucus mambrane, normal skin turgor, no tenting Heart: S1 and S2 with no abnormal heart sounds Lungs; CTA Liver: 1cm below Rt costal margin: nontender Abdomen: BS present at all quads, normoactive, No bruits or friction sounds. Dullness on LLQ, Tender to touch, with guarding and distension. 2x4cm oblong mass palpated on LLQ. RUQ : with scar s/p choleystectomy, and al lower transverse abdominal scar from s/p cs no CVA tenderness Pelvic: neg Rectal: no hemorrhoids, strong spincter reflex, fecal mass detected in rectal vault Extremties: no edema: normal reflexes UA: clear but dark urine, neg for nitrites, wbc or ketones.
• General Survey: Uncomfortable and flushed appearing elderly woman seated on exam table grimacing at times. Appears stable mildly distressed. • HEENT: Mucus membranes are moist. Normal skin turgor; no tenting. • Cardiovascular: S1, S2, no murmurs, gallops or rubs; no S3, S4 rubs. No lower extremity edema. • Respiratory: Respirations quiet and unlabored, able to speak in sentences. Breath sounds clear to auscultation. • Abdominal: 6 cm scar in RUQ and 10 cm scar at midline in suprapubic region. An abdominal exam reveals no discoloration; normoactive bowel sounds in all quadrants; no bruits; no friction sounds over spleen or liver; tympany presides with scattered dullness over LLQ; abdomen soft in all quadrants; an oblong ma noted in the LLQ with mild guarding, distension; no organomega no CVA tenderness; liver span 7 cm @ MCL; no hernias. • Rectal: No hemorrhoids, no fissures or ulceration; strong sphinc tone, fecal mass in rectal vault. • Pelvic: No inflammation or irritation of vulva, abnormal discharg or bleeding; no masses, growths, or tenderness upon palpation. • Urinalysis: Urine clear, dark yellow, normal odor. No nitrites, WB RBCs, or ketones detected; pH 6.5, SG 1.017.
Assessment
Constipation causing abdominal mass Intestinal obstruction Diverticulitis Irritable bowel syndrome
Mrs. Park’s bowel sounds are normoactive in all quadrants, with bruits or friction sounds. Scattered dullness in LLQ during percussion is suggestive of feces in the colon; otherwise, her abdomen is tympanic. Her abdomen is soft to palpation; mild guarding and oblong mass suggesting feces were discovered in LLQ. No CVA tenderness; liver span 7 cm @ MCL; no splenic dullness. Digital rectal exam revealed a fecal mass in the rectal v No abnormalities were noted during the pelvic exam, so pelvic inflammatory disease is not suspected. Ms. Park’s urinalysis was normal, which rules out a urinary tract infection. No signs of dehydration or cardiovascular abnormalities. Mrs. Park’s sympto and health history suggest she has constipation. Differential diagnoses are constipation, diverticulitis, and intestinal obstruction
Plan
stool for occult blood CBC/ ESR with CRP Metabolic panel serum amylase abdominal sonogram or abdominal x-ray for to locate mass; Bowel rest if diverticulitis : if neg: increase po fluids, increase fiber, increase activity as tolerated. Creating a bowel regimen is encouraged.
Mrs. Park should receive diagnostic tests to rule out differentials CBC to assess for elevated WBCs associated with diverticulitis, electrolyte profile to evaluate electrolyte and fluid status, and a C scan to assess for obstruction. If Mrs. Park has diverticulitis I recommend IV fluids and bowel rest. If she has bowel obstructio recommend NPO, IV fluids, and general surgical consult. If she h constipation, I recommend that she increase fluids, increase fibe and increase activity as tolerated.
Comments
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Focused Exam: Cough Results | Turned In Advanced Physical Assessment – March 2020, advanced_physical_assessment__td8__031720__sect1
Return to Assignment (/assignments/313480/)
Documentation / Electronic Health Record
Document: Provider Notes
Student Documentation Model Documentation
Subjective
Dany is a 8 year old hispanic boy, brought into clinic by his grandmother. He is able to answer the questions independently and maintains eye contact. He reports a gurgly watery cough for the last 4-5 days. His throat is hurting with the cough, and is feeling tired. Difficult sleeping due to the cough. His mother gave him a “purple medicine” this morning, for the cough, although he doesn’t know the name of it. It has helped, but then his cough presents itself again. He has c/o right ear pain, that started yesterday. He has had hx of ear infections when he was 2 yo. He denies fever or chills, or watery eyes but states he gets the “cold” frequently. Denies chest pain or difficult breathing No allergies to meds or pollen Immunizations: updated PMHx; ear infections at childhood Surgical hx: none Social hx: Lives with parents, grandmother assists with care, when parents are at work. does not smoke, exposed to 2nd hand smoke from his Papi. Washes hands before eating or after restroom. No family history of asthma or allergies.
Danny reports a cough lasting four to five days. He describes the cough as “watery and gurgly.” He reports the cough is worse at n and keeps him up. He reports general fatigue due to lack of slee He reports pain in his right ear. He is experiencing mild soreness his throat. He reports his mother treated his cough symptoms wi over-the-counter medicine, but it was only temporarily effective. reports frequent cold and runny nose, and he states that he had frequent ear infections as a child. He reports a history of pneumo in the past year. He reports normal bowel movements. He denies fever, headache, dizziness, trouble swallowing, nosebleed, phleg or sputum, chest pain, trouble breathing and abdominal pain. He denies cough aggravation with activity. Shadow Health Focused Exams
Objective
Daniel appears slightly tired, and has been coughing throughout the exam Vital signs stable Spirometer: FEV1: 3.15L FVC 3.91L/ 80.5% Head: Cervical lymph nodes enlarged and tender on right side; Sinus: no tenderness on frontal or maxillary eyes: pink in color, no discharge Ears: right ear redness and inflammed: no d/c nose: clear watery phlem, no odor Throat: oropharynix: cobberstone, redness with postnasal drip Lungs: CTA bilaterally: Breath sounds: clear bilaterally anterior and posterior. bronchophony: negative Chest: S1 and S2 audible, no murmurs or abnormal heart sounds
• General Survey: Fatigued appearing young boy seated on nurs station bench. Appears stable. • HEENT: Mucus membranes are moist, clear nasal discharge. Redness, cobblestoning in the back of throat. Eyes are dull in appearance, pink conjunctiva. Right Tympanic membrane is red inflamed. Right cervical lymph node enlarged with reported tenderness. • Cardiovascular: S1, S2, no murmurs, gallops or rubs. • Respiratory: Respiratory rate increased, but no acute distress. A to speak in full sentences. Breath sounds clear to auscultation. Negative bronchophony. Chest wall resonant to percussion. Expected fremitus, equal bilaterally. Spirometry: FEV1: 3.15 L, FV 3.91L (FEV1/FVC: 80.5%)
Your Results Lab Pass (/assignment_attempts/6699430/lab_pass.pd
Overview
Transcript
Subjective Data Collection
Objective Data Collection
Education & Empathy
Documentation
Document: Vitals Document: Provider Notes
Student Documentation Model Documentation
Assessment
Differential diagnosis: 1. flu-like syndrome or cold 2. strep throat 3. Allergies 4. Allergic rhinitis
My differentials include cold, strep throat, rhinitis, allergies and asthma based on abnormal findings affecting the ears, upper respiratory tract and lymphatic region.
Plan
Discuss hand hygiene and hygiene ettiquitte when coughing: cough in elbows, and hand hygiene. Strep culture Cough medication to help sleep at night and suppress cough Antihistamine to dry up secretions Encourage fluid intake, avoid dairy products that can make cough worse: phlem may get thicker Refer for allergy testing if antihistamine did not work Educate warning signs for immediate attention like difficult breathing, fever, chills, or cough worsening. Follow up in a week or telephone appt in 3 days to follwo up on progress Educate the family the importance of hand hygiene
Danny should be referred for an allergy test to rule out allergies a well as a lung function test to rule out asthma. He should receive strep culture to rule out strep throat. I recommend antitussive treatment at night to help with his sleep in addition to bed rest.
Comments
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Focused Exam: Abdominal Pain Results | Turned In Advanced Physical Assessment – March 2020, advanced_physical_assessment__td8__031720__sect1
Return to Assignment (/assignments/313482/)
Education & Empathy : 6 of 7 (85.7%)
During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below ar 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
Description: Ms. Park describes staying socially active and exercising.
Is there anything that makes it worse Questio
03:07 PM MD
Yes. When I move around the house or try to garden, I feel more pain. And I did not go to my exercise classes. I was sure that would be too much. I prefer to be active, but my daughter wants me to rest.
Does the pain radiate anywhere in your body Questio
03:14 PM MD
Model Statement: “It sounds like you stay physically and socially active. That’s great!”
Your Results Lab Pass (/assignment_attempts/6709886/lab_pass.pd
Overview
Transcript
Subjective Data Collection
Objective Data Collection
Education & Empathy
Documentation
Student Survey
1 Symptoms Followed Up
2 Medications Followed Up
3 Diet Followed Up
4 Activity Level Not Followed Up
5 Medical History Followed Up
6 Sexual Activity Followed Up
7 Family and Support Followed Up
Comments
If your instructor provides individual feedback on this assignment, it will appear here.
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Focused Exam: Chest Pain Results | Turned In Advanced Physical Assessment – March 2020, advanced_physical_assessment__td8__031720__sect1
Return to Assignment (/assignments/313481/)
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Education & Empathy : 5 of 6 (83.3%)
During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below ar 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
Description: Mr. Foster describes his past medical history of hypertension and high cholesterol.
What is your medical history Questio
07:07 PM MD
The doctors told me I have a little bit of high blood pressure and cholesterol, but that’s it.
Have you had any surgeries Questio
07:07 PM MD
I’ve never had any surgeries.
Are you allergic to any medication Questio
07:07 PM MD
I think I’m allergic to codeine. It makes me toss my cookies.
Model Statement: “It’s good that I know you have been diagnosed with hypertension and high cholesterol, because those conditions can cause additional heart problems. I would like to find out more about your diagnosis and treatment of those conditions.”
Your Results Lab Pass (/assignment_attempts/6701636/lab_pass.pd
Overview
Transcript
Subjective Data Collection
Objective Data Collection
Education & Empathy
Documentation
1 Symptoms Followed Up
2 Hypertension and High Cholesterol Not Followed Up
3 Exercise Followed Up
4 Diet Followed Up
5 Weight Gain Followed Up
6 Family History Followed Up
Comments
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WhatsAppFocused Exam: Abdominal Pain Results | Turned In Advanced Physical Assessment – March 2020, advanced_physical_assessment__td8__031720__sect1
Return to Assignment (/assignments/313482/)
Transcript
Started: Apr 22, 2020 | Total Time: 115 min
Question 04/22/20 3:02 PM MD
Question 04/22/20 3:03 PM MD
Question 04/22/20 3:04 PM MD
Question 04/22/20 3:05 PM MD
Question 04/22/20 3:05 PM MD
Your Results Lab Pass (/assignment_attempts/6709886/lab_pass.pd
Overview
Transcript
Subjective Data Collection
Objective Data Collection
Education & Empathy
Documentation
Student Survey
All Lines (271) Interview Questions (135) Statements (42) Exam Actions (94)
Hello.
Thank you for explaining that.
What brings you into the office today
I have some pain in my belly. . . and I’m having difficulty going to the bathroom. My daughter was worried about me.
Thank you.
What do you mean by difficult going to the bathroom (Clarified to What do you mean by difficulty going to the bathroom?.)
Well, for several days I’ve had to strain to even have a bowel movement, and I can’t make it happen. And the pain is there in my stomach. [AUDIO COMING SOON] (Clarified to what I mean by difficulty going to the bathroom.)
Thank you for explaining that.
What is your name and date of birth
My name is Esther Park, and I was born on January 7th . . . [Ms. Park reports correct birth year.]
Do you know where you’re at today
Yes. I am at Shadowville General Clinic.
Do you know what time it is (Clarified to What is todays date?.)
Question 04/22/20 3:05 PM MD
Question 04/22/20 3:05 PM MD
Question 04/22/20 3:06 PM MD
Question 04/22/20 3:06 PM MD
Question 04/22/20 3:06 PM MD
Question 04/22/20 3:07 PM MD
Question 04/22/20 3:14 PM MD
Question 04/22/20 3:14 PM MD
Question 04/22/20 3:15 PM MD
Question 04/22/20 3:15 PM MD
Today must be . . . [Ms. Park reports the correct date]. (Clarified to what today’s date is.)
What time is it (No matching questions found.)
When did the pain start
The pain started as a general discomfort, about five days ago, when I started having the. . . difficulties going to the bathroom.
Where is the pain at
The pain and discomfort is down low in my belly.
How long is this been happening
I have not felt as energetic as usual for — I believe for the past week.
Describe your pain
I’d say it’s crampy and. . . a dull, crampy feeling.
Thank you.
Thank you.
Is there anything that makes it worse
Yes. When I move around the house or try to garden, I feel more pain. And I did not go to my exercise classes. I was sure that would be too much. I prefer to be active, but my daughter wants me to rest.
Does the pain radiate anywhere in your body
I wouldn’t say that, no. It’s more of a general pain that stays in one place.
Does anything make the pain better
When I rest and try not to move much, I feel better. But the pain is still there.
can you Point to your pain (Clarified to Can you point to the location of your abdominal pain?.)
Well my whole belly is uncomfortable to some degree, but it’s mostly in the lower part, that’s where the pain is. Down in my lower belly. (Clarified to if I can point to where my abdominal pain is.)
Does your back hurt
Question 04/22/20 3:16 PM MD
Question 04/22/20 3:19 PM MD
Question 04/22/20 3:19 PM MD
Question 04/22/20 3:19 PM MD
Question 04/22/20 3:20 PM MD
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Question 04/22/20 3:21 PM MD
Question 04/22/20 3:21 PM MD
No. I think my exercising helps me avoid that.
What is your pain scale from 1 to 10
Right now. . . 6 out of 10.
What is the pain at its worst (Clarified to What would you rate your pain at its worst?.)
I’d say it’s as bad as it gets right now. . . about a 6 out of 10. (Clarified to how I would rate my pain at its worst.)
Is this all the time (No matching questions found.)
Is this constant pain (Clarified to Is your pain constant?.)
Yes. Certain things can make it a tiny bit better or a tiny bit worse, I suppose. But it’s always there. (Clarified to if the pain is constant.)
What makes it better
When I rest and try not to move much, I feel better. But the pain is still there.
Have you tried anything to help it
I’ve tried taking small sips of warm water, resting. The warm water does nothing. A friend suggested it, but it’s nonsense.
Are you taking any pain medication
I’m not taking anything for it.
Are you taking any laxatives (Clarified to Have you tried taking laxatives?.)
I haven’t tried laxatives. I don’t think they’re very good for you. [AUDIO COMING SOON] (Clarified to if I have tried taking laxatives.)
Thank you for explaining that.
Does eating make it worse (Clarified to Does eating anything make your pain worse?.)
Yes. The pain is there all the time, but eating can make it worse. (Clarified to if eating makes the pain worse.)
Is it worse when you’re walking around (Clarified to How are you getting around?.)
When I have to go somewhere that’s too far for me to walk, my daughter drives me. But usually, I get most places by walking. I usually like to do that whenever I can. (Clarified to how I am getting around.)
Question 04/22/20 3:22 PM MD
Question 04/22/20 3:23 PM MD
Question 04/22/20 3:23 PM MD
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Question 04/22/20 3:24 PM MD
Question 04/22/20 3:26 PM MD
Question 04/22/20 3:26 PM MD
Question 04/22/20 3:26 PM MD
Question 04/22/20 3:26 PM MD
Thank you for explaining that.
Does this interfere with your daily activities (Clarified to Has the pain affected your usual activities?.)
Well, I don’t feel unnaturally tired or weak. But I have experienced low energy, like I need to rest more often. (Clarified to if my pain has affected my activities.)
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Thank you.
Do you take naps (Clarified to Do you take vitamins or supplements?.)
No, I don’t take anything like that. (Clarified to if I take vitamins or supplements.)
Have you had any diarrhea
Yes, I did have a bout of diarrhea pretty recently. [AUDIO COMING SOON]
How often do you get diarrhea
I don’t have diarrhea often at all. . . the bout six months ago was the first time in a long while. [AUDIO COMING SOON]
When was your last diarrhea episode
That must have been six months ago. It lasted for a day. [AUDIO COMING SOON]
Do you have anything on your stool like mucus (No matching questions found.)
Do you have anything on your stool like blood or mucus (No matching questions found.)
Do you have bloody stools
No. I’ve never experienced that.
do you have mucus in your stool
No, I haven’t noticed anything like that.
Are you avoiding okay
No.
Do you have trouble peeing
No, no trouble.
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What color is your urine
Yellow and. . . maybe a bit darker than usual.
Do you have blood in your urine
No, it seems normal enough to me. Maybe a little darker than usual.
How much fluids are you taking Daily
Usually I drink, oh, two glasses of water a day. But it’s been difficult to drink much in the last few days. [AUDIO COMING SOON]
Thank you for explaining that.
Do you drink caffeinated drinks
No. I avoid caffeinated drinks altogether.
Do you drink soda
No, I never do.
What is your typical bowel movement routine
What has been happening with my. . . digestion. . . is new. I’m usually fairly regular, but I haven’t moved my bowels in about five days. [AUDIO COMING SOON]
What color is your stool
Brown. A normal shade of brown. Like. . . oh, I don’t know. Cardboard.
Is it soft or hard (No matching questions found.)
is your stool soft or hard
My stool? Usually it’s brown, not too hard. Solid. Not watery.
Are you allergic to any medication
No, not that I’m aware of.
Do you have any food allergies
No.
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Are you allergic to anything
I have an allergy to latex.
What happens with latex
I get an itchy skin rash.
Do you see the doctor regularly
Yes. I usually see Dr. Keller, here–at Shadowville Primary Care. But I was told she’s out today.
When was your last pap smear
A pap smear? I haven’t had one in years. Ten years, at least.
define your health today
I haven’t been feeling well lately.
Have you ever had a colonoscopy
I’ve had two colonoscopies. The last one was ten years ago.
What was your results (Clarified to What was the result of your colonoscopy?.)
They had nothing to report. [AUDIO COMING SOON] (Clarified to what the result of my colonoscopy was.)
What was your result for your last pap smear
A pap smear? I haven’t had one in years. Ten years, at least.
what is your result for your pap smear (Clarified to What was the result of your last smear test?.)
It was years ago, so I don’t remember anything about it. I’m sure it was fine. (Clarified to what the result of my last pap smear was.)
Have you ever had any sexual transmitted infections (Clarified to Do you have a history of STD?.)
No, I’ve never had anything… like that. (Clarified to if I have had an STD.)
Are you still sexually active
I have a gentleman friend and, yes… We are intimate.
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Does it burn or hurt with urination (Clarified to Do you feel burning when you urinate?.)
No, my urination has felt normal. (Clarified to if it burns when I urinate.)
Thank you for explaining that.
do you take any blood pressure medications
Yes.
Have you had trouble with your blood pressure lately
Yes, I have been diagnosed with high blood pressure. But I take very good care of that.
Thank you for explaining that.
Have you had any surgeries
I’ve had two operations, both many years ago.
What was the reason for your surgery (Clarified to What type of surgery did you have?.)
I’ve had two. I had my gallbladder out, and I had a C-section. Both in my early 40s. (Clarified to what surgery I had.)
Have you been hospitalized before
Yes. I had a couple surgeries years ago. And of course I stayed in the hospital briefly when Jennifer and Timothy were born.
Are you taking any over-the-counter medication
No. Those over-the-counter medicines. . . Tylenol–they say it’s very bad for the stomach.
Difficult with daily activities (Clarified to Have you required assistance in performing daily activities?.)
Usually I don’t need much help. But since I’ve been sick, my daughter has been helping me, doing things around the house–gardening, cleaning, making sure I eat a little something. She’s very busy with her job, and it’s very sweet of her to help me. (Clarified to if I have needed help with daily activities.)
Are you able to dress yourself
No — I had to miss my exercise classes this week — I didn’t have the energy for them. That’s unusual for me.
Do you need help eating
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I don’t need any help right now. Thank you.
Do you have difficult walking (Clarified to Is it hard for me to walk?.)
I can walk just fine. (Clarified to if it is hard for me to walk.)
Do you need help bathing
No, I can do that myself.
Are you able to get in and out of a chair
Any kind of movement makes my abdominal discomfort worse, but I don’t usually have problems with that.
Tell me about your diet (Clarified to What is your diet like?.)
I usually eat low fat foods, healthy proteins. . . on holidays our family gets together, so I make traditional dishes then. Korean dishes. But usually I eat very light. (Clarified to what my diet is like.)
Do you eat three meals a day
Usually three, but sometimes I skip breakfast. I don’t eat snacks.
What are you eating habits (Clarified to What are your eating habits?.)
Hm. Toast for breakfast. For lunch. . . usually soup. But I don’t always have lunch. And for dinner I eat fish, or sometimes chicken, and rice. [AUDIO COMING SOON] (Clarified to what my eating habits are.)
Thank you for explaining that.
Have you had any change in weight
No, not that I’ve noticed.
Have you had any fever or chills
No, I haven’t been feverish or chilly. [AUDIO COMING SOON]
Have you had night sweats
No. That is not a problem for me.
so you see swelling in your extremities or face
