Esther Park Shadow Health Focused Exam Abdominal Pain
Within the Shadow Health platform, complete the Focused Exam: Abdominal Pain. The estimated average time to complete this assignment is 1 hour and 25 minutes. Please note, this is an average time. Some students may need longer.
This clinical experience is a focused exam. Students have one opportunity to complete this assignment and score at the Proficiency level. Upon completion, submit the lab pass through the assignment dropbox.
Students successfully scoring within the Proficiency level in the Digital Clinical Experience will earn a grade of 100 points. Students who do not pass the performance-based assessment and scoring within the Proficiency level will receive a failing grade (68 points).
Please review the assignment in the Health Assessment Student Handbook in Shadow Health prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT
Shadow Health Focused Exam Abdominal Pain Esther Park
Hello!
Question
01/18/20 11:03 AM MST
Diana Shadow Hi. I’m Preceptor Diana. I will explain the details of this assignment and your objectives, just as a preceptor would in real life. Pay close attention to this information as it will help guide your exam. At the end of this prebrief, you will answer a short question about the upcoming assignment. During the simulation, you may return to these instructions at any time by scrolling to the top of your transcript.
What is the situation?
Question
01/18/20 11:04 AM MST
Diana Shadow Your patient is Esther Park, a 78-year-old Korean woman presenting with abdominal pain in Shadow General Hospital’s Emergency Department. Your role in this simulation is that of a healthcare provider who will conduct a focused history and physical examination of Mrs. Park in order to assess her condition and transfer her care.
What are my objectives in this assessment?
Question
01/18/20 11:04 AM MST
Diana Shadow In your interview with Mrs. Park, you will ask about the history of her presenting illness and the functioning of relevant systems in order to obtain subjective data related to her abdominal pain. If you discover any disease states, ask about symptoms and the patient’s experiences of them. Your questioning should cover a broad array of the symptoms’ characteristics. In addition to collecting subjective data, you will perform a physical exam on Mrs. Park to gather objective data about her health and physiology. While you should communicate with patients using accessible, everyday language, it is standard practice to use professional medical terminology everywhere else, such as in documenting physical findings and nursing notes. You may complete the exam activities in any order and move between them as needed. Shadow Health Focused Exam Abdominal Pain Esther Park
How does this assignment prepare me for the real world?
Question
01/18/20 11:06 AM MST
Diana Shadow In this assessment, you will become familiarized with the structure and content of a abdominal focused exam so that with real-life patients, you can: º ask effective and comprehensive questions º use therapeutic language º evaluate the patient’s risk of disease, infection, injury, and complications º obtain and assess objective data. º and transfer patient care using SBAR.
Diana Shadow In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: In a geriatric patient, what are some common considerations regarding abdominal pain?
Bowel obstruction is a common cause of abdominal pain in geriatric patients..
Statement
01/18/20 11:09 AM MST
Hello
Greet
01/18/20 11:09 AM MST
Esther Park Hello.
My name is Chinwe and I will be conducting the abnormal physical assessment on you. (No matching questions found.)
Question
01/18/20 11:10 AM MST
My name is Chinwe and I will be conducting the abnormal physical assessment on you.
Educate
01/18/20 11:10 AM MST
Esther Park Thank you for explaining that.
do you have any abdominal pain?
Question
01/18/20 11:13 AM MST
Esther Park Yes . . . it isn’t terrible at the moment, thank goodness, but there has certainly been pain.
sorry to hear that
Empathize
01/18/20 11:13 AM MST
Esther Park Thank you.
are you able to have a bowel movement? Shadow Health Focused Exam Abdominal Pain Esther Park
Question
01/18/20 11:14 AM MST
Esther Park I haven’t gone to the bathroom in almost a week.
can you tell me who you are?
Question
01/18/20 11:15 AM MST
Esther Park I’m Esther Park.
do you know where you are right now?
Question
01/18/20 11:15 AM MST
Esther Park Yes. I am at Shadowville General Clinic.
do you know why you are here today?
Question
01/18/20 11:15 AM MST
Esther Park I have pain in my belly. . . and I’m having some difficulty with going to the bathroom. My daughter was concerned.
what is the date and year?
Question
01/18/20 11:16 AM MST
Esther Park It must be… [says correct date and year].
how long have you had stomach pain?
Question
01/18/20 11:16 AM MST
Esther Park The pain started as a general discomfort, about five days ago, when I started having the. . . difficulties going to the bathroom.
has the stomach pain changed?
Question
01/18/20 11:17 AM MST
Esther Park Well, the type of pain never changes, nor does the location. But the pain sort of fluctuates in intensity.
where is your discomfort located?
Question
01/18/20 11:31 AM MST
Esther Park The pain and discomfort is down low in my belly.
is the pain in a specific spot?
Question
01/18/20 11:32 AM MST
Esther Park It’s mostly in the lower part. Down in my lower belly.
do you have pain on your sides?
Question
01/18/20 11:32 AM MST
Esther Park No, no. The pain is more towards the front, down low.
how would you rate your pain on a scale of one to ten?
Question
01/18/20 11:33 AM MST
Esther Park It has its ups and downs. At the moment, I’d say it’s a 2.
how would you rate your pain at its lowest?
Question
01/18/20 11:34 AM MST
Esther Park Probably a 2. Luckily, that’s what it is at the moment.
how would you rate your pain at its worst? Shadow Health Focused Exam Abdominal Pain Esther Park
Question
01/18/20 11:35 AM MST
Esther Park I’d say at its worst. . .maybe an 8.
can you describe the pain?
Question
01/18/20 11:35 AM MST
Esther Park I’d say it’s cramping and. . . a dull, cramping feeling, yes.
is your pain constant?
Question
01/18/20 11:36 AM MST
Esther Park The pain has its ups and downs, but it’s always there. It fluctuates in how severe it is.
does your pain fluctuate?
Question
01/18/20 11:36 AM MST
Esther Park Well, the type of pain never changes, nor does the location. But the pain sort of fluctuates in intensity.
what relieves your pain besides medication?
Question
01/18/20 11:37 AM MST
Esther Park I’ve just been resting, but it barely helps. I did try drinking warm water slowly. . .I think that’s a myth, that that works.
have you taken medication for the stomach pain?
Question
01/18/20 11:39 AM MST
Esther Park I’m not taking anything for it.
have you taken laxatives?
Question
01/18/20 11:39 AM MST
Esther Park No. I can’t imagine they are very good for you.
does eating aggravate the pain?
Question
01/18/20 11:40 AM MST
Esther Park Yes. The pain is there all the time, but eating can make it worse.
does physical activity aggravate the pain?
Question
01/18/20 11:40 AM MST
Esther Park 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.
how has your illness affected your daily life?
Question
01/18/20 11:41 AM MST
Esther Park Well, I have been slowed down lately. This week I missed both of my fitness classes. I never miss a class. . . and I like to help with the cleaning at home, but I’m just too weak. It’s very discouraging.
have you had low energy?
Question
01/18/20 11:42 AM MST
Esther Park Yes, it seems like my energy got low when I did simple things around the house, like tidying up. I had to miss my exercise classes this week — I didn’t have the energy for them. That’s unusual for me.
are you constipated right now?
Question
01/18/20 11:42 AM MST
Esther Park Yes, right now, and for the past five or so days.
for how long have you been constipated?
Question
01/18/20 11:43 AM MST
Esther Park It has been five whole days now.
have you had diarrhea recently?
Question
01/18/20 11:43 AM MST
Esther Park No. The last time I had anything of that nature was . . . maybe six months ago.
how long ago did you have diarrhea?
Question
01/18/20 11:44 AM MST
Esther Park Well, that must have been six months ago. Luckily, the ordeal only lasted a day.
did the diarrhea happen suddenly?
Question
01/18/20 11:45 AM MST
Esther Park It came on all of a sudden and only lasted a day–a few bouts of it over the course of a day.
how long did your diarrhea last?
Question
01/18/20 11:46 AM MST
Esther Park It came on all of a sudden and only lasted a day–a few bouts of it over the course of a day.
has there been mucus in your stool? Shadow Health Focused Exam Abdominal Pain Esther Park
Question
01/18/20 11:47 AM MST
Esther Park No, I haven’t noticed anything like that.
has there been blood in your stool?
Question
01/18/20 11:47 AM MST
Esther Park No. I’ve never experienced that.
have you had any changes in the frequency of your urination?
Question
01/18/20 11:48 AM MST
Esther Park I’ve been going slightly less often because. . . well, I’ve been little less thirsty than usual.
has your urine been darker recently?
Question
01/18/20 11:49 AM MST
Esther Park Yes, it has been a little darker than usual lately.
have you had blood in your urine?
Question
01/18/20 11:49 AM MST
Esther Park No, it seems normal enough to me. Maybe a little darker than usual.
have you been thirstier recently? (No matching questions found.)
Question
01/18/20 11:49 AM MST
have you been thirstier lately?
Question
01/18/20 11:50 AM MST
Esther Park I haven’t been as thirsty. I suppose I’ve been drinking a little less water than usual, just in these last few days.
have you had changes in your fluid intake?
Question
01/18/20 11:51 AM MST
Esther Park I haven’t been as thirsty. I suppose I’ve been drinking a little less water than usual, just in these last few days.
how many glasses of water do you drink daily?
Question
01/18/20 11:51 AM MST
Esther Park A glass or two a day, I’d say. It’s been too difficult to drink even that since all this started.
do you drink caffeinated beverages?
Question
01/18/20 11:52 AM MST
Esther Park No. I avoid caffeinated drinks altogether.
are you typically constipated?
Question
01/18/20 11:53 AM MST
Esther Park I don’t usually have problems going to the bathroom, but this has been going on for . . . about five days now. It’s taken quite a toll.
how many bowel movements do you typically have per week?
Question
01/18/20 11:54 AM MST
Esther Park Before this? Every day. Well, I miss a day now and then, but usually every day.
are your stools typically brown?
Question
01/18/20 11:54 AM MST
Esther Park Brown. A normal shade of brown. Like. . . oh, I don’t know. Cardboard.
are your stools typically formed?
Question
01/18/20 11:55 AM MST
Esther Park Yes, they’re in the formed shape I think they should be.
are your stools typically soft?
Question
01/18/20 11:55 AM MST
Esther Park They’re normally soft.
do you have a latex allergy?
Question
01/18/20 11:56 AM MST
Esther Park Yes. Latex gives me an itchy rash.
are you allergic to any medications?
Question
01/18/20 11:56 AM MST
Esther Park No, not that I’m aware of.
do you have any food allergies?
Question
01/18/20 11:56 AM MST
Esther Park No.
do you have a primary care doctor?
Question
01/18/20 11:57 AM MST
Esther Park Yes. I see Dr. Keller, at my clinic–Shadowville Primary Care.
when was your last pap smear?
Question
01/18/20 11:58 AM MST
Esther Park A pap smear? I haven’t had one in years. Ten years, at least.
do you feel you are healthy?
Question
01/18/20 11:58 AM MST
Esther Park I suppose so, yes. I don’t put an inordinate amount of thought into it — I just do what comes naturally. Shadow Health Focused Exam Abdominal Pain Rachel Adler
have you had a colonoscopy?
Question
01/18/20 11:59 AM MST
Esther Park I’ve had two colonoscopies. The last one was ten years ago.
have you ever been tasted for STIs? (Clarified to Have you been tested for STDs?.)
Question
01/18/20 11:59 AM MST
Esther Park No, that hasn’t been necessary. I haven’t had any symptoms. (Clarified to if I have ever been tested for STDs.)
have you ever been tested for STIs?
Question
01/18/20 12:00 PM MST
Esther Park No, that hasn’t been necessary. I haven’t had any symptoms.
have you had STI symptoms?
Question
01/18/20 12:01 PM MST
Esther Park No, I’ve never had anything. . .like that. I don’t have any symptoms.
are you sexually active?
Question
01/18/20 12:01 PM MST
Esther Park I have a gentleman friend and, yes. . .We are intimate.
do you have high blood pressure?
Question
01/18/20 12:01 PM MST
Esther Park Yes, I have been diagnosed with high blood pressure. But I take very good care of that.
did you have any complications during pregnancy?
Question
01/18/20 12:02 PM MST
Esther Park Near the end of my pregnancy, I felt her stop moving. The doctors did the C-section, but it was too late. She’d been caught up in the cord, around her neck.
at what age did you have a C-section?
Question
01/18/20 12:02 PM MST
Esther Park Forty.
have you had a gallbladder removed?
Question
01/18/20 12:03 PM MST
Esther Park I had gallstones–many, many years ago. I had my gallbladder removed.
at what age did you have your gallbladder removed?
Question
01/18/20 12:04 PM MST
Esther Park I was. . . 42.
did you have any complications after your surgery?
Question
01/18/20 12:05 PM MST
Esther Park No, no complications.
do you take high blood pressure medication?
Question
01/18/20 12:05 PM MST
Esther Park Yes.
what medication do you take for your high blood pressure?
Question
01/18/20 12:06 PM MST
Esther Park It’s called Accupril.
what dose is your high blood pressure medication?
Question
01/18/20 12:06 PM MST
Esther Park 10 milligrams.
when do you take your high blood pressure medication?
Question
01/18/20 12:07 PM MST
Esther Park I take it every morning at about 8 a.m., after breakfast.
do you have any over-the-counter medication? (Clarified to Do you take over the counter medications a lot?.)
Question
01/18/20 12:08 PM MST
Esther Park No. Those over-the-counter medicines. . . Tylenol–they say it’s very bad for the stomach. (Clarified to if I take over the counter medication a lot.)
do you take any over-the-counter medications?
Question
01/18/20 12:08 PM MST
Esther Park No. Those over-the-counter medicines. . . Tylenol–they say it’s very bad for the stomach.
do you have any difficulty getting on and off the toilet?
Question
01/18/20 12:09 PM MST
Esther Park No. I have no trouble doing that.
do you have difficulty dressing yourself?
Question
01/18/20 12:10 PM MST
Esther Park I can dress myself, thank you.
do you have difficulty feeding yourself?
Question
01/18/20 12:11 PM MST
Esther Park I can feed myself, but I just haven’t been hungry. It hurts to eat.
do you have difficulty walking?
Question
01/18/20 12:11 PM MST
Esther Park I can walk just fine. I just have been resting as much as possible. Moving too much hurts.
do you have difficulty bathing yourself?
Question
01/18/20 12:12 PM MST
Esther Park I can do that just fine.
do you have difficulty getting in and out of chairs?
Question
01/18/20 12:13 PM MST
Esther Park I can do that–I’ve been doing what I need to do. I just have so little energy, and moving too much hurts.
when was your last meal?
Question
01/18/20 12:13 PM MST
Esther Park I haven’t been eating much at all lately. . . the last time I ate was this morning, a little toast.
how many meals do you typically eat per day?
Question
01/18/20 12:14 PM MST
Esther Park Usually three, but sometimes I skip breakfast. I don’t eat snacks.
what do you typically eat for a snack?
Question
01/18/20 12:15 PM MST
Esther Park I don’t usually have snacks.
what do you usually eat for breakfast?
Question
01/18/20 12:15 PM MST
Esther Park Toast, usually. Fruit, maybe once or twice a week.
what do you usually eat for lunch?
Question
01/18/20 12:16 PM MST
Esther Park Sometimes I skip lunch if I’m not feeling hungry, but usually I eat something light, like soup.
what do you usually eat for dinner?
Question
01/18/20 12:20 PM MST
Esther Park Chicken or fish, with some rice.
do you take fiber supplements?
Question
01/18/20 12:20 PM MST
Esther Park No, I don’t take any extra fiber. I hadn’t quite considered it . . .
do you think you get enough fiber?
Question
01/18/20 12:20 PM MST
Esther Park I don’t know how much fiber is in what . . . I don’t think about it, even. I have a vegetable every day or two, which I’d guess has fiber.
what sources of fiber do you eat?
Question
01/18/20 12:21 PM MST
Esther Park I’m not sure–I’m not positive what fiber is in what. I don’t consciously eat foods with fiber, I mean. I have a vegetable every day or two, and a fruit once or twice a week . . . those probably have a good amount of fiber.
do you eat fruit?
Question
01/18/20 12:21 PM MST
Esther Park No . . . once every three of four days or so. I’ll have it instead of my breakfast toast.
do you stay active?
Question
01/18/20 12:21 PM MST
Esther Park Yes, I garden, take walks. I take exercise classes at the community center — water aerobics, and I started enjoying Pilates as well.
what is your typical activity level?
Question
01/18/20 12:22 PM MST
Esther Park Normally, I garden, take walks, I even do exercise classes at the center. But since getting sick. . .it’s not that I have difficulty taking care of myself; I just don’t have as much energy to do so. Shadow Health Focused Exam Abdominal Pain Rachel Adler
do you use illicit drugs?
Question
01/18/20 12:22 PM MST
Esther Park I have never used drugs of any kind.
do you smoke cigarettes?
Question
01/18/20 12:23 PM MST
Esther Park I’ve never smoked a cigarette in my life. What a sad habit.
do you consume alcohol?
Question
01/18/20 12:23 PM MST
Esther Park Yes, but very little.
how many nights a week do you drink alcohol?
Question
01/18/20 12:23 PM MST
Esther Park On Sundays, I have my only drink for the week.
how many alcoholic drinks do you have in a month? Shadow Health Focused Exam Abdominal Pain Esther Park
Question
01/18/20 12:24 PM MST
Esther Park I only have a drink on Sundays, and then only one glass of white wine — four drinks each month. That seems very moderate to me.
when you have alcohol, what do you typically drink?
Question
01/18/20 12:25 PM MST
Esther Park I always have one glass of wine. A dry white wine.
do you live with anyone?
Question
01/18/20 12:25 PM MST
Esther Park I live with my daughter, Jennifer. It’s very nice living with her.
who can you go to for support?
Question
01/18/20 12:26 PM MST
Esther Park 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.
have you travelled anywhere recently?
Question
01/18/20 12:26 PM MST
Esther Park No, I haven’t gone on any trips in several years.
have you experienced any physical abuse?
Question
01/18/20 12:26 PM MST
Esther Park Goodness. . .I’ve never been abused in any sense of the word.
have you experienced any sexual abuse?
Question
01/18/20 12:27 PM MST
Esther Park Goodness. . .I’ve never been abused in any sense of the word.
have you experienced any emotional abuse?
Question
01/18/20 12:28 PM MST
Esther Park No, the people in my life–they treat me very well.
have you experienced any financial abuse?
Question
01/18/20 12:28 PM MST
Esther Park Goodness. . .I’ve never been abused in any sense of the word.
have you experienced any verbal abuse?
Question
01/18/20 12:29 PM MST
Esther Park No, the people in my life–they treat me very well.
have you had any recent weight changes?
Question
01/18/20 12:29 PM MST
Esther Park No, not that I’ve noticed.
have you had a fever recently?
Question
01/18/20 12:30 PM MST
Esther Park No, I don’t believe so.
have you had chills?
Question
01/18/20 12:30 PM MST
Esther Park No chills.
do you have night sweats?
Question
01/18/20 12:30 PM MST
Esther Park No. That is not a problem for me.
have you had any swelling?
Question
01/18/20 12:31 PM MST
Esther Park I haven’t seen anything swelling.
do you have fatigue?
Question
01/18/20 12:31 PM MST
Esther Park Well, I have experienced low energy, like I need to rest more often. It’s quite frustrating not being my normal self.
have you had difficulty sleeping?
Question
01/18/20 12:31 PM MST
Esther Park No, usually I sleep right through the night.
do you have a history of heartburn?
Question
01/18/20 12:32 PM MST
Esther Park No. I don’t get indigestion, heartburn, nothing like that.
have you ever had appendicitis?
Question
01/18/20 12:33 PM MST
Esther Park No.
do you have a history of stomach cancer?
Question
01/18/20 12:33 PM MST
Esther Park No.
do you have a history of stomach cancer?
Question
01/18/20 12:34 PM MST
Esther Park No.
do you have a history of liver disease?
Question
01/18/20 12:35 PM MST
Esther Park I’ve never had any problems with my liver.
do you have palpitations?
Question
01/18/20 12:35 PM MST
Esther Park No. My heart rate has always been normal.
do you have chest pain?
Question
01/18/20 12:35 PM MST
Esther Park No, I don’t ever experience chest pain.
do you have heart race?
Question
01/18/20 12:36 PM MST
Esther Park No. My heart rate has always been normal.
do you have a sore throat?
Question
01/18/20 12:36 PM MST
Esther Park No. My throat is fine.
have you been coughing?
Question
01/18/20 12:36 PM MST
Esther Park No, I haven’t been coughing at all.
do you have difficulty swallowing?
Question
01/18/20 12:37 PM MST
Esther Park No. I am able to swallow without any problems.
have you had difficulty breathing?
Question
01/18/20 12:37 PM MST
Esther Park No. I can breathe well. My lungs feel very healthy.
do you feel bloated?
Question
01/18/20 12:37 PM MST
Esther Park Yes. Quite a bit.
do you have more gas than usual?
Question
01/18/20 12:38 PM MST
Esther Park I have been slightly more . . . gassy. [AUDIO COMING SOON]
Shadow Health Focused Exam Abdominal Pain Rachel Adler
how is your appetite?
Question
01/18/20 12:38 PM MST
Esther Park I haven’t been hungry. Eating only makes me feel worse.
do you have nausea?
Question
01/18/20 12:39 PM MST
Esther Park No. I haven’t vomited or had any nausea. It’s more of a problem with pain. . . and difficulty going to the bathroom.
have you been vomiting?
Question
01/18/20 12:39 PM MST
Esther Park Very rarely. The last time I vomited. . . I had a stomach virus a few years ago. One of those nasty, 24-hour bugs.
do you have food poisoning?
Question
01/18/20 12:39 PM MST
Esther Park No, I didn’t eat anything unusual.
do you have a history of bladder disease?
Question
01/18/20 12:40 PM MST
Esther Park No.
do you have any pain when you urinate?
Question
01/18/20 12:40 PM MST
Esther Park No. It feels just the same as always.
do you have burning with urination?
Question
01/18/20 12:41 PM MST
Esther Park No, my urination has felt normal.
do you have problems holding your urine?
Question
01/18/20 12:42 PM MST
Esther Park I’ve never had problems with. . . controlling myself.
have you had past urinary tract infections?
Question
01/18/20 12:42 PM MST
Esther Park I don’t remember ever having one, no.
do you hold your urine in unnecessarily?
Question
01/18/20 12:43 PM MST
Esther Park I wouldn’t say I hold it in, no.
do you have any gynecological problems?
Question
01/18/20 12:49 PM MST
Esther Park No. I don’t have problems with that area.
do you have vaginal bleeding?
Question
01/18/20 12:49 PM MST
Esther Park No.
do you have vaginal discharge?
Question
01/18/20 12:50 PM MST
Esther Park I think I have the normal amount of vaginal discharge. . . it all seems fine.
when did you start menopause?
Question
01/18/20 12:50 PM MST
Esther Park Oh my. . . it was twenty years or more ago. . . I think I was 54.
do you have a history of kidney disease?
Question
01/18/20 12:51 PM MST
Esther Park No, I’ve never had any kidney trouble.
Measured vitals
Exam Action
01/18/20 12:56 PM MST
Inspected general face: Slight flushing of cheeks
Exam Action
01/18/20 12:57 PM MST
Inspected forehead and scalp
Exam Action
01/18/20 12:57 PM MST
Inspected nose and mouth
Exam Action
01/18/20 12:57 PM MST
Inspected right side of face
Exam Action
01/18/20 12:58 PM MST
Inspected back of head
Exam Action
01/18/20 12:58 PM MST
Inspected left side of face
Exam Action
01/18/20 12:58 PM MST
Inspected general face: Slight flushing of cheeks
Exam Action
01/18/20 12:58 PM MST
Performed otoscopic examination of right naris
Exam Action
01/18/20 12:58 PM MST
Performed otoscopic examination of left naris
Exam Action
01/18/20 12:58 PM MST
Inspected mouth and throat
Exam Action
01/18/20 12:59 PM MST
Inspected right side of abdomen
Exam Action
01/18/20 12:59 PM MST
Inspected front of abdomen
Exam Action
01/18/20 12:59 PM MST
Inspected right side of abdomen
Exam Action
01/18/20 1:00 PM MST
Inspected front of abdomen
Exam Action
01/18/20 1:00 PM MST
Inspected left side of abdomen
Exam Action
01/18/20 1:00 PM MST
Inspected right leg for edema: No edema
Exam Action
01/18/20 1:01 PM MST
Inspected front of legs for edema: No edema
Exam Action
01/18/20 1:01 PM MST
Inspected left leg for edema: No edema
Exam Action
01/18/20 1:01 PM MST
Inspected front of legs for edema: No edema
Exam Action
01/18/20 1:01 PM MST
Auscultated aortic area with the bell
Exam Action
01/18/20 1:02 PM MST
Auscultated aortic area with the diaphragm
Exam Action
01/18/20 1:02 PM MST
Auscultated pulmonic area with the diaphragm
Exam Action
01/18/20 1:02 PM MST
Auscultated pulmonic area with the bell
Exam Action
01/18/20 1:02 PM MST
Auscultated Erb’s point with the bell
Exam Action
01/18/20 1:02 PM MST
Auscultated Erb’s point with the diaphragm
Exam Action
01/18/20 1:02 PM MST
Auscultated tricuspid area with the diaphragm
Exam Action
01/18/20 1:02 PM MST
Auscultated tricuspid area with the bell
Exam Action
01/18/20 1:02 PM MST
Auscultated mitral area with the bell
Exam Action
01/18/20 1:02 PM MST
Auscultated mitral area with the diaphragm
Exam Action
01/18/20 1:02 PM MST
Auscultated breath sounds in anterior right upper lobe
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in anterior left upper lobe
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in anterior right middle lobe
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in anterior left mid-chest (upper lobe)
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in anterior right lower lobe
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in anterior left lower lobe
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in posterior left upper lobe
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in posterior right upper lobe Shadow Health Focused Exam Abdominal Pain Rachel Adler
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in posterior left mid-back (lower lobe)
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in posterior right mid-back (lower lobe)
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in posterior left lower lobe
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in posterior left lower lobe on side
Exam Action
01/18/20 1:04 PM MST
Auscultated breath sounds in posterior left lower lobe near spine
Exam Action
01/18/20 1:05 PM MST
Auscultated breath sounds in posterior right lower lobe
Exam Action
01/18/20 1:05 PM MST
Auscultated breath sounds in posterior right lower lobe near spine
Exam Action
01/18/20 1:05 PM MST
Auscultated breath sounds in posterior right lower lobe on side
Exam Action
01/18/20 1:05 PM MST
Auscultated aorta in abdomen
Exam Action
01/18/20 1:06 PM MST
Auscultated right upper quadrant
Exam Action
01/18/20 1:06 PM MST
Auscultated left upper quadrant
Exam Action
01/18/20 1:06 PM MST
Auscultated right lower quadrant
Exam Action
01/18/20 1:06 PM MST
Auscultated left lower quadrant
Exam Action
01/18/20 1:06 PM MST
Auscultated right renal artery
Exam Action
01/18/20 1:07 PM MST
Auscultated left renal artery
Exam Action
01/18/20 1:07 PM MST
Auscultated right iliac artery
Exam Action
01/18/20 1:07 PM MST
Auscultated left iliac artery
Exam Action
01/18/20 1:07 PM MST
Auscultated right femoral artery
Exam Action
01/18/20 1:07 PM MST
Auscultated left femoral artery
Exam Action
01/18/20 1:07 PM MST
Percussed right upper quadrant
Exam Action
01/18/20 1:08 PM MST
Percussed left upper quadrant
Exam Action
01/18/20 1:08 PM MST
Percussed right lower quadrant
Exam Action
01/18/20 1:08 PM MST
Percussed left lower quadrant
Exam Action
01/18/20 1:08 PM MST
Percussed left flank for CVA tenderness
Exam Action
01/18/20 1:09 PM MST
Percussed right flank for CVA tenderness
Exam Action
01/18/20 1:09 PM MST
Percussed for spleen
Exam Action
01/18/20 1:10 PM MST
Percussed for liver span: 7 cm in the mid-clavicular line
Exam Action
01/18/20 1:12 PM MST
Palpated right upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension
Exam Action
01/18/20 1:14 PM MST
Palpated left upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension
Exam Action
01/18/20 1:14 PM MST
Palpated right lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension
Exam Action
01/18/20 1:14 PM MST
Palpated left lower quadrant with light pressure: Tenderness reported; palpable guarding and distension, no masses
Exam Action
01/18/20 1:14 PM MST
Palpated right upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension
Exam Action
01/18/20 1:15 PM MST
Esther Park That feels alright.
Palpated left upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension
Exam Action
01/18/20 1:15 PM MST
Esther Park That feels alright.
Palpated right lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension
Exam Action
01/18/20 1:15 PM MST
Esther Park That feels alright.
Palpated left lower quadrant with light pressure: Tenderness reported; palpable guarding and distension, no masses
Exam Action
01/18/20 1:15 PM MST
Esther Park Mmm, it feels sore there.
Palpated right upper quadrant with deep pressure: No masses
Exam Action
01/18/20 1:16 PM MST
Esther Park That feels alright.
Palpated left upper quadrant with deep pressure: No masses
Exam Action
01/18/20 1:16 PM MST
Esther Park That feels alright.
Palpated right lower quadrant: with deep pressure: No masses
Exam Action
01/18/20 1:16 PM MST
Esther Park That feels alright.
Palpated left lower quadrant with deep pressure: Firm, oblong mass (2x4cm)
Exam Action
01/18/20 1:16 PM MST
Esther Park Ooo, that–that’s sore right there.
Palpated for liver: Palpable 1 cm below right costal margin
Exam Action
01/18/20 1:17 PM MST
Palpated for spleen: Not palpable
Exam Action
01/18/20 1:18 PM MST
Palpated bladder: Not palpable; no distention or tenderness
Exam Action
01/18/20 1:18 PM MST
Palpated for right kidney: Not palpable
Exam Action
01/18/20 1:18 PM MST
Palpated for left kidney: Not palpable
Exam Action
01/18/20 1:19 PM MST
Tested skin turgor
Exam Action
01/18/20 1:19 PM MST
Diana Shadow In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: In a geriatric patient, what are some common considerations regarding abdominal pain?
Already answered
Statement
01/19/20 11:35 AM MST
Diana Shadow Time to begin.
Diana Shadow In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: In a geriatric patient, what are some common considerations regarding abdominal pain?
What is the situation?
Question
01/19/20 11:54 AM MST
Diana Shadow Your patient is Esther Park, a 78-year-old Korean woman presenting with abdominal pain in Shadow General Hospital’s Emergency Department. Your role in this simulation is that of a healthcare provider who will conduct a focused history and physical examination of Mrs. Park in order to assess her condition and transfer her care.
Diana Shadow In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: In a geriatric patient, what are some common considerations regarding abdominal pain?
Diana Shadow In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: In a geriatric patient, what are some common considerations regarding abdominal pain?
Diana Shadow In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: In a geriatric patient, what are some common considerations regarding abdominal pain?
Diana Shadow In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: In a geriatric patient, what are some common considerations regarding abdominal pain?
They are at risk for both small and large bowel obstructions.
Statement
01/19/20 8:50 PM MST
Diana Shadow Time to begin.
Esther park is a 78-year-old woman who is presenting with persistent, generalized abdominal pain. She rated the pain at 6/10 and said that it is dull and crampy. She has had vague abdominal discomfort discomfort for almost a week, and her pain has gotten worse. (No matching questions found.)
Question
01/19/20 8:57 PM MST
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
- Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
- Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
- One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
- I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
- Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
- In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
- Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
- Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
- Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
- Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
- I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
- I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
- As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
- It is best to paraphrase content and cite your source.
LopesWrite Policy
- For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
- Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
- Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
- Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
- The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
- Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
- If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
- I do not accept assignments that are two or more weeks late unless we have worked out an extension.
- As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
- Communication is so very important. There are multiple ways to communicate with me:
- Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
- Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
| Hello! | Question 05/10/20 11:57 PM MDT | |
 | Hi. I’m Preceptor Diana. I will explain the details of this assignment and your objectives, just as a preceptor would in real life. Pay close attention to this information as it will help guide your exam. At the end of this prebrief, you will answer a short question about the upcoming assignment. During the simulation, you may return to these instructions at any time by scrolling to the top of your transcript. | |
 | What is the situation? | Question 05/10/20 11:58 PM MDT |
| Your patient is Esther Park, a 78-year-old Korean-American woman presenting with abdominal pain in Shadow General Hospital’s Emergency Department. Your role in this simulation is that of a healthcare provider who will conduct a focused history and physical examination of Ms. Park in order to assess her condition and transfer her care. | |
| What is the situation? | Question 05/10/20 11:58 PM MDT |
| Your patient is Esther Park, a 78-year-old Korean-American woman presenting with abdominal pain in Shadow General Hospital’s Emergency Department. Your role in this simulation is that of a healthcare provider who will conduct a focused history and physical examination of Ms. Park in order to assess her condition and transfer her care. | |
| What else will this exam involve? | Question 05/11/20 12:00 AM MDT |
| You will complete nursing tasks to protect the patient’s safety, privacy, and health. You can document your findings, including vital signs, in the Electronic Health Record. This record provides necessary information for healthcare professionals who will continue patient care. | |
| How will I be evaluated? | Question 05/11/20 12:00 AM MDT |
| The activities evaluated by the simulation are Subjective and Objective Data Collection and Education and Empathy. Nursing tasks and Documentation, while they provide valuable practice for their real-world counterparts, are not automatically evaluated by the simulation. The evaluation of your interview is dependent on how you word your questions therapeutically and precisely and explore all relevant topics with comprehensive breadth and depth. The evaluation of your physical exam is based on how successfully you report on your physical findings by selecting among clinical terms in the Electronic Health Record. Your success in Education and Empathy is based on whether you promptly respond after identifying a moment worthy of therapeutic communication. This assignment takes on average between 45 and 60 minutes. You can pause and resume the assignment at any time; your work is always saved automatically. | |
| How does this assignment prepare me for the real world? | Question 05/11/20 12:04 AM MDT |
| In this assessment, you will become familiarized with the structure and content of an abdominal focused exam so that with real-life patients, you can: º ask effective and comprehensive questions º educate and empathize with the patient º evaluate the patient’s risk of disease, infection, injury, and complications º and obtain and assess objective data | |
| What is the situation? | Question 05/11/20 12:04 AM MDT |
| Your patient is Esther Park, a 78-year-old Korean-American woman presenting with abdominal pain in Shadow General Hospital’s Emergency Department. Your role in this simulation is that of a healthcare provider who will conduct a focused history and physical examination of Ms. Park in order to assess her condition and transfer her care. | |
| What are my objectives in this assessment? | Question 05/11/20 12:11 AM MDT |
| In your interview with Ms. Park, you will ask about the history of her presenting illness and the functioning of relevant systems in order to obtain subjective data related to her abdominal pain. If you discover any disease states, ask about symptoms and the patient’s experiences of them. Your questioning should cover a broad array of the symptoms’ characteristics. In addition to collecting subjective data, you will perform a physical exam on Ms. Park to gather objective data about her health and physiology. Throughout the conversation, you should educate and empathize with Ms. Park when appropriate to increase her health literacy and sense of well-being. While you should communicate with patients using accessible, everyday language, it is standard practice to use professional medical terminology everywhere else, such as in documenting physical findings and nursing notes. You may complete the exam activities in any order and move between them as needed. | |
| In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: In a geriatric patient, what are some common considerations regarding abdominal pain? | |
| Bowel obstruction | Statement 05/11/20 12:14 AM MDT |
| Time to begin. | |
| In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: In a geriatric patient, what are some common considerations regarding abdominal pain? | |
| Bowel Obstruction | Statement 05/11/20 12:17 AM MDT |
| Time to begin. | |
| Hello and welcome to the clinic. My name is xxxxx. I will interview you today and do a physical examination. What is your name? |
