SURGERY 929_ Shadown Health Focused Exam_Long Bone Fracture

Digital Clinical Experience Score 96.6% This score measures your performance on the Student Performance Index in relation to other students in comparable academic programs. Your instructor has chosen to scale your Student Performance Index score so that the average score on the index is a 80.0%. This score may not be your final grade if your instructor chooses to include additional components, such as documentation or time spent. Student Performance Index 52.4 out of 60.5 Proficiency Level: Proficient • Beginning • Developing • Proficient Students rated as “proficient” demonstrate entry-level expertise in nursing competencies and clinical reasoning skills. In comparable nursing programs, the top 25% of students perform at the level of a proficient nurse. Subjective Data Collection 26 out of 26 Objective Data Collection 17.4 out of 18 Education and Empathy 4 out of 8 Care Plan 5 out of 8.5 Time 124 minutes total spent in assignment Interaction with patient 124 minutes Started: Sep 17, 2020 | Total Time: 124 min All Lines (218)Interview Questions (139)Statements (24)Exam Actions (55) Hello, I'll be your nurse today. Greet 09/17/20 9:01 AM CDT Hi. I can hear that you're crying, what happened? (No matching questions found.) Question 09/17/20 9:01 AM CDT Are you in a lot of pain? (No matching questions found.) Question 09/17/20 9:01 AM CDT Are you in pain? (Clarified to What is causing the pain?.) Question 09/17/20 9:01 AM CDT Moving or touching. I told Mommy not to touch it. [AUDIO COMING SOON] (Clarified to what is causing the pain.) I'm sorry it hurts, Landon> Empathize 09/17/20 9:02 AM CDT Thanks. What is your mom's name? (No matching questions found.) Question 09/17/20 9:02 AM CDT When did you get hurt? Question 09/17/20 9:02 AM CDT After naptime. Mommy wasn't home yet. What happened? Question 09/17/20 9:03 AM CDT My arm is hurting bad. I'm sorry your arm is hurting. Empathize 09/17/20 9:03 AM CDT Um, thank you. What happened to your arm? Question 09/17/20 9:03 AM CDT I fell. Do you need any ice? (Clarified to Do you need anything?.) Question 09/17/20 9:03 AM CDT No, I went to the bathroom already. [AUDIO COMING SOON] (Clarified to if I need anything.) Do you need some water? (No matching questions found.) Question 09/17/20 9:03 AM CDT Have you taken any pain medication? Question 09/17/20 9:03 AM CDT No, medicine is yucky. [AUDIO COMING SOON] Medicine can help with your pain. Educate 09/17/20 9:04 AM CDT OK. I'm sorry medicine tastes yucky. Empathize 09/17/20 9:04 AM CDT Thats nice. Putting ice on your pain can help too. Educate 09/17/20 9:04 AM CDT Yeah. Where is your pain? Question 09/17/20 9:04 AM CDT Umm . . . [Landon reports pain in his upper left arm by pointing] [AUDIO COMING SOON] How did you get hurt? Question 09/17/20 9:05 AM CDT I fell. Did you break your arm? (No matching questions found.) Question 09/17/20 9:05 AM CDT How much does it hurt? Question 09/17/20 9:05 AM CDT Really bad. [AUDIO COMING SOON] Do you fall a lot? (Clarified to Can you tell me how you fell?.) Question 09/17/20 9:06 AM CDT I was showing Donnie a basketball trick. I couldn't do it so I fell. It was my fault. (Clarified to how I fell.) Did you fall on your arm? Question 09/17/20 9:06 AM CDT No, on the floor. [AUDIO COMING SOON] how long has your arm been hurting? Question 09/17/20 9:06 AM CDT Since when I fell. [AUDIO COMING SOON] Is there anything else that makes your pain better? (Clarified to Does anything help the pain?.) Question 09/17/20 9:08 AM CDT Keeping still. (Clarified to if anything helps the pain.) Is this woman your mom? (No matching questions found.) Question 09/17/20 9:08 AM CDT What is your relationship to Landon? Question 09/17/20 9:08 AM CDT Mommy's friend. We were playing when I fell . . . Do you feel dizzy? Question 09/17/20 9:09 AM CDT Yeah . . . [AUDIO COMING SOON] Do you have trouble seeing? (No matching questions found.) Question 09/17/20 9:09 AM CDT Do you have trouble remembering what happened? (No matching questions found.) Question 09/17/20 9:10 AM CDT Do you have trouble moving? (No matching questions found.) Question 09/17/20 9:10 AM CDT Is it hard to move? (Clarified to Do you have difficulty moving your fingers?.) Question 09/17/20 9:10 AM CDT No, they're OK. [AUDIO COMING SOON] (Clarified to if I have difficulty moving my fingers.) Do your muscles feel weak? (No matching questions found.) Question 09/17/20 9:11 AM CDT Is it hard to move? (Clarified to Does the pain limit your movement?.) Question 09/17/20 9:11 AM CDT I don't wanna move my arm. It really hurts to move. (Clarified to if the pain is limiting my movement.) I'm sorry it hurts to move your arm. Empathize 09/17/20 9:11 AM CDT Thank you. Keeping your arm still can help relieve the pain too. Educate 09/17/20 9:12 AM CDT Mhm, yeah. Do you have muscle pain? (No matching questions found.) Question 09/17/20 9:12 AM CDT Does it feel warm where you hurt your arm? (No matching questions found.) Question 09/17/20 9:13 AM CDT Do you play a lot? (No matching questions found.) Question 09/17/20 9:14 AM CDT Do you play a lot of basketball? (No matching questions found.) Question 09/17/20 9:14 AM CDT Do you run around a lot? (No matching questions found.) Question 09/17/20 9:14 AM CDT Does it hurt to move? (No matching questions found.) Question 09/17/20 9:14 AM CDT Do you have trouble moving? (No matching questions found.) Question 09/17/20 9:14 AM CDT is there any bone pain? (No matching questions found.) Question 09/17/20 9:14 AM CDT Do you have pain in more than one joint? (No matching questions found.) Question 09/17/20 9:17 AM CDT Do you have pain elsewhere? Question 09/17/20 9:17 AM CDT It's only my arm. How is this woman related to you? (No matching questions found.) Question 09/17/20 9:18 AM CDT How is she related to you? (No matching questions found.) Question 09/17/20 9:18 AM CDT Is this your mom here? (No matching questions found.) Question 09/17/20 9:18 AM CDT Is she your arm? (No matching questions found.) Question 09/17/20 9:18 AM CDT Who is this adult next to you? (No matching questions found.) Question 09/17/20 9:18 AM CDT who brought you in today? (Clarified to Do you know what brings you in today?.) Question 09/17/20 9:18 AM CDT . . . my arm. (Clarified to if I know why I came in.) Who brought you in? (No matching questions found.) Question 09/17/20 9:18 AM CDT Is this woman your mom? (No matching questions found.) Question 09/17/20 9:19 AM CDT Who is with you? Question 09/17/20 9:19 AM CDT Mommy's friend. We were playing when I fell . . . Did you mom bring you here? (No matching questions found.) Question 09/17/20 9:19 AM CDT Your hurt your arm? (Clarified to Did Donnie hurt your arm?.) Question 09/17/20 9:19 AM CDT Um, no. [AUDIO COMING SOON] (Clarified to if Donnie hurt my arm.) who brought you here? (Clarified to Who are you?.) Question 09/17/20 9:20 AM CDT I'm Landon. (Clarified to who am I.) and who is the other person? (No matching questions found.) Question 09/17/20 9:20 AM CDT who is the other person? (No matching questions found.) Question 09/17/20 9:20 AM CDT Do you have any allergies? Question 09/17/20 9:21 AM CDT Um... [AUDIO COMING SOON] It's good to come to the hospital right away after getting hurt. Educate 09/17/20 9:21 AM CDT Umm, ok. How long has it been since you hurt your arm? (Clarified to How long have you been in pain?.) Question 09/17/20 9:21 AM CDT Since when I fell. [AUDIO COMING SOON] (Clarified to how long I have been in pain.) When did you fall? Question 09/17/20 9:21 AM CDT After naptime. Mommy wasn't home yet. When was nap time? (No matching questions found.) Question 09/17/20 9:22 AM CDT Did you come here right away? Question 09/17/20 9:22 AM CDT My arm is hurting bad. Guardian, what is your relationship? (No matching questions found.) Question 09/17/20 9:22 AM CDT What is your relationship to Landon? Question 09/17/20 9:23 AM CDT Mommy's friend. We were playing when I fell . . . Who was babysitting you? (No matching questions found.) Question 09/17/20 9:23 AM CDT Who babysits you? (No matching questions found.) Question 09/17/20 9:23 AM CDT Where is your mom? (No matching questions found.) Question 09/17/20 9:23 AM CDT How long has your arm been hurting? Question 09/17/20 9:24 AM CDT Since when I fell. [AUDIO COMING SOON] Is this your parent? (No matching questions found.) Question 09/17/20 9:26 AM CDT Who is this person that is with you? (No matching questions found.) Question 09/17/20 9:30 AM CDT Guardian (No matching questions found.) Question 09/17/20 9:39 AM CDT What is your relationship to Landon? (Clarified to What is your relationship to the patient?.) Question 09/17/20 9:40 AM CDT I'm Landon's mother. [AUDIO COMING SOON] (Clarified to what my relationship is to the patient.) How did Landon get hurt? Question 09/17/20 9:43 AM CDT Well, I was at the office, but my boyfriend was at home watching Landon. He said Landon was off playing in his room when he heard a thud and crying. When he went into Landon's room, Landon was on the floor and cradling his arm. [AUDIO COMING SOON] Did Landon break his arm? (No matching questions found.) Question 09/17/20 9:45 AM CDT Is his arm broken? (No matching questions found.) Question 09/17/20 9:45 AM CDT Landon hurt his arm? (Clarified to How did your son get hurt?.) Question 09/17/20 9:46 AM CDT Well, I was at the office, but my boyfriend was at home watching Landon. He said Landon was off playing in his room when he heard a thud and crying. When he went into Landon's room, Landon was on the floor and cradling his arm. [AUDIO COMING SOON] (Clarified to how my son injured himself.) What brings Landon in today? Question 09/17/20 9:46 AM CDT Landon fell while I was at work . . . l think his arm broke the fall. He seems pretty hurt. [AUDIO COMING SOON] It's best to keep the bone still to prevent further injury. Educate 09/17/20 9:47 AM CDT OK. Thank you. Icing his arm will help to relieve his pain too. (No matching questions found.) Question 09/17/20 9:48 AM CDT It will help to take some pain medication too. Educate 09/17/20 9:48 AM CDT taking some pain medication will help. (No matching questions found.) Question 09/17/20 9:48 AM CDT Gotcha. How long has it been since Landon got hurt? (Clarified to How long has it been since your son hurt himself?.) Question 09/17/20 9:48 AM CDT It's been about two hours since he fell and hurt his arm. [AUDIO COMING SOON] (Clarified to how long it has been since my son hurt himself.) What helps the pain? (No matching questions found.) Question 09/17/20 9:49 AM CDT What are some relieving factors? (No matching questions found.) Question 09/17/20 9:49 AM CDT What makes the pain feel better? (Clarified to What helps your son feel better?.) Question 09/17/20 9:49 AM CDT I wasn't there when he fell, but when I got home I realized right away we needed to come to the hospital. Mothers just know when something is wrong with their baby. [AUDIO COMING SOON] (Clarified to what helps my son feel better.) Does Landon take any other medication? Question 09/17/20 9:51 AM CDT No, we're very lucky he doesn't need any. [AUDIO COMING SOON] What's Landon's medical history? (No matching questions found.) Question 09/17/20 9:52 AM CDT Has Landon been to the hospital before? (Clarified to Has your son ever been to the hospital before?.) Question 09/17/20 9:52 AM CDT No, no hospitalizations at all. [AUDIO COMING SOON] (Clarified to if my son has been hospitalized before.) Does Landon have any allergies? Question 09/17/20 9:54 AM CDT No, he's allergy free. [AUDIO COMING SOON] Does he take any supplements? (No matching questions found.) Question 09/17/20 9:54 AM CDT Does Landon live with you? (No matching questions found.) Question 09/17/20 9:58 AM CDT Does anybody else live at home? (No matching questions found.) Question 09/17/20 9:58 AM CDT What is your living situation? Question 09/17/20 9:58 AM CDT My living situation is great. It's just me and Landon right now and I love our little home. My parents used to watch Landon a lot more, but we live further away now so that's not really an option anymore. But I like Landon in daycare, he gets to play and be around kids his own age. [AUDIO COMING SOON] How do you like daycare? (No matching questions found.) Question 09/17/20 10:08 AM CDT Do you like daycare? (No matching questions found.) Question 09/17/20 10:09 AM CDT Is there any emotional and physical abuse at home? (No matching questions found.) Question 09/17/20 10:09 AM CDT Does Landon get hurt often? (No matching questions found.) Question 09/17/20 10:09 AM CDT I'm sorry you live farther away from your parents now. Empathize 09/17/20 10:09 AM CDT Thanks, I . . . I needed to hear that I think. It's hard when you don't have many family members around. (No matching questions found.) Question 09/17/20 10:10 AM CDT Daycare is a great option otherwise. (No matching questions found.) Question 09/17/20 10:10 AM CDT Daycare does help with a lot of learning. Educate 09/17/20 10:10 AM CDT That makes sense, thanks. Is your home safe? Question 09/17/20 10:10 AM CDT Yeah, of course I do. I'm going to get rid of Landon's bunk bed now though, so he doesn't fall again and hurt himself. [AUDIO COMING SOON] Does Landon feel any pain? (No matching questions found.) Question 09/17/20 10:12 AM CDT Does Landon have trouble seeing? (Clarified to Is your son having difficulty moving?.) Question 09/17/20 10:12 AM CDT His movements seem normal. I mean, he definitely doesn't want to move his arm around. But he got in and out of the car OK once I got him out of his car seat. [AUDIO COMING SOON] (Clarified to if my son is having difficulty moving.) Are there any neurological issues? (No matching questions found.) Question 09/17/20 10:13 AM CDT Was Landon conscious? (No matching questions found.) Question 09/17/20 10:14 AM CDT Does Landon have trouble remembering anything? Question 09/17/20 10:14 AM CDT His movements seem normal. I mean, he definitely doesn't want to move his arm around. But he got in and out of the car OK once I got him out of his car seat. [AUDIO COMING SOON] Can Landon remember what he had for breakfast? (No matching questions found.) Question 09/17/20 10:14 AM CDT Does Landon have memory problems? (No matching questions found.) Question 09/17/20 10:15 AM CDT Can Landon move his fingers? Question 09/17/20 10:15 AM CDT Yeah, I asked him to wiggle his fingers for me earlier and he could without issue. [AUDIO COMING SOON] Did he scrape himself? (No matching questions found.) Question 09/17/20 10:15 AM CDT Did Landon get any cut? (No matching questions found.) Question 09/17/20 10:15 AM CDT Checked ID band Exam Action 09/17/20 10:36 AM CDT Assessed vitals Exam Action 09/17/20 10:36 AM CDT is he bleeding? (No matching questions found.) Question 09/17/20 10:16 AM CDT Is he bleeding? (No matching questions found.) Question 09/17/20 10:16 AM CDT Assessed vitals Exam Action 09/17/20 10:37 AM CDT Is he bleeding? (No matching questions found.) Question 09/17/20 10:37 AM CDT Is he bleeding? (No matching questions found.) Question 09/17/20 10:37 AM CDT Inspected shoulders from the front Exam Action 09/17/20 10:38 AM CDT Inspected left shoulder Exam Action 09/17/20 10:38 AM CDT Inspected upper back Exam Action 09/17/20 10:38 AM CDT Inspected left arm Exam Action 09/17/20 10:39 AM CDT Inspected front of left arm: swelling and discoloration Exam Action 09/17/20 10:39 AM CDT Inspected side of left arm: swelling and discoloration Exam Action 09/17/20 10:40 AM CDT Inspected back of left arm: swelling and discoloration Exam Action 09/17/20 10:40 AM CDT Inspected side of left arm: swelling and discoloration Exam Action 09/17/20 10:40 AM CDT Inspected front of left arm: swelling and discoloration Exam Action 09/17/20 10:40 AM CDT How did Landon fall? Question 09/17/20 10:40 AM CDT I wasn't home at the time, but Donnie said he heard a thump from upstairs where Landon was playing. He ran upstairs and found him crying on the floor, holding his arm. His bed is about four feet tall-- it's one of those bunks for little kids that Landon insisted I get for him. It must have been a pretty nasty fall. [AUDIO COMING SOON] Was the bruise this big? (No matching questions found.) Question 09/17/20 10:41 AM CDT Did he have a bruise? (No matching questions found.) Question 09/17/20 10:41 AM CDT Was he bruised? (No matching questions found.) Question 09/17/20 10:41 AM CDT Inspected left elbow Exam Action 09/17/20 10:41 AM CDT Inspected right elbow Exam Action 09/17/20 10:41 AM CDT Inspected both wrists Exam Action 09/17/20 10:42 AM CDT Inspected both hands: No visible abnormal findings Exam Action 09/17/20 10:42 AM CDT Inspected front of hips Exam Action 09/17/20 10:42 AM CDT Inspected front of hips Exam Action 09/17/20 10:42 AM CDT Inspected front of thighs Exam Action 09/17/20 10:42 AM CDT Inspected front of knees Exam Action 09/17/20 10:42 AM CDT Inspected front of thighs Exam Action 09/17/20 10:42 AM CDT Inspected front of knees Exam Action 09/17/20 10:42 AM CDT Inspected front of legs Exam Action 09/17/20 10:42 AM CDT Inspected right ankle Exam Action 09/17/20 10:43 AM CDT Inspected top of feet Exam Action 09/17/20 10:43 AM CDT Inspected top of feet Exam Action 09/17/20 10:43 AM CDT Tested capillary refill Exam Action 09/17/20 10:43 AM CDT Tested ROM of shoulders - flexion Exam Action 09/17/20 10:44 AM CDT Tested ROM of elbows - flexion and extension Exam Action 09/17/20 10:48 AM CDT Tested ROM of wrists - flexion Exam Action 09/17/20 10:49 AM CDT Tested left arm sensation Exam Action 09/17/20 10:49 AM CDT Tested right arm sensation Exam Action 09/17/20 10:49 AM CDT Inspected left torso: No abnormal findings Exam Action 09/17/20 10:51 AM CDT Inspected back torso: There is a fading bruise. No other abnormal findings. Exam Action 09/17/20 10:51 AM CDT Inspected right torso: No abnormal findings Exam Action 09/17/20 10:52 AM CDT Inspect skin Exam Action 09/17/20 10:52 AM CDT How did you get that bruise on your back? Question 09/17/20 10:52 AM CDT I . . . I dunno . . . I fell. Do you fall often? Question 09/17/20 10:52 AM CDT I just fall sometimes . . . Donnie says Im clumsy. Do you get hurt a lot? Question 09/17/20 10:53 AM CDT I mean I think so. Now you have me a little paranoid with these questions. Landon is an active kid. I thought falling around, bumps, and bruises were normal for a 4-year-old. He said the bruise on his back was from falling on a toy and I believed him. How long has that bruise been there? Question 09/17/20 10:53 AM CDT Probably because hes so slow on the uptake. Donnies really sweet, but hes no genius, trust me. When did you get that bruise on your back? (Clarified to How did you get the bruise?.) Question 09/17/20 10:54 AM CDT I fell down. (Clarified to how I got the bruise.) Does Landon bruise easily? (Clarified to Does your son have any bruises?.) Question 09/17/20 10:54 AM CDT He's got a bruise on his back from a tumble a few days ago, but it's healing up. Other than that, there's just the bruising and swelling from his arm. [AUDIO COMING SOON] (Clarified to if my son has any bruises.) Are there any other safety concerns? Question 09/17/20 10:55 AM CDT Not really. I mean, I'm a little freaked out about all of this. But I'll answer anything you ask me. I just want Landon to be taken care of. He's my number one priority. The most common injuries for children his age are head injuries and broken bones. Educate 09/17/20 10:55 AM CDT I appreciate you telling us, now we know. I'm sorry Landon got hurt. Empathize 09/17/20 10:55 AM CDT I'm glad to hear that, thank you. How long have you been with Donnie? Question 09/17/20 10:57 AM CDT I've known Donnie for about 7 months. We met at a restaurant. I introduced him to Landon a few weeks ago, and he's been visiting the house lately. [AUDIO COMING SOON] Has Landon gotten any bruises before you met Donnie? (No matching questions found.) Question 09/17/20 10:58 AM CDT