Nursing > Case Study > Focused Exam: Pain | Completed | Shadow Health

Focused Exam: Pain | Completed | Shadow Health

If you are using Safari and have issues with audio in your assignment, please click here for assistance. Click here for more (/site_notice_dismissals?from_flash=true&site_notice_id=283) information (https://support.shadowhealth.com/hc/en-us/articles/360009548313) If you are are experiencing audio ... issues while using Safari, please visit this article (https://support.shadowhealth.com/hc/en-us/articles/360009548313-Audio-issues-in-Safari) on our Help Desk for further information. Subjective Data Collection: 58 of 58 (100.0%) Chief Complaint Orientation Patient Status Your Results Lab Pass (/assignment_attempts/6203901/lab_pass.pdf) Overview Transcript Subjective Data Collection Objective Data Collection Education & Empathy QSEN Competencies Documentation SBAR Reflections Indicates an item that you found. Indicates an item that is available to be found. Category Scored Items Experts selected these topics as essential components of a strong, thorough interview with this patient. Patient Data Not Scored A combination of open and closed questions will yield better patient data. The following details are facts of the patient's case. Established chief complaint Reports pain Reports recent fall Reports worry about worsening symptoms Established orientation Oriented to person Oriented to place Oriented to time Oriented to situation Hover To Reveal... Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions. https://www.coursehero.com/file/56396343/Focused-Exam-Pain-Completed-Shadow-Healthpdf/ This study resource was shared via CourseHero.com Focused Exam: Pain | Completed | Shadow Health 3/1/20, 7:34 PM file:///Users/onyi/Downloads/Focused%20Exam:%20Pain%20%7C%20Completed%20%7C%20Shadow%20Health.webarchive Page 2 of 8 History of Present Illness Asked about medication administered in ER Reports receiving oxycontin Reports oxycontin has been effective Asked about patient comfort and needs Denies needing to use the bathroom Asked about onset and duration of symptoms Reports recent episode of severe pain started this morning Reports pain has been getting progressively worse in the last few weeks Asked about location of pain Reports hip pain Reports knee pain Asked about characteristics of pain Describes pain as aching Describes pain as "deep" Denies shooting or sharp pain Reports occasional "grating" sensation in joints Denies burning pain Denies stinging pain Asked about severity of pain Reports current pain is a 1 Reports pain before medication was a 9 Asked about non-medication relieving factors of pain Reports that rest typically relieves the pain Reports not using any non-medication treatments to treat this morning's pain Reports occasional use of moist heat as treatment on hips Reports using range of motion exercises for knees Reports wearing elastic supports on knees bilaterally Denies use of ice as treatment Asked about aggravating factors of pain Reports that exercise exacerbates pain and stiffness Reports that weight bearing exacerbates pain and stiffness Reports that pain and stiffness are worse in the morning Reports that changes in weather exacerbate pain and stiffness Followed up on details of the fall Reports falling getting out of bed Reports hitting his back on bed frame Denies dizziness, syncope, or vertigo at time of fall Denies substance use that could have related to the fall https://www.coursehero.com/file/56396343/Focused-Exam-Pain-Completed-Shadow-Healthpdf/ [Show More]