Shadow Health Respiratory Assessment Transcript

Shadow Health Respiratory Assessment Transcript and Answers

Shadow health respiratory assessment transcript Pre-Brief

Shadow Health Respiratory Assessment Transcript

Tina had an asthma episode 2 days ago. At that time, she used her albuterol inhaler and her symptoms decreased although they did not completely resolve. Since that incident she notes that she has had ten episodes of wheezing and has shortness of breath approximately every four hours. Tina presents with continued shortness of breath and wheezing. Be sure to ask pertinent questions during the interview about related body systems. This case study will provide the opportunity to carefully assess lung sounds during the physical examination. Be sure to appropriately document your findings using correct medical terminology.

Reason for visit: Patient presents complaining of a recent asthma episode that is not fully resolved.

shadow health respiratory assessment answers

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Hello my name sara an FNP student and I will be interviewing you today.
Hey.
Can you please state your name for me?
Tina Jones.
Your date of birth?
February 17th.shadow health respiratory assessment answers
Year of birth please? (Clarified to What year were you born.)
I was born in . . . [Ms. Jones reports correct birth year.] [AUDIO
COMING SOON]

How old are you ms. Jones? (Clarified to how old are you.)
I’m 28.
What brings you in today?
I came in because I’ve been having breathing problems, and my
inhaler just isn’t working the way it normally does.
Why did you XXX
I XXX normally does.

I’m XXX.
XXX  that. Shadow health respiratory assessment transcript.
What XXX?
Well. . . I’ve hadxxxx since I was really little, though for a while
there it wasn’t really much of a problem. And I have xxxx,
too.
What XXX?
It’s XXX.

How XXX?
I’ve XXX.
XXX start?
I don’t know if I’d call it an asthma attack, but XXX house. She has cats, and I’m
allergic, so I’m used to it being a problem there, but usually the
inhaler fixes it. . . it doesn’t feel totally under control, though.
I’m sorry you’re having difficulty with your breathing problems.
Thanks.
How XXX  problems?
My breathing’s been acting up off and on for the past two days.
How XXX?

Maybe XXX? It’s a lot.
And how XXX? (Clarified to
how long does an episode last.)
I haven’t had a XXX normal. .
. that’s not what’s been happening recently, though.
How xxxx?
I haven’t had a xxx, but usually once I use xxx
it only takes a minute or two for my xxxck to normal. .
. that’s not what’s been happening recently, though.
How manyxxxx

Well. . . it’s kind of hard to count because my breathing’s been at
least a little bad most of the past two days, but it’s really acted up,
like with wheezing and everything, probably every four hours or so–
like five times each day.
Is your     ?
My
How     xxx.)
My asthma used to be really scary. I haven’t had a full attack in
years, and if you had asked me before this I would have said my
asthma wasn’t that bad anymore, but the last couple days I’ve had a
lot of trouble breathing Shadow Health Respiratory Assessment Transcript
How xxx?
My asthma used to be really scary. I haven’t had a full attack in
years, and if you had asked me before this I would have said my
asthma wasn’t that bad anymore, but the last couple days I’ve had a
lot of trouble breathing.
Is there xxx?
There usually xxxx. . . I
guess I try to avoid things that make my breathing worse, but that’s
about it. The past couple days, though, it’s been hard to do anything.
Do you wheeze during an asthma exacerbation?
During a full attack, I would wheeze a lot, like I couldn’t breathe at all,
but until the past couple days, I would usually just wheeze a little
when I had breathing problems.
Are you having any chest tightness? Shadow health respiratory assessment transcript.
It’s not so bad right this second, but it’s been pretty tight lately, like I
can’t take in air.
Have you xxx?
I’ve been xxxxa lot, yeah.
How long have you had the xxxx?
Since my asthma acted up two days ago.
How would you describe the xxx?
Um. . . I guess I’d describe it asxxx.
What makes your xxxbetter?
Drinking some water helps a little, as long as the water isn’t too cold.
Have you tried txxx your xxx?
I haven’txxx.
Is your xxx?
It has been the past cxxx, yeah.

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Does lxxx worse?
Just recently lying on my back has definitely made my breathing
worse.
To try to help your breathing you may want to elevate your head with
two pillows.
OK, I understand.
Inspected anterior chest wall
Inspected anterior chest wall
Inspected left side chest wall
Inspected anterior chest wall
Inspected right side chest wall
Inspected anterior chest wall
Palpated chest expansion: Both sides rise symmetrically
Palpated fremitus in anterior upper chest wall: Equal bilaterally,
expected vibration
Ninety-nine.
Palpated fremitus in anterior lower chest wall: Equal bilaterally,
expected vibration
Ninety-nine.
Palpated fremitus in posterior upper chest wall: Equal bilaterally,
expected vibration
Ninety-nine.
Palpated fremitus in posterior middle chest wall: Equal bilaterally,
expected vibration
Ninety-nine.
Palpated fremitus in posterior lower chest wall: Equal bilaterally,
expected vibration
Ninety-nine.
Percussed anterior left upper lobe
Percussed anterior right upper lobe
Percussed anterior left mid-chest (upper lobe)
Percussed anterior right middle lobe
Percussed anterior left lower lobe
Percussed anterior right lower lobe
Percussed posterior right upper lobe
Percussed posterior left upper lobe
Percussed posterior right mid-back (lower lobe)
Percussed posterior left mid-back (lower lobe)
Percussed posterior right lower lobe
Percussed posterior left lower lobe. Shadow health respiratory assessment transcript.
Percussed posterior left lower lobe on side
Percussed posterior left lower lobe near spine
Percussed posterior right lower lobe near spine
Percussed posterior right lower lobe on side
Auscultated breath sounds in anterior left upper lobe
Auscultated breath sounds in anterior right upper lobe
Auscultated breath sounds in anterior right middle lobe
Auscultated breath sounds in anterior left mid-chest (upper lobe)
Auscultated breath sounds in anterior left lower lobe
Auscultated breath sounds in anterior right lower lobe
Auscultated breath sounds in posterior right upper lobe
Auscultated breath sounds in posterior left upper lobe
Auscultated breath sounds in posterior left mid-back (lower lobe)
Auscultated breath sounds in posterior right mid-back (lower lobe)
Auscultated breath sounds in posterior right lower lobe
Auscultated breath sounds in posterior left lower lobe
Auscultated breath sounds in posterior left lower lobe on side
Auscultated breath sounds in posterior left lower lobe near spine
Auscultated breath sounds in posterior right lower lobe near spine
Auscultated breath sounds in posterior right lower lobe on side
Auscultated voice sounds in anterior left upper lobe
Ninety-nine.
Ninety-nine.
Auscultated voice sounds in anterior right upper lobe
Ninety-nine.
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Ninety-nine.
Ninety-nine.
Auscultated voice sounds in anterior left upper lobe
Auscultated voice sounds in anterior left mid-chest (upper lobe)
Ninety-nine.
Auscultated xxx
Auscultated xxxx
Ninety-nine.
Auscultated voice sounds in anterior left lower lobe
Ninety-nine.
Ninety-nine.
Ninety-nine.
Auscultated xxxx
Ninety-nine.
Auscultated voice sounds in posterior left upper lobe
Shadow health respiratory assessment transcript
Ninety-nine.
Auscultated voice sounds in posterior right mid-back (lower lobe)
Ninety-nine.
Auscultated voice sounds in posterior left mid-back (lower lobe)
Ninety-nine.
Auscultated voice sounds in posterior right lower lobe
Ninety-nine.
Auscultated voice sounds in posterior left lower lobe
Ninety-nine.
Auscultated voice sounds in posterior left lower lobe on side
Ninety-nine.
Auscultated voice sounds in posterior left lower lobe near spine
Ninety-nine.
Auscultated voice sounds in posterior right lower lobe near spine
Ninety-nine.
Shadow health respiratory assessment transcript
Auscultated voice sounds in posterior right lower lobe on side
Ninety-nine.
Checked pulse xxx
Check pulse xx
Checked xxxx
Checked xxx
Always make sure yourxxxx
Sure, I think I understand what you mean.
Make sure to read all instructions and store as indicated (No
matching questions found.)
Make sure to read all instructions and store as indicated
Alright, thanks for letting me know.
Always shake well before using.
Thanks for telling me.
Also after every complete use you should always rinse out your
mouth with water.
Shadow health respiratory assessment transcript.
That makes sense. shadow health respiratory assessment answers
What medications do you take?
My xxx is the only prescription I always have, but I usually don’t
need it everyday, except for recently. . .
When did you last use your xxx?
I had to use it early this morning.
How is your xxx prescribed?
Yes.
How often is your xxx?
Yes.
How many times have you use xxx?
I’ve been needing my xxx about every four hours, I’d say.
How many xxxx 4 hours? (Clarified to how xxxx are you prescribed.)
I’m supposed to just do twoxxx [Nurse confirmed with Pharmacy:
xxx]
How many xxx are you doing?
I’m supposed to just do xxx. [Nurse confirmed with Pharmacy:
xxx]

Make sure to follow thexxx instructions as prescribed
Thanks for telling me.
Are you taking any other medications?
No, all I really use is xxx.
You take any over-the-counter medications?
I take xxx, but not
often.
How much xxxdo you take?
I just take a couple. I usually get them at night from reading–
squinting I guess–and so I take one and go to bed. [Nurse confirmed
with Pharmacyxxx ]
How much xxx do you take for cramps?
I take three at a time. And I’d bet I take it up to three times a day.
[Nurse confirmed with Pharmacy: xxx]
Do you have xxxx?
Yeah, I’mxxx.
Do you have axxx?
No, not that I know of.
When didxxx

This all started at my cousin’s house. Shexxxxalways goes crazy when I’m there.
Does being around dust trigger asthma?
Yeah, being around a lot of dust, especially hanging out in a really
dusty house, can make my asthma act up.
Sorry to hear that about your asthma
Thanks for understanding.
Does cxxxa?
Only when I’m in a rush and have to hurry up them.
Do you have xxxx? (Clarified to do you have
seasonal allergies.)
A little while ago, I had some seasonal allergies, but it didn’t really
bother my asthma, and it’s better now.
Does xxxe? shadow health respiratory assessment answers
Well. . . sometimes when txxx often.
Do you xxx?
I used to go to Dr. Dewitt, but she moved her practice recently.
Luckily she’s still been able to call in refills of my inhaler, but I haven’t
actually been in to see her in about two years.

Since you have asthma it is important to follow up on a regular basis
with your asthma specialist
Alright, thanks for letting me know.
How xxx?
I’ve had xxxle.
How xxxx?
My xxx.
Have you everxxx?
I xxx?
I used to go to thexxxt not since I
was sixteen.
Have yoxxx?
You mean like, did they ever have to put me on a breathing machine?
No, I haven’t had an asthma attack that serious.
Do you use a xxx?
Not really. . .
Do you cxxx?

I’ve heard of that, but no, I don’t do it.
Do you use xxx
No, but I have before.
We may cxxx
That makes sense.
Also a way to track your asthma symptoms and episodes. (No
matching questions found.)
Also a way to track your     s and episodes.
OK, I understand.

Sending you home with a peak flow meter and document regularly.
I’ve heard of that, but no, I don’t do it.
We will also teach you how to use nebulizer at home.
Sure, I think I understand what you mean.
How often do you change your sheets?
I change my bedding once a week, I’d say.
5/11/2018 Respiratory | Completed | Shadow Health
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Do you have pets at home?
No. . . I’m too busy to take care of a dog, and I can’t have cats
because of my allergies.
Does    ?
No, nobody at home    .
If exposed to secondhand smoke it is definitely a Asthma trigger.
Alright, thanks for letting me know.
Have you ever had eczema?
No, I don’t have that kind of skin problem.
history of sinus problems? (Clarified to do you have a history of sinus
problems?.)
I don’t really have a problem with my sinuses.
Do you have xxx?
I don’t know what that is, so I guess probably not?
Have you ever been   xxx
Have you xxx?

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Shadow health respiratory assessment transcript
No, I’ve never done that. I think it’s gross.
I’m glad you think that
Thanks for understanding.
Smoking is a known trigger for asthma
OK, I understand.
Have you xxx
Well, I used to xx. . . but I don’t do that anymore.
When was the xxx?
I haven’t sxxx.
Have you ever experimented with xxxx?
No, no way. That’s a nasty thing to do.
Have you been sick recently?
No, I’m usually healthy.
Have you had any xxx?
No, I haven’t had a xxx.
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Have you had any nausea or vomiting?
I haven’t had thrown up, or even had an upset stomach, in a long
time.
Have you had chills?
No, I haven’t.
Are you fatigued?
I feel tired, yeah, probably because I haven’t been able to sleep very
well.
Do you have any xx?
I don’t getxxx, but sometimes I wake up hot and have to kick off
my xxx.
Sometimexxxybe an indication of being sick
That makes sense.
Have you been cxxx anything?
No, nothing’s coming up.
Have you had any problemsxxx?
Nope.
Do you have any nasal drainage?
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No, my nose has been fine.
Has anyone been sick at home?
No, no one at home has been sick.
Does anyone in your family have asthma?
It’s just me and my baby sister that have asthma, but she really
doesn’t have problems with it.
Does anyone in your family have allergies?
My sister has hay fever, I think, and it sometimes makes her asthma
get pretty bad.
Does anyone in your family have eczema?
No. . .
Do you have a family history of sinus problems?
I don’t think anyone in the family has sinus problems.
Are you in any pain right now?
It doesn’t hurt. . . it’s just hard to breathe, but there’s no pain.
Is there pain when you wheeze? (No matching questions found.)
are you in pain when you wheeze?
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Right now it doesn’t sound too bad, but I’ve definitely been
wheezing the past couple days.
Any changes in your appetite?
I wouldn’t say it’s changed recently, but I do feel hungry a lot.
When was your last chest x-ray?
The last time I went to the hospital for an asthma attack, when I was
still in high school, they did a chest x-ray.
Comments
If your instructor provides individual feedback on this assignment, it will appear here.

APPROACH

Overview
Transcript
| Subjective Data Collection
| Objective Data Collection
| Education & Empathy
| Documentation / Electronic Health Record
| Student Pre-Survey
| Lifespan Activity
| Review Questions
| Self-Reflection Activity

SAMPLE Shadow Health Respiratory Assessment

Model Documentation

Subjective

Social History: She is not aware of any environmental exposures or irritants at her job or home……

Review of Systems:

  • General: Denies changes in…
  • Nose/Sinuses:
  • Gastrointestinal:
  • Respiratory:

Objective                   

  • General: Ms. Jones is a pleasant….
  • Respiratory: Chest expansion is….

Assessment                

  • Mild-persistent….

Plan

Diagnostics

  • Obtain office….

Education

  • Encourage Ms. Jones to continue t….

Referral/Consultation

  • Refer to…..

 Follow-up Planning

  • Order ….
  • Instruct Ms. Jones …..
  • Revisit….
  1. Tina’s second cousin was diagnosed with asthma at age 5. What would be included in your treatment plan? What factors might concern you related to compliance?

The treatment plan for this child would be to….

  1. Consider that Tina’s uncle is now 68 years old and has smoked heavily every day since he was fifteen. What would you expect to find in his respiratory assessment? How would this affect your oxygenation goals for this patient?

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Common significant deviations of the chest for older adults include xxxx (Hogstel & Curry, 2005). xxxx become thinner, more rigid, and change shape, and muscles may become weakened. This results in a lower oxygen level with less carbon dioxide removed from the body, and decreased ability to cough. xxxx causes decreased xxx height. xxx also causes thexxxto lose their shape causing shortness of xxx. Due to diminishedxxxwith decreased sensitivity, large amounts of particles that are more difficult to expectorate can collect in the xxx. In addition, the xxxx is less sensitive to xxxx and xxx and higher residual volume. As a result of these changes, xxx are at increased risk for xxxx and xxxx (Minaker, 2011; Sharma & Goodwin, 2006). Shadow health respiratory assessment transcript.

In the respiratory assessment of this patient, I expect to find xxx, increased xxxx of the xxx, diminished chest expansion, and xxxx. The weakened muscles will result in xxx  levels and lower xxxx leading to decreased xxxx capacity. xxx will also will also lose their shape leading toxxx. Therefore, x goals will hxave to take in cognizance these realities and advise the patient accordingly. Consequently, efforts to increase exercise tolerance, treat complication, and relieve symptoms will be initiated.

  1. If Tina had mentioned that she was just diagnosed with pneumonia, what would you have expected to find during percussion?
  2. If the results of Tina’s pulse oximetry had been 97%, which of the following would have been true?
  3. Suppose that, during your lung exam on Tina, you had heard bronchial breath sounds in the left lower lung posteriorly. What would you have suspected based on this finding?
  4. Suppose that while auscultating, you assessed a few scattered expiratory wheezes. Why would this be an expected finding for a patient with Tina’s history
  5. When you observe a patient like Tina throughout an exam, there are many ways to determine whether a patient is experiencing respiratory distress. Identify one indicator of respiratory distress that can be assessed through observation alone.

 

  1. Describe how you would assess Tina for dyspnea

Dyspnea can be assessed both……

  1. Explicitly describe the tasks you undertook to complete this exam.

The examination…..

  1. Explain the clinical reasoning behind your decisions and tasks.
  2. Identify how your performance could be improved and how you can apply “lessons learned” within the assignment to your professional practice Shadow health respiratory assessment transcript.

My performance could be improved by seeking more history from the patient…..

Pre-brief

Obtaining an accurate history is the critical first step in determining the etiology of a patient’s problem. A large percentage of the time, you will actually be able to make a diagnosis based on the history alone. The value of the history, of course, will depend on your ability to elicit relevant information. Your sense of what constitutes important data will grow exponentially as you practice your interviewing skills and through increased exposure to patients and illness…………………… Interviewing patients is an art and should remain an essential skill for successful practice.

In this activity, you will interview Tina Jones to collect data to assess Ms. Jones’ condition. You will also have the opportunity to educate and empathize with Tina to engage in effective therapeutic communication; create a problem listusing evidence from the data you collected; prioritize the identified problems to differentiate immediate from non-immediate care; plan how to best address the most important concern with further assessment, interventions, and patient education; and compare your documentation to model documentation.

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Ms. Jones is a pleasant, 28-year-old obese African American single woman who presents to establish care and with a recent right foot injury. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Her speech is clear and coherent and she maintains eye contact throughout the interview.

Reason for visit: Patient presents for an initial primary care visit today complaining of an infected foot wound.

  • | Overview
  • | Transcript
  • | Subjective Data Collection
  • | Objective Data Collection
  • | Education & Empathy
  • | Documentation / Electronic Health Record
  • | Information Processing
  • | Lab Pass: Certificate of Completion

NR 509 Week 2 Alternate Writing Assignment: Respiratory Summer 2018

Purpose

As a family nurse practitioner, you must possess excellent physical assessment skills. This alternative writing assignment mirrors the discussion content of the debriefing session and will allow the student to expand their knowledge of physical health assessment principles specific to the advanced practice role. Shadow health respiratory assessment transcript.

Course Outcomes

This assignment is guided by the following Course Outcomes (COs):

  1. Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations. (PO 1, 2)
  2. Differentiate normal and abnormal health history and physical examination findings. (PO 1, 2)
  3. Adapt health history and physical examination skills to the developmental, gender-related, age-specific, and special population needs of the individual patient. (PO 1, 2)

The purposes of this assignment are to: (a) identify and articulate advanced assessment health history and physical examination techniques which are relevant to a focused body system (CO 1), (b) differentiate normal and abnormal findings with regard to a disease or condition that impacts the body system (CO 2), and (c) adapt advanced assessment skills if necessary to suit the needs of specific patient populations (CO 4).

NOTEYou are to complete this alternative writing assignment ONLY if you had not participated or do not plan to participate in a debriefing session for the given week.

Due Date: This alternative written assignment is due no later than the Sunday of the week in which you did not attend the weekly debriefing session. The standard MSN Participation Late Assignment policy applies to this assignment.

Preparing the Paper:

  1. Select a focused body system from the weekly lesson which corresponds with the week of the written assignment.
  2. Carefully read and review the selected body system in your course textbooks.
  3. Incorporate at least onescholarly peer-reviewed journal article that relates to the body system. It may be useful to identify an article that relates to a disease that impacts the body system.
  4. The paper must clearly articulate the relevance of advanced physical assessment skills, techniques, application of advanced practice knowledge, and assessment modification (when necessary) to accommodate for specific patient populations.
  5. Provide concluding statements that should summarize key points of the overall assignment content.
  6. In-text citations and reference page(s) must be written using proper APA format (6thedition).

NR 509 Week 2 Quiz

  1. A mother brings her two month old daughter in for an examination says “my daughter rolled over against the wall and now I have noticed that she has the spot soft on the top of her head, is there something terribly wrong?” The FNP‘s best response would be:
  2. During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This most likely results from:
  3. The patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The FNP suspects Damage to:
  4. When examining the face, the FNP is aware that the two pairs of salivary gland‘s that are accessible to examination are the _____ glands
  5. A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by____
  6. When examining a patient’s cranial nerve function, the FNP remembers that the muscles in the neck that are innervated by CN XI are the:
  7. The patient’s laboratory data reveal an elevated thyroxine level. The FNP would proceed with an examination of the _____ gland Shadow health respiratory assessment transcript.
  8. A patient says that she has recently noticed a lump in the front of her neck below her “Adams apple” that seems to be getting bigger. During the assessment, the finding that leaves the FNP to suspect that this may not be a cancerous thyroid nodule is that the lump:
  9. The FNP notices that the patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the FNP would assess the patient’s:
  10. The FNP is aware that the four areas in the body were lymph nodes accessible are the:
  11. A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The FNP should know that floaters are usually not significant and are caused by:
  12. The FNP is preparing to assess the visual acuity of a 16-year-old patient. How should the FNP proceed?
  13. A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The FNP interprets these results to indicate that:
  14. A patient is unable to read even the largest letters on the Snellen chart. The FNP should take which action next:
  15. A patient’s vision is reported as 20/80 in each eye. The FNP interprets this finding to mean that
  16. When performing the corneal light reflex assessment, the FNP notes that the light is reflected at 2 o’clock in each eye. The FNP should
  17. The FNP is performing the diagnostic positions test. Normal findings would be which of these results?
  18. During an assessment of the sclera of an African-American patient, the FNP would consider which of these an expected finding?
  19. A 60-year-old man is at the clinic for an examination. The FNP suspects that he has ptosis of one eye. How should the FNP check for this?Shadow Health Respiratory Assessment Transcript
  20. The FNP is doing an assessment on a 21-year-old patient and notices that his nasal mucosa appears pale gray and swollen. What would be the most appropriate question to ask the patient?
  21. The FNP is palpating the sinus areas. If the findings are normal, then the patient should report which sensation?
  22. During an oral assessment of a 30-year-old African-American patient, the FNP notices bluish lips and a dark line along the gingival margin. What would the FNP do in response to these findings
  23. During an assessment of a 20-year-old patient with a three day history of nausea and vomiting the FNP notices dry mucous and deep vertical fissures on the tongue. These findings are reflective of:
  24. The FNP is reviewing the technique of palpating for tactile fremitus with a new graduate. Which statement by the graduate FNP reflects a correct understanding of tactile fremitus?
  25. The FNP student is reviewing physical assessment findings of the HEENT system associated with pregnancy. Which statement by the graduate FNP reflects a correct understanding of expected HEENT changes associated with pregnancy? During pregnancy:

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NR 509 Week 2 Quiz Review – (Jarvis 8,9,13,14,15,16,18), (Swartz 4,6,7,8,9,10)

NR 509 Week 2 Quiz

  1. A mother brings her two month old daughter in for an examination says “my daughter rolled over against the wall and now I have noticed that she has the spot soft on the top of her head, is there something terribly wrong?” The FNP‘s best response would be:
  2. During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This most likely results from:
  3. The patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The FNP suspects Damage to:
  4. When examining the face, the FNP is aware that the two pairs of salivary gland‘s that are accessible to examination are the _____ glands
  5. A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by____
  6. When examining a patient’s cranial nerve function, the FNP remembers that the muscles in the neck that are innervated by CN XI are the:
  7. The patient’s laboratory data reveal an elevated thyroxine level. The FNP would proceed with an examination of the _____ gland
  8. A patient says that she has recently noticed a lump in the front of her neck below her “Adams apple” that seems to be getting bigger. During the assessment, the finding that leaves the FNP to suspect that this may not be a cancerous thyroid nodule is that the lump:
  9. The FNP notices that the patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the FNP would assess the patient’s:
  10. The FNP is aware that the four areas in the body were lymph nodes accessible are the:
  11. A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The FNP should know that floaters are usually not significant and are caused by:
  12. The FNP is preparing to assess the visual acuity of a 16-year-old patient. How should the FNP proceed?
  13. A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The FNP interprets these results to indicate that:
  14. A patient is unable to read even the largest letters on the Snellen chart. The FNP should take which action next:
  15. A patient’s vision is reported as 20/80 in each eye. The FNP interprets this finding to mean that
  16. When performing the corneal light reflex assessment, the FNP notes that the light is reflected at 2 o’clock in each eye. The FNP should
  17. The FNP is performing the diagnostic positions test. Normal findings would be which of these results?
  18. During an assessment of the sclera of an African-American patient, the FNP would consider which of these an expected finding?
  19. A 60-year-old man is at the clinic for an examination. The FNP suspects that he has ptosis of one eye. How should the FNP check for this?
  20. The FNP is doing an assessment on a 21-year-old patient and notices that his nasal mucosa appears pale gray and swollen. What would be the most appropriate question to ask the patient?
  21. The FNP is palpating the sinus areas. If the findings are normal, then the patient should report which sensation?
  22. During an oral assessment of a 30-year-old African-American patient, the FNP notices bluish lips and a dark line along the gingival margin. What would the FNP do in response to these findings
  23. During an assessment of a 20-year-old patient with a three day history of nausea and vomiting the FNP notices dry mucous and deep vertical fissures on the tongue. These findings are reflective of: Shadow health respiratory assessment transcript.
  24. The FNP is reviewing the technique of palpating for tactile fremitus with a new graduate. Which statement by the graduate FNP reflects a correct understanding of tactile fremitus?
  25. The FNP student is reviewing physical assessment findings of the HEENT system associated with pregnancy. Which statement by the graduate FNP reflects a correct understanding of expected HEENT changes associated with pregnancy? During pregnancy:

Identifying and Reliability:
Ms. Jones is an obese 28-year-old female who is
presenting to the office today with an athma
exacerbation. She is the primary and only source of
personal and medical data. Pleasent, cooperative
and readily open to freely dissiminate health
information. Good eyeye contact, well-groomed,
good posture, and comunicates clearly with logical
flow of ideas.
General Survey:
Upon entering the patient’s examination room,
patient was found to be sitting straight and erect,
good posture, well-groomed, well nourished with a
pleasent demeanor and manner of communicating.
Reason for Visit:
“Breathing problems and my inhaler just isn’t
working the way it normally does.”
HPI: Ms. Tina Jones is a 28-year-old African
American woman who walked in to the clinic
complianing of SOB and wheezing after nearly
haveing a “bad” asthma attack two days ago. Pt.
Overview
Transcript
Subjective Data Collection
Objective Data Collection
Education & Empathy
Documentation
Student Pre-Survey
Lifespan
Review Questions
Self-Reflection
reports xxx which triggered her asthma
symptoms while she was visitn her cousins house.
Initially, at the time of the climax of her near asthma
attack, xxx It lasted for 5 minutes Shadow Health Respiratory Assessment Transcript
following the use of her rescuexxx . Pt.
reports only chest tightness at the time, which has
continued to the present with no increase in
tightness. Pt. denies all other allergic symptoms
during the exaccerbation of her asthma. The inhalor
had amild to moderate effect, not fully resolving the
asthma symptoms. Pt. reports that since the initial
exacerbation, she has had ten similar asthma
episodes consisting of SOB, “not able to get
enough air in” to her lungs, chest tightness all occur
every 4 hours, even through the night, awakinging
her from sleep. Her symptomsare worsoned when
laying supine, including coughing fits each time she
lays down, which easily resolves once sitting
backup. Instead of using the xxx, pt. has been using xxxx with minimal to moderate relief. Most
recent episode was this morning prior to her arrival.
xxx are aggrevated by exposure
to cats, perhaps dust, and currently exacerbated by
exertion and laying supine with a subsequent
coughing fit. occur Cough is non-productive.
Pt. concerned her new albuterol inhaler is ineffective
compared to previous device. Her asthma has been
slowly interferring with her life the past year or so,
while still being manageable. Over the past 2 days,
her asthma has interferred with her daily life,
including her response that if she had not had these
past two days off of work, she “would have called in
sick for sure.” Pt. feels minimal asthma symptoms
curretly, following her xxx over an hour
ago.
Diagnosed with asthma at 2.5-years-old, She
frequented hospital visits and including five
hospitalizations before she was 16-years-old. Since
then she hasn’t been hospitalized. Pt. xxxx. Pt. doesn’t keep
asthma record of exacerbations and triggers; denies
asthma medication usage excet for albuterolresuce
inhaler. Pt. not currrently beingmanaged by a
pulmonologist or someone for her allergies. Pt.
denies using a vaporizer or nebulizer at home.
PMH:
Pt. reports Type 2 Diabetes, possible borderline
hypertension (no actual dx).
Allergies:
Cats: Develops itchy, watery eyes; an itchy, “runny
nose”; an itchy, sometimes a sore throat, and often
an asthma exacerbation – SOB, DOE, wheezing,
coughing, and chest tightness.
Dust: Develops a rash, no tiching.
Penicillin: “Rash, like, hives.”
HPI: Ms. Jones is a pleasant 28-year-old African
American woman who presented to the clinic with
complaints of xxxxx attack that she had two
days ago. She reports that she was xxxx and was exposed to cats which triggered her
asthma symptoms. At the time of the incident she
notes that her wheezes were a 6/10 severity and her
shortness of breath was a 7-8/10 severity and
lasted five minutes. She did not experience any
chest pain or allergic symptoms. At that time she
used her albuterol inhaler and her symptoms
decreased although they did not completely resolve.
Since that incident she notes that she has had 10
episodes of wheezing and has shortness of breath
approximately every four hours. Her last episode of
shortness of breath was this morning before coming
to clinic. She notes that her current symptoms seem
to be worsened by lying flat and movement and are
accompanied by a non-productive cough.shadow health respiratory assessment answers. She
awakens with night-time shortness of breath twice
per night. She complains that her current symptoms
are beginning to interfere with her daily activities

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Medications:
Rx: xxx.
OTC: xxxfor occasional
xxxx related to readingfor prolonged periods
of . xxxx
Social History:
Pt. reports fairly severe xxx (xxx);
A moderate allergic reaction to excessive dust
accumulation (axxx); and Penicillin (report from
mom when pt.was a child, mother reports
development of a rash only; unknown if xxx and axx
occured as well. Pt. is meticullus about dust,
allergins, mildew accumulation; using hypoallergenic
practices with bed, sheets, pillows and spead.
Mattress is 12 months old. Pt. denies ever using
tabacco in any form, as well as illicit drugs and
prescription medicaton abuse. Pt. does report that
from 15-16-years old she smoked marijuana, but
hasn’t partaken in it since 21-years-old. Pt. states
she doesn’t exercise, eats “whatever”, with some
restrint in high sugar beverages and treats.
Family History: Pt. states sister has history of
asthma and hayfever.
Surgical History: Pt. denies previous surgeries.
ROS:
General: Pt. states recent changes in appetite as
she is “always hungry” even after she has eaten a
large meal. Reports exercise intolerance, usually
feels fatigued. Pt. denies recent weight changes,
fevers, chills. body aches, sweats. feels she is
generally a healthy person.
Skin: Pt. reports skin color and pigment changes
localized only around her neck – which has been
changeing the past couple of years now. Pt. reports
that moles on her back have not changed in size or
color.Skin is dryer than usual and feels dehydrated
and always thirsty. Denies sores, lesions, scabs.
Pulmonary: Pt. states that she has coughing fits
when exposed to allergens like dust adn especially
cats. Coughing also occurs when asthma “acts up”
and anytime she lays down in the past month she
begins to cough. Lately she will wake up twice a
night because of uncontrolable coughing which
resolves after she has been in a sitting or upright
position for a few minutes. Denies productive cough
or coughing up blood. Denies being exposed to
anyone sick, has not traveled.
Reports SOB when she has to hurry somewhere or
whan she climbs a large flight of stairs. Has
orthopnea twice a night with coughing fits. xxxx and denies OSA.
xxx: Pt. state she may have borderline
and she is concerned that her xxxx
seems to be less effective than previous. Currently
she states that her breathing is normal. Diagnosed
with asthma at age 2.5 years. She has no recent use
of spirometry, does not use a peak flow, does not
record attacks, and does not have a home nebulizer
or vaporizer. She has been hospitalized five times
for asthma, last at age 16. She has never been
intubated for her asthma. She does not have a
current pulmonologist or allergist.
xxx: She is not aware of any
environmental exposures or irritants at her job or
home. She changes her sheets weekly and denies
dust/mildew at her home. She uses a hypoallergenic
pillow cover and her mattress is one year old. She
denies current use of tobacco, alcohol, and illicit
drugs. She did smoke marijuana for 5 or 6 years,
her last use was at age 21 years. She does not
exercise.
Review of Systems: General: Denies changes in
weight, fatigue, weakness, fever, chills, and night
sweats.
• xxx: Denies rhinorrhea with this episode.
Denies stuffiness, sneezing, itching, previous allergy,
epistaxis, or sinus pressure.
• Gastrointestinal: No changes in appetite, no
nausea, no vomiting, no symptoms ofxxx
• xxx: Complains of shortness of breath and
cough as above. Denies sputum, xxx,
pneumonia, bronchitis, emphysema, tuberculosis.
She has a history of asthma, last hospitalization was
age 16, last chestxxxx.

hypertension. Pt. denies xxxx,
palpitations, tachycardia or racing heart, orthostatic
changes, edema, heart arrythmias and denies
sickle-cell disease.
Endocrine: Pt. reports having previous diagnosis of
diabetesxxxx, xxx,
lethargy. Pt. reposrts having xxx, dxxx,
being overweight. Pt. denies changes in hair
pattern, weight changes, node enlargement, breast
changes, galactorhea, never been pregnant,
tremors. Shadow health respiratory assessment transcript.
GI: Pt. denies N/V, anorexia, diarhea, GERD, ulcers,
colonoscopy, constipation, hematamesis,
hematechezia, recent changes in bowel evacuation
habits, dysphagia, flatulance.
GU: Pt. reports xxxx, feels
thirsty all the time now, drinks a lot of fluids which
doesn’t seem to quench thirst. She has now been
experiencing nocturia 2-3 times per night. Denies
xxx, chronic or recent xxxx, history
of or knowlingly being xxxx. Reports
haveing three sexual partners in her life, all of which
are men. Has been absinent for over a year now.
Denies incontinence.
Neurologic: Pt. denies changes in sensation,
weakness, light-headedness, dizziness, chronic
xxxxchanges in mentation,
long or short term memory, concussions,xxxx
HEENT: Pt. denies history of xxx, except for
occassionally occuring when she reads too long xxx
changes, except for “blurry eyes” after reading for
too long. Denies other visions problems, hearing
issues, nasal discharge, epistaxis, gingivitis, mouth
sores. Pt. doesn’t see dentist annually nor teetch
professionally cleaned – hasn’t been to the dentist
for “years.”
Objective
Tina is an obese 28-year-old African American
woman who does not seem to be in any acute
distress. Alert and oriented, sitting upright, ,
maintains appropriate eye contact, is
conversational, and answers questions approprietly.
Respiratory: Respiratory examination found Tina’s
chest expansion to be symetrical with respiration.
Bilaterally symetrical tactile fremitous, negative
broncophony anteriorly and posteriorly in all lung
fields. Chest resonent when percussed, devoid of
any dullness. Bilateral lower lxxxx. All other
lung fields clear to auscultation. No crackles,
rhonchi, coarseness noted in lung auscultation.
Muffled words bilaterally with prominent expiratory
wheezes in the posterior lower lobes only.
Spirometry yielded xxxxon room air, xxxx, BP
General: Ms. Jones is a pleasant, xxx 28-year-old
African American woman in no acute distress. She
is alert and oriented and sitting upright on exam
table. She maintains eye contact throughout
interview and examination.
• Respiratory: Chest expansion is symmetrical with
respirations. Normal fremitus, symmetric bilaterally.
Chest resonant to percussion; no dullness. Bilateral
expiratory wheezes in posterior lower lobes.
Bilateral muffled words with notable expiratory
wheezes in posterior lower lobes. No crackles. In
office xxx%.
x
140/81, Temperature xxxdegrees Farenhiet.
Assessment
Mild-Persistent Asthma with Exacerbation. Mild-persistent asthma with exacerbation
Plan
Diagnostics: Obtain oxygen saturation and baseline
spirometry and peak flow readings.
Medication: NMI at office one time. Continue
albuterol rescue inhalor. Initiate step up inhaled
corticosteroid.
Education: Encourage Tina to log her asthma
symptoms and episodes of exacerbation every day
and bring log in to next visit. Monitor trigger
exposures adn resultant asthma symptoms and
severity of exacerbations. Encourage Tina to
remove and/or clean all possible harborers of
allergens, including bedding, seats, pillows carpet.
Change air filters in home and car to incrased
allergiin removal from the air. Encourage an incrase
in fluid consumption, especially water. Help guide
pt. indeveloping an asthma action plan and assess
effectiveness and apropriateness of plan in next
visit.
Orders: xxxx
after each exacerbation for purposes of comparison
and establishing pt. trends.
Instruct Tina to return to clinic if ongoing symptoms.
Also inform xxx if
worsoning asthma symptoms, xxxx that is
unresolved by a short rest. Also go to xxxis
unresolved xxx, wheezing not allevaited
xxx and xxx.
Follow-Up: Return to clinic in 3 weeks for follow-up
evaluation regarding coarse of illness, medication
use and needs, as well as medication effectivenss.
Diagnostics
• Obtain office oxygen saturation
Medication
• xxxin office x 1
• Initiate step-up medication therapy with xxxx
• Continue xxx
Education
• Encourage Ms. Jones to continue to xxx
symptoms and wheezing with associated factors
and bring log to next visit
• Encourage to wash xxx and consider xxx to decrease axxe
symptoms
• Educate to increase intake of water and other
fluids
• Create Axxx
Referral/Consultation
• Refer to allergy specialist for evaluation and testing
Follow-up Planning
• Order PFTs to be completed after exacerbation to
have baseline available for future comparison
• Instruct Ms. Jones on when to seek emergent care
including episodes of chest pain or shortness of
breath unrelieved by rest, worsening asthma
symptoms or wheezing, or the sense that rescue
inhaler is not helping
• Revisit clinic in 2-4 weeks for follow up and
evaluation
Comments
If your instructor provides individual feedback on this assignment, it will appear here.

NR 509 Week 2 Quiz Review – (Jarvis 8,9,13,14,15,16,18), (Swartz 4,6,7,8,9,10)

1.    What does dullness when percussing lung fields: Jarvis pg 427

2.       Facial sensation controlled by which CN: Jarvis 283,

3.       Know what two salivary glands are accessible during exam

4.       What CN is being … when pt shrugs shoulders Jarvis 646

5.       What muscles are being …. when …. CN 11 (spinal accessory nerve)

6.       Concern for malignant nodules versus benign lymph nodule

7.       Know what you’d do next if you palpated a submental lymph node: Jarvis pg 253

8.       Define visual acuity

9.       Know what to do if your patient can’t read the largest number on the Snellen chart: Jarvis 289

10.   Example of good visual acuity : Jarvis 289

11.   Example of poor visual acuity: Jarvis 289

12.   What is …. with corneal light reflex-

13.   Know normal variances of sclera : Jarvis 283

14.   Know how to check for Ptosis: Jarvis 292

15.   What does ptosis indicate: Jarvis 292

16.   Nasal fissure of pt with chronic allergies : Jarvis 271

·         Acute allergies : Jarvis p 363 .

17.   What is an abnormal palpation of sinuses: Jarvis 362

·         Normal palpation of sinuses

18.   Know normal variations in gingival margin

19.   Know what a dehydrated oral cavity will look like: Jarvis 387

20.   What is tactile fremitus, how do you test for it and what does it indicate. Jarvis 425

N 518 Module 2: THE GENERAL SURVEY AND HEENT

Module 2: Discussion Question

Start by reading and following these instructions:

You are responsible for minimally at least 3 posts for each question in your discussion boards; your initial post and reply to two of your classmatesYour initial post(s) should be your response to the questions posed in the discussion question. You should research your answer and cite at least one scholarly source when appropriate, and always use quality writing.The discussion board is never a place to use text language or emoticons. You will also be asked to respond to your classmates.Shadow Health Respiratory Assessment Transcript. This is designed to enhance the academic discussion around the topic. It is all right to disagree with something posted by another, however your responses should always be thoughtful and respectful and reflect your opinions professionally.

Discussion Question:

In your professional opinion, what is the difference between chronic and acute pain? How is the assessment for each type of pain different? What must you keep in mind when assessing acute pain? What must you keep in mind when assessing chronic pain?  Reflect upon a time when you assessed a patient in pain. What did you do well? What points could you have improved upon? How did the pain impact the patient? What specific treatments could have lessened the impact of the pain on the patient?

Your initial posting should be 200 to 300 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 100 words in length. To properly “thread” your discussion posting, please click on REPLY.

When you are ready for the discussion, do the following:

  1. Click on the discussion link above.
  2. Start your answer by clicking “Start a New Thread” button with the title of your answer and the body of text following the guidance above.
  3. To properly post your answer, please click on the “Post” button.
  4. After posting your contribution, you must read what others have posted, reply to at least two of those posts, and respond (when appropriate) to those you have responded to you.

To reply to a classmate’s post:

  1. Click on the title of another student’s post.
  2. Click “Reply to Thread” and type your response to the student.
  3. Click the “Post” button to post your reply.

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N 581 Module 2: Assignment

Remember to submit your work following the file naming convention FirstInitial.LastName_M01.docx. For example, J.Smith_M01.docx. Remember that it is not necessary to manually type in the file extension; it will automatically append.

Start by reading and following these instructions:

  1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.
  2. Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
  3. Consider the discussion and the any insights you gained from it.
  4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

Exercises

  • Complete the Shadow Health HEENT assessment.

Professional Development

  • Write a reflection essay of your experience with the Shadow Health virtual assessment. At least two scholarly sources in addition to your textbook should be utilized. Please be sure to address each of the following prompts:
    • 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? What could you change to make it better?

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Shadow Health Physical Assessment Rubric

Shadow Health Physical Assessment Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeSubjective Data, Organization, Communication, and Summary (DCE Score or transcript)
25.0 pts

Above Average- DCE Score greater than or equal to 93; Comprehensive introduction with expectations of exam verbalized; questions worded in a non-judgmental way; professional language exercised; questions well-organized; appropriate closing with summary of findings verbalized to patient.

21.0 pts

Average- DCE Score greater than or equal to 86-92; Adequate introduction; some questions worded in a non-judgmental way; professional language mostly exercised; questions generally organized; somewhat complete closing.

10.0 pts

Below Average- DCE Score greater than or equal to 80-85; Incomplete introduction; many questions worded in a judgmental way; some professional language exercised; questions somewhat organized; incomplete closing.

0.0 pts

Unsatisfactory- DCE Score less than or equal to 79; Introduction missing; questions worded in a judgmental way; little professional language; questions unorganized; closing missing.

25.0 pts
This criterion is linked to a Learning OutcomeObjective Data, Physical Examination, Interpretation of Findings, Assessment, and Documentation
20.0 pts

Above Average- Physical assessment documentation includes all relevant body systems; all pertinent normal and abnormal findings identified; documentation reflects professional language; treatment plan includes each of the following components: diagnostics, medication, education, consultation/referral, and follow-up planning.

16.0 pts

Average- Physical assessment documentation lacks sufficient details pertaining to one or two relevant body systems; or identifies ≥ 50% of the pertinent normal and abnormal findings; or documentation lacks professional language; or treatment plan lacks one or two components (diagnostics, medication, education, consultation/referral, or follow-up planning).

8.0 pts

Below Average- Physical assessment documentation lacks sufficient details pertaining to three or more relevant body systems; or identifies < 49% of the pertinent normal and abnormal findings; or documentation includes unprofessional language; or treatment plan lacks three or more components (diagnostics, medication, education, consultation/referral, or follow-up planning).

0.0 pts

Unsatisfactory- No physical assessment documentation or no treatment plan.

20.0 pts
This criterion is linked to a Learning OutcomeSelf-Reflection
5.0 pts

Above Average- Responds to three of the three reflection post questions; and provides analysis of performance; and reflection posts written using professional language; and reflection posts demonstrate insight.

3.0 pts

Average- Responds to two of the three reflection post questions; or provides limited self-analysis of performance; or reflection posts are somewhat unclear related to the assignment and the student’s experience; or reflection posts lack insight.

2.0 pts

Below Average- Responds to one of the three reflection post questions; or does not provide self-analysis of performance; or reflections are not related to the assignment and the student’s experience; or does not provide insight

0.0 pts

Unsatisfactory- No reflection posts for the assignment.

shadow health respiratory assessment transcript.Shadow Health Digital Clinical Environment (DCE) is a high-fidelity virtual patient simulation program that is currently being utilized in over 230 nursing schools (15,000-20,000 students) across the United States. Simulation is defined as “an event or situation made to resemble clinical practice as closely as possible”. Shadow Health DCE is designed to promote undergraduate and graduate student learning through the use of digital standardized patient. The Shadow Health DCE consists of 9 modules; each module is designed around a specific body system. The Shadow Health DCE also offers additional concept labs that are used to examine body systems more in-depth. Concept labs offered through Shadow Health DCE include respiratory, cardiovascular and abdominal. A conversation concept lab is also provided, whereby students can improve interview skills shadowhealth.com, n.d.).

Implementation of Shadow Health DCE

Shadow Health DCE engages students in learning through clinical simulation, critical thinking, and self-reflection, as students identify pertinent nursing diagnoses and develop plans of care. Students learn to improve interview skills, physical assessment skills, and documentation through experiential simulation. Immediate feedback of performance is provided to students in the form of “Pro Tips” (shadowhealth.com, n.d.). “Pro Tips” are provided to students where opportunities for learning occur such as “managing acute pain is an immediate high priority, because other health concerns cannot be effectively addressed while a patient experiences severe pain” (Shadow Health, n.d.). Faculty can assess student learning through review of transcripts, module data, clinical findings, and student self-reflection. Through the examination of student performance, faculty is enabled to reflect upon student needs and areas for improvement. For example, if students show poor performance in diabetes education provided, the instructor becomes aware of gaps in knowledge.

Use of Simulation in Nursing Education

Simulation has become an increasingly used pedagogical approach in nursing education, particularly since 2004 when high-fidelity manikins were introduced. Benefits of simulation include improvement of knowledge acquisition, refining both cognitive and psychomotor skills, bridging a gap between theories and actual practice and developing communication skills among teams. “Simulation contributes to improved critical thinking, clinical reasoning skills and problem solving without fear of causing harm to actual patients”. Therefore, simulation provides a safe environment for nursing students to learn new knowledge and practice skills. Simulation improves clinical thinking skills, which translates to improved patient safety and quality of care once students enter the workforce. shadow health respiratory assessment transcript Furthermore, simulation promotes active student learning and engagement. Active participation is the preferred learning method for adult learners. Active learning leads to higher learning satisfaction.

Respiratory System Assessment

The respiratory system involves more than just the lungs. It includes respirations, oxygenation, and interactions with the cardiac system. Respiratory assessment also includes the assessmentand identification of risk factors for disease. The respiratory system includes the trachea, bronchi, bronchioles, lungs, and diaphragm.

This topic addresses the following competency:

]

Competency 745.1.4: Respiratory Assessment

The graduate analyzes the findings of basic physical assessments of the respiratory system.

 

This topic addresses the following learning objectives:

 

Identify the structures of the respiratory system.

Identify risk factors associated with the respiratory system.

Identify the equipment necessary to perform a respiratory system exam.

Identify the anatomical location and character of normal breath sounds.

Explain the functions of the respiratory system.

Explain the process for performing a respiratory system exam.

Explain the symptoms and risks of the respiratory system associated with common nutrition and hydration issues.

Analyze health history results related to the respiratory system.Shadow Health Respiratory Assessment Transcript.Shadow Health Respiratory Assessment Transcript

Select appropriate focused assessment strategies based on health history findings related to the respiratory system.

Select primary prevention strategies for patient education related to the respiratory system.

Conclusions

Shadow Health DCE utilizes a virtual patient, Tina, to teach physical assessment, conduct a health history, communication skills, health promotion and education, and documentation skills to nursing students. Shadow Health DCE provides an opportunity for learning best clinical practices in a safe environment. An experienced nurse is likely to conduct a health history and perform physical assessment based one’s established preference and intuition. BS-MS enter a Master’s of Nursing program with a high level of confidence. Shadow Health DCE meets the AACN standards of the 3 Ps in providing advanced learning in physical assessment to the MS nursing student cohort. shadow health respiratory assessment transcript.However, based on a small sample surveyed in this project, BS-MS students did not feel that Shadow Health DCE was a valuable learning tool and that level of confidence in performing physical assessment actually decreased. Based on this information, MS faculty may wish to re-design and/or implement required coursework in order to prepare student to learn in the Shadow Health DCE environment, and ultimately, be prepared for roles as graduate level nurses.

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