Have you noticed any side effects from the metformin? Grand Canyon University Walden University (83) In this guide, we will outline the steps involved in completing a SHCAP, as well as provide 50 Shadow Health Comprehensive Assessment examples that you can use to practice and improve your skills. faster than usual. Ive maybe used it twice since I came in with those asthma problems. Asking Tina why she started taking birth control will allow Tina to express any concerns or problems in her own words. There are three levels: Beginning, Developing, and Proficient. Description: Tina describes problems sleeping and stress-symptoms like racing thoughts. specific changes in her diet recently, but notes that she has not b meat and vegetable, snacks are French fries or pretzels. click here for Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions Grand Canyon University University of Massachusetts Lowell Once three months ago, and before that it had been months, too. in the morning on her commute to class. Everything's an Argument with 2016 MLA Update University Andrea A Lunsford, University John J Ruszkiewicz. Tina denies smoking and states she seldomly drinks. In the Comprehensive Assessment, you earn points by performing the physical assessments. She started me on birth control, and it seems to be helping things. What is your relationship like with your family? I can give you some more information, on what a balanced diet looks like for someone with, diabetes. Terms of Use This includes an assessment of past medical history, including any symptoms that may indicate an illness or disease. How often do you monitor your blood glucose? The opportunities listed below are, those identified by nursing experts to be of particular importance to this patient. She is well-nourished, well-developed, and dressed appropriately with good hygiene. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation, Scattered pustules on face and facial hair on upper lip, Right eye: equal hair distribution on lashes and eyebrows, lids without lesions, no ptosis or edema, Left eye: equal hair distribution on lashes and eyebrows, lids without lesions, no ptosis or edema, Thyroid smooth without nodules, no goiter, Upper eyelids: conjunctiva pink, no lesions, white sclera, Lower eyelids: conjunctiva pink, no lesions, white sclera, Right pupil: equal, round, reactive to light, Left pupil: equal, round, reactive to light, Peripheral vision intact in both eyes, all fields, Inspected interior eyes with ophthalmoscope, Left fundus with sharp disc margins, no hemorrhages, Right upper quadrant: no masses, guarding or rebound, Right lower quadrant: no masses, guarding or rebound, Left upper quadrant: no masses, guarding or rebound, Left lower quadrant: no masses, guarding or rebound, Liver: palpable 1 cm below right costal margin, Neck without swelling, masses, or deformity, Right shoulder without swelling, masses, or deformity, Right arm without swelling, masses, or deformity, Right elbow without swelling, masses, or deformity, Right wrist and hand without swelling, masses, or deformity, Left shoulder without swelling, masses, or deformity, Left arm without swelling, masses, or deformity, Left elbow without swelling, masses, or deformity, Left wrist and hand without swelling, masses, or deformity, Fingernails: no ridges or abnormalities in nails, pink nailbeds, Hips without swelling, masses, or deformity, Right leg without swelling, masses, or deformity, Right knee without swelling, masses, or deformity, Right ankle without swelling, masses, deformity, or discoloration, Right foot without swelling, masses, or deformity, Left leg without swelling, masses, or deformity, Left knee without swelling, masses, or deformity, Left ankle without swelling, masses, or deformity, Left foot without swelling, masses, or deformity, Toenails: no ridges or abnormalities in nails, pink nailbeds, 128/82 mm Hg (97.3 MAP) HR 78 SpO2 99% RR 15 Temperature 37.2 c Weight 84 kgs, Height: 170 cm Weight: 84 kg BMI: 29.0 Blood Glucose: 100 RR: 15 HR: 78 BP:128 / 82 Pulse Ox: 99% Temperature: 99.0 F, The patient is a 28-year-old female who presented for a pre-employment physical exam. 10:25 PM EDT. Heart rate is is regular and normal. examples of picot questions (12) Nursing Essay Examples (82) since I was really little. Diagnosed with PCOS four months ago. Your document will be more comprehensive and organized. Do you have any problem with your breasts? Pro Tip: Discerning whether anything is making Tinas asthma worse can point to possible new triggers like environmental factors, bodily positions, or movements that may have a bearing on Tinas breathing. With our premium writing service, you no longer have to spend days and nights meticulously working on your assignment, instead use that time to do other important things. She denies use of tobacco, alcohol, a Pro Tip: Assessing range of motion of each major joint noting any limitations in mobility, pain, or crepitation can identify joint disease or injury. Pro Tip: Initially establishing a chief complaint allows the patient to express their reason for seeking care, primary concerns, or condition they are presenting with. Nursing Theory list (41) Some of these items may not appear depending on the assignment and the options set by your instructor. - Shadow Health Support Center How is Education & Empathy scored? Additionally, Tina needs education in regards to her risks related to Does your dads father have health issues? regulations. A Model Statement is provided as an example of an The first number represents the amount of points you earned. what do you usually do before bed Cardiac: Denies a diagnosis of hypertension, but states that she Nursingstudy.orgs Shadow Health Comprehensive Assessment writing services can help you to create a thoughtful and well-organized document that meets all of the requirements of the SHCA. You must follow up within two interactions in order to receive the points. There are three possible statuses Not Encountered, Not Followed Up, and Followed Up. Most people, with diabetes feel better when they limit all. Ms. Jones is a pleasant, 28-year-old African American single woman who presents for a pre-employment physical. Conduct a comprehensive review of systems to rule out any possible organ dysfunction or disease. Nursingstudy.org helps students cope with college assignments and write papers on a wide range of topics. not stressed at all. Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. Reports needing a pre-employment physical, Asked about last visit to a healthcare provider, Last visit to a healthcare provider was 4 months ago, Reason for last visit was annual gynecological exam, Last general physical examination was 5 months ago when she was prescribed metformin and daily inhaler, Asked about current prescription medications, Reports taking prescription birth control pills, Reports that eating probiotic yogurt helps with side effects and they have abated over time, Followed up on metformin frequency and dose, Reports using Flovent inhaler twice daily, Last use of Proventil inhaler was three months ago, Has used Proventil inhaler twice in the last year, Followed up about birth control prescription, Started taking birth control 4 months ago, Reason for birth control was to manage PCOS symptoms, Birth control type is Yaz (drospirenone and ethinyl estradiol), Takes birth control pill at the same time every day, Asked about current non-prescription medications, Reports no recent seasonal allergy symptoms, Reports no current medication for allergies, Reports managing diabetes with diet and exercise in addition to medication. Things are pretty good between all of uswere a tight knit family. No EKG chanes. Asking Tina if she still has her inhaler will indicate her treatment plan and the degree to which she is following it. This button will Reopen your attempt. Why did you decide to start taking birth control? Pro Tip: Skin changes are common in patients with uncontrolled diabetes. Well, Im starting my new job in two weeks, and Im really excited about that. Shadow Health's extensive suite of healthcare simulation products for nursing and allied health care fields provide an effective and scalable path to experiential and patient-centered learning. Some of these items may not appear depending on the assignment and the options set by your instructor. I r, learn more about what you are experiencing, and I will try to help, Let me learn more about what youre experiencing, and I will try to help. Subjective Data Collection: 50 of 50 (100.0%), Objective Data Collection: 70 of 73 (95.9%), Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation, Nursing Capstone Project Writing Services, Nursing Annotated Bibliography by Professional, Online Nursing Research Paper writing service. Ive realized that I got kind of overwhelmed with everything back when I was having those sleep problems. Yeah. The Exam Time is time spent asking questions, performing actions, and documenting in the exam room. Under the grading explanation, you will see a list of Relevant Diagnoses and how many points you earned for that diagnosis. Confirming the name of Tinas birth control pill will solicit information about her health history and current treatment plan. For the past four months (after initiating Yaz) cycles regular (every 4 weeks) with moderate bleeding lasting 5 days. In determining the cause of the back pain, based on your knowledge of, A 42-year-old male reports pain in his lower back for the past month. We will write your work from scratch and ensure it's plagiarism-free, you just submit the completed work. Ive been feeling much better lately, though. Sure, I think I understand what you mean. Please I need help with shadow health assessment week 9 with Tina . Additionally, you will see an example question that would unlock the finding. EKG with (Clarified to: Do you control your diabetes through, Yeah, I stay away from sugar and watch what I eat, in general. how do you feel when youre stressed (Clarified to Does your younger sister have health problems?. Are you looking for someone to help with shadow health assignments? Pro Tip: Asthma exacerbation can result in increased wheezing, shortness of breath, and chest tightness. Shadow Health Comprehensive Assessment Guide | Help, A Guide to the Shadow Health Comprehensive Assessment Process Nursing Study. The pain sometimes radiates to his left leg. At the top of this section, you will see a key as to how each item was graded. 10:22 PM EDT. Popular books. I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler. Decreased sensation to monofilament in bilateral plantar surfaces. Asking Tina if she takes supplements will indicate her current treatment plan. know her normal heart rate or her heart rate during these episode I am glad you came in. NURS 362 COMPREHENSIVE ASSESSMENT PAPER FINAL DRAFT.docx. presented to the clinic with complaints of 3-4 episodes of rapid he Exam (elaborations) - Focused exam: hypertension and type 2 diabetes - week 10 results | turned in advanced. I think she had high blood pressure and cholesterol, too. She monitors her blood sugar once daily in the morning with average readings being around 90. I just always want to be learning new things and getting better at my job. work and school. . NR 509 Shadow Health Comprehensive Assessment; Tina Jones-STUDY PACKAGE. She describes t SOAP Note (14) were followed up by students, and include the dialogue between student and patient 1 Expression of pain Followed UpFollowed Up 2 Impact of injury on daily life Followed UpFollowed Up 3 Gaps in health literacy around diabetic diet Not Followed UpNot Followed Up 4 Lack of treatment with diabetes medication Not Followed UpNot Followed Up 5 Lack of ABI is 0. We socialize before and after church, and I go to Bible study on Wednesdays, too. This button will not appear after the due date of an assignment, or if your instructor has set the assignment so that only the first attempt is marked as turned in.