NSG 516 Gastrointestinal Shadow Health 4 Complete Solution
Advanced Health Assessment - Spring 2019, NSG516 Online
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Experience
... [Show More] Overview
Patient: Tina Jones
Digital Clinical Experience Score
99.3%
Student Performance Index
49 out of 52
Proficiency Level: Proficient
Beginning Developing Proficient
Students rated as “proficient” demonstrate an entrylevel expertise in advanced practice competencies and
clinical reasoning skills. In comparable programs, the
top 25% of students perform at the level of a proficient
practitioner.
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 84.0%. This
score may not be your final grade if your instructor
Subjective Data
Collection
30 out of 30
Education and Empathy
2 out of 4
Objective Data Collection
17 out of 18
chooses to include additional components, such as
documentation or time spent. Time
67 minutes total spent in assignment
Interaction with patient
59 minutes
Post-exam activities
8 minutes
Education & Empathy : 2 of 4 (50.0%)
Overview
Transcript
Subjective Data Collection
Objective Data Collection
Education & Empathy
Documentation
Self-Reflection
Student Survey
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 the symptoms that have been bothering her.
What brings you in? Question
09:51 AM EST
I've been having this stomach pain for awhile. It keeps coming back, and it
really is starting to bother me.
Sorry to hear you are having trouble with stomach pain. Let;s see if we can
figure out what the problem is.
Empathize
09:52 AM EST
Thanks for saying that.
When did the stomach pain start? Question
09:52 AM EST
Probably at least a month ago. Maybe longer. It started out really minor so it
took me awhile to realize it was getting bad.
Can you describe the stomach pain? Question
09:52 AM EST
Um, it feels like heartburn. But sometimes, if it's bad, it's sharper than that.
Does anything make the pain worse? Question
09:52 AM EST
Eating seems to cause it.
Oh, what a burden! Hopefully you are not experiencing it all the time! Empathize
09:53 AM EST
I appreciate you telling me that.
Does the stomach pain radiate? Question
09:55 AM EST
No, it's right in the center of my stomach, like between my belly button and
my ribs.
How often do you get stomach pain? Question
09:55 AM EST
It started really gradually, so I didn't notice for awhile that it was happening
more and more often. Now it's like, every day.
It must be hard to have to deal with stomach pains daily. Empathize
09:55 AM EST
I appreciate you saying that.
How long does the pain last? Question
09:55 AM EST
For a few hours after I eat.
How would you rate the stomach pain from 0-10? Question
09:56 AM EST
Right now, it's like a 1 or 2. But after I eat, it's like a. . . 5?
How long does the stomach pain last? Question
09:56 AM EST
For a few hours after I eat.
A daily pain of 5/10 is a lot to deal with. Empathize
09:56 AM EST
Thanks for understanding.
Does the pain interfere with your life? (Clarified to: Has the pain affected your
usual activities?)
Not too much. I'm still able to do everything with work and school. But it
affects the way I eat -- I haven't wanted to eat much, because I feel like it's
gonna hurt if I eat the wrong thing, or if I eat too much at one time. (Clarified
Question
09:57 AM EST
y pain has affected my activities)
What foods make it worse? Question
09:59 AM EST
Definitely spicy food. I stopped eating anything spicy. And any really big meal
makes it hurt worse.
How does the stomach pain affect your appetite? Question
09:59 AM EST
Yes. Every time I eat it hurts. I've been eating less because I don't like being
in pain.
I am surprised you havent lost more weight. Lets come up with a plan to
address it
Thanks for saying that.
Empathize
10:00 AM EST
Has the stomach pain caused weight loss? Question
10:00 AM EST
Yeah, I've been trying to eat really little meals. I haven't been that hungry, and
I don't want to have the pain of eating a big meal.
I completely understand. Empathize
10:01 AM EST
Thanks for understanding.
Eating smaller meals and making some diet modifications can help with
these symptoms.
That makes sense.
Educate
10:01 AM EST
Have your dietary patterns changed? Question
10:12 AM EST
Yeah, I've been trying to eat really little meals. I haven't been that hungry, and
I don't want to have the pain of eating a big meal.
Sometimes, sitting up after meals and avoiding to eat about 2-3 hours prior
to going to bed can be very helpful with these symptoms.
Sure, I think I understand what you mean.
Educate
10:13 AM EST
This morning, I had breakfast at home.
Model Statement: "I’m sorry to hear you’re having stomach pain. I’m glad
you came in to see me. Stomach pain can be caused by several different
things, so I will ask you questions and we’ll see if we can determine what’s
causing yours."
2 Medications Followed Up
Description: Tina describes her medication regimen, including antacids
for her stomach pain.
What makes the stomach pain better? Question
09:53 AM EST
I feel the best in-between meals. And sitting up on the couch seems to help.
And sometimes I take an antacid.
How often do you take antacids? Question
09:54 AM EST
I take them every few days. Just if the heartburn gets bad.
How much do antacids help? Question
09:54 AM EST
Yeah, they help. I try to only take them when the pain seems worse than
usual.
I am glad to hear you are able to get some relief from the antacids Empathize
09:54 AM EST
Thanks.
Model Statement: "Thank you for letting me know that you’re using
antacids in addition to the medications you usually take. I will ask you a few
questions about how you’re using each medication."
3 Diet Not Followed Up
Description: Tina’s diet contains high levels of carbohydrates, which is
not recommended for a person with diabetes.
When was your last meal? Question
10:09 AM EST
What did you eat for breakfast? Question
10:09 AM EST
This morning, I had toast with butter and honey, and some orange juice.
Did your breakfast cause pain? Question
10:10 AM EST
What did you eat in the last 24 hours? Question
10:10 AM EST
Um ...Yesterday, I had ... Let me start at breakfast. I had a bowl of cereal. For
lunch ... I had a piece of pizza. For dinner, I made baked potatoes with
broccoli and cheese soup. This morning I had toast with butter and honey,
and some orange juice, and that's the last thing I've had.
What is your typical diet like? Question
10:10 AM EST
It's pretty good, I think. I'm not a huge health nut or anything.
What do you usually eat for breakfast? Question
10:11 AM EST
I usually have either cereal or toast, or if I pick something up on my way to
work, I'll get a muffin or some pumpkin bread.
What do you usually eat for lunch? Question
10:11 AM EST
I usually either make a sandwich and bring it with me, or I get a sandwich
somewhere. And I have chips or pretzels with it. Or *maybe* French fries, but
I try not to get them too often.
WHat do you usually eat for dinner? Question
10:11 AM EST
Oh, we try to make something easy. We eat a lot of frozen chicken breasts.
We do hamburgers that we make at home every so often. We make sure we
have a vegetable, and we eat a lot of potatoes. And we usually have rolls or
something.
What do you usually eat for snacks? Question
10:11 AM EST
Well, if I'm at home, I would have pretzels or chips. Or crackers, whatever we
had around. If I'm on my way to work or campus... sometimes I stop and get
l thing of French fries at Sonic.
What do you like to drink? Question
10:11 AM EST
Model Statement: "It sounds like you’re eating quite a few carbohydrates,
which can be unhealthy for people with diabetes. Carbohydrates are found in
things like pizza crust, potatoes, bread, and juice. Let’s talk about eating
foods with fewer carbohydrates."
4 Soda Intake Not Followed Up
Description: Tina drinks Diet Coke every day, which is acidic and could
irritate her symptoms.
What do you like to drink? Question
10:11 AM EST
Most of the time I just drink Diet Cokes.
Do you drink water? Question
10:11 AM EST
Yeah, I've been drinking tons of water lately.
Do you drink coffee? Question
10:12 AM EST
No, I never drink it.
Model Statement: "Some forms of stomach pain can be irritated by
acidic drinks or foods. Drinking less soda and more water could relieve some
of your stomach pain."
Comments
If your instructor provides individual feedback on this assignment, it will appear here.
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