NR 509 Asthma Respiratory Completed Shadow Health (NR509)

Exam (elaborations) NR 509 Asthma Respiratory Completed Shadow Health (NR509) Respiratory Results | Turned In Advanced Health Assessment - Chamberlain, NR509-June-2018 Return to Assignment Your Results Lab Passss Started: Jul 21, 2018 | Patient Exam Time: 738 min Transcript Greet 07/21/18 11:17 PM CDT Question 07/21/18 11:18 PM CDT Question 07/21/18 11:18 PM CDT Question 07/21/18 11:19 PM CDT Overview Transcript Subjective Data Collection Objective Data Collection Education & Empathy Documentation Student Pre-Survey Lifespan Review Questions Self-Reflection IIntterrvviiew Quessttiionss (()) Sttattementtss ((2233)) Exxam Acttiionss ((5588)) Tiina,, iitt''ss good tto ssee yyou agaiin.. IIff yyou don''tt rrememberr me,, II''m Scotttt,, yyourr nurrsse prracttiittiionerr.. II''llll be doiing yyourr exxamiinattiion ttodayy.. Hey. Whatt brriingss yyou iin ttodayy? I came in because I've been having breathing problems, and my inhaler just isn't working the way it normally does. Tellll me aboutt tthe brreatthiing iissssuess yyourr exxperriienciing? It feels like it's been hard to take in air. My chest feels all tight and I've been wheezing... I've had to use my inhaler a lot, and it doesn't feel like it's totally working. To makke ssurre II underrssttand,, yyou ffeell lliikke yyou can''tt gett enough aiirr? ((No mattchiing quessttiionss ffound..)) Allll Liiness (()) Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/21/18 11:19 PM CDT Empathize 07/21/18 11:20 PM CDT Educate 07/21/18 11:22 PM CDT Question 07/21/18 11:22 PM CDT Question 07/21/18 11:22 PM CDT Question 07/21/18 11:22 PM CDT Question 07/21/18 11:23 PM CDT Question 07/21/18 11:23 PM CDT You can''tt gett enough aiirr iin tto yyourr llungss? ((No mattchiing quessttiionss ffound..)) II''m ssorrrryy,, tthattss a tterrrriiblle ffeelliing.. Thanks for saying that. II kknow tthatt we havve been tthrrough tthesse ssame ssett off quessttiionss,, sso II''m ssorrrryy II''m goiing tto asskk tthem agaiin.. II''m nott rreallllyy iinssullttiing yyourr iinttelllliigence,, alltthough iitt mayy sseem lliikke II am.. Alright, thanks for letting me know. When diid yyourr brreatthiing iissssuess begiin? All of these breathing problems started two days ago, at my cousin's house. Werre yyou arround cattss? Two days ago, at my cousin's house. She has three of them, and my asthma always goes crazy when I'm there. Becausse yyourr allllerrgiic tto cattss,, rriightt? Definitely. Cats make my asthma go crazy. How llong werre yyou exxpossed tto tthesse cattss? ((No mattchiing quessttiionss ffound..)) Hass yyourr asstthma gotttten worrsse ssiince yyou werre exxpossed tto tthe cattss? Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/21/18 11:24 PM CDT Question 07/21/18 11:24 PM CDT Question 07/21/18 11:25 PM CDT Question 07/21/18 11:25 PM CDT Question 07/21/18 11:26 PM CDT Question 07/21/18 11:26 PM CDT Question 07/21/18 11:27 PM CDT No, my asthma has definitely got better since I was little. It used to be really bad--I would get asthma attacks all the time. Just lately, though, it's been worse than usual. Diid anyytthiing makke yyou asstthma ffeell betttterr? ((No mattchiing quessttiionss ffound..)) Yourr iinhallerr diidn''tt hellp yyourr asstthma? ((Cllarriifified tto whatt do yyou do iiff yyourr iinhallerr doessn''tt worrkk..)) I guess I don't really have a backup plan; it's always worked in the past, though lately I've needed more puffs than usual. How manyy puffffss do yyou need? Sometimes I have to take three puffs instead of two, and the past couple days, always three. [Nurse confirmed with Pharmacy: albuterol 90mcg/spray MDI] How manyy ttiimess diid yyou usse yyourr iinhallerr tthe passtt ttwo dayyss? ((Cllarriifified tto how manyy ttiimess havve yyou ussed yyourr iinhallerr iin tthe passtt ttwo dayyss..)) I've been needing my inhaler about every four hours, I'd say. Whatt havve yyou done tto ttrreatt yyourr asstthma? ((Cllarriifified tto how do yyou manage yyourr asstthma..)) I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler. Whyy diidn''tt yyou avvoiid tthe cattss tthiiss ttiime? I haven't been sleeping as well because my asthma has been getting a little worse at night, and it's been waking me up, too. How manyy ttiimess tto yyou wakke up wiitth asstthma? Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/21/18 11:27 PM CDT Question 07/21/18 11:28 PM CDT Question 07/21/18 11:28 PM CDT Question 07/24/18 11:37 AM CDT Question 07/24/18 11:39 AM CDT Question 07/24/18 11:41 AM CDT Empathize 07/24/18 11:42 AM CDT I feel like I've woken up at least twice each night with breathing problems the past two nights. Arre yyou ablle tto ffallll backk asslleep? ((No mattchiing quessttiionss ffound..)) Havve yyou been ssiickk llattellyy? No, I'm usually healthy. Havve yyou been exxpossed tto anyy dusstt llattellyy? No. . . I'm not around dust much. It mostly happens if I'm at someone's house and they don't keep it very clean, and that hasn't happened in a while. How offtten havve yyou been havviing ttrroublle brreatthiing? Maybe as much as every four hours? It's a lot. When iiss tthe llasstt ttiime yyou werre hosspiittalliizzed becausse off an asstthma attttackk? I used to go to the hospital a lot for asthma attacks, but not since I was sixteen. Whatt havve yyou done tto avvoiid hosspiittalliizzattiionss due tto asstthma? ((No mattchiing quessttiionss ffound..)) Thatt''ss awessome -- tto be ablle tto avvoiid goiing tto tthe hosspiittall ssiince 16 yyearrss olld.. I appreciate you saying that. Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/24/18 11:42 AM CDT Question 07/24/18 11:42 AM CDT Question 07/24/18 11:43 AM CDT Question 07/24/18 11:44 AM CDT Question 07/24/18 11:44 AM CDT Question 07/24/18 11:45 AM CDT Question 07/24/18 11:46 AM CDT How havve yyou been ttrreattiing yyourr asstthma? I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler. How offtten havve yyou been ussiing yyourr iinhallerr llattellyy? I don't usually use it every day, but I've used it a bunch the past couple days. How manyy ttiimess a dayy do yyou ssue yyourr iinhallerr? I don't usually use it every day, but I've used it a bunch the past couple days. How manyy puffffss do yyou need tto hellp yyou brreatth betttterr? ((Cllarriifified tto How manyy iinhallerr puffffss do yyou need..)) Sometimes I have to take three puffs instead of two, and the past couple days, always three. [Nurse confirmed with Pharmacy: albuterol 90mcg/spray MDI] How manyy iinhallerr puffffss arre yyou prresscrriibed? I'm supposed to just do two puffs. [Nurse confirmed with Pharmacy: albuterol 90mcg/spray MDI] How effffecttiivve hass yyourr iinhallerr been? ((No mattchiing quessttiionss ffound..)) IIss yyourr iinhallerr been ffuncttiioniing abnorrmallllyy llattellyy? I don't usually use it every day, but I've used it a bunch the past couple days. Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/24/18 11:46 AM CDT Question 07/24/18 11:47 AM CDT Question 07/24/18 11:48 AM CDT Question 07/24/18 11:48 AM CDT Question 07/24/18 11:49 AM CDT Question 07/24/18 11:50 AM CDT Question 07/24/18 11:51 AM CDT Do yyou usse anyy ottherr mediicattiionss fforr yyourr asstthma? My inhaler is the only prescription I always have, but I usually don't need it everyday, except for recently. . . Do yyou ttakke anyy ottherr mediicattiionss? ((Cllarriifified tto arre yyou ttakkiing ottherr mediicattiionss..)) No, all I really use is my inhaler. Havve yyou evverr been prresscrriibed wiitth a corrttiicosstterroiid? Yeah, when I was diagnosed they gave me a medicine to try. Whatt mediicattiion diid ttheyy giivve yyou when yyou werre fifirrsstt diiagnossed wiitth asstthma? ((Cllarriifified tto how olld werre yyou when yyou werre diiagnossed wiitth asstthma..)) My doctor told me when I was pretty little... I think I was about two and a half? I used to have a lot of trouble with asthma attacks back then. Whiich mediicattiion diid yyourr docttorr fifirrsstt diiagnossed wiitth asstthma? ((No mattchiing quessttiionss ffound..)) Whiich mediicattiionss havve yyou ttrriied fforr asstthma iin tthe passtt? It's just a regular Proventil inhaler. Do yyou gett asstthma ssyympttomss when yyou exxerrciisse? ((Cllarriifified tto Do yyou havve asstthma when yyou exxerrciisse..)) Well, I don't exercise, really. I mean, I'm active -- I'm on my feet all day -- but I don't go running or stuff like that. I bet I'd get winded pretty fast, and I'd probably need my inhaler. Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/24/18 11:51 AM CDT Question 07/24/18 11:53 AM CDT Question 07/24/18 11:54 AM CDT Empathize 07/24/18 12:00 PM CDT Question 07/24/18 12:00 PM CDT Question 07/24/18 12:01 PM CDT Question 07/24/18 12:01 PM CDT Question 07/24/18 12:02 PM CDT Do yyou gett wiinded whiille goiing up a flfliightt off ssttaiirrss? ((Cllarriifified tto Do yyou gett sshorrtt off brreatth when yyou go up a flfliightt off ssttaiirrss?..)) Only when I'm in a rush and have to hurry up them. Do yyou havve sshorrttnessss off brreatth whiille doiing norrmall acttiivviittiiess arround tthe housse? It's definitely been harder to move around without worrying my asthma was going to act up again. Havve yyou evverr had an asstthma attttackk tthatt wass sso ssevverre tthatt yyou nearrllyy diied? ((Cllarriifified tto How manyy asstthma attttackkss havve yyou had..)) I haven't had a full attack, but I've had a lot of breathing problems-- probably. . . ten times since I was at my cousin's house two days ago. II''m ssorrrryy,, tthatt''ss rrough and a butt sscarryy.. Thanks for saying that. Arre yyou exxperriienciing anyy chesstt paiin? My chest has been feeling tight, but it doesn't hurt or anything. Do yyou ffeell iincrreassed ttiighttnessss when yyou ttakke a ssllow deep brreatth? ((No mattchiing quessttiionss ffound..)) Do yyou havve an iincrreasse iin chesstt ttiighttnessss when yyou ttakke a deep brreatth? ((Cllarriifified tto do yyou havve paiin when yyou brreatthe..)) No, my chest feels tight when I have breathing problems, but it doesn't hurt. On a sscalle ffrrom 0 tto 10,, tten beiing tthe worrsstt chesstt ttiighttnessss yyou''vve evverr ffelltt,, how woulld yyou rratte yyourr chesstt ttiighttnessss rriightt now? Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/24/18 12:04 PM CDT Question 07/24/18 12:04 PM CDT Question 07/24/18 12:11 PM CDT Question 07/24/18 12:41 PM CDT Question 07/24/18 12:43 PM CDT Question 07/24/18 12:43 PM CDT It doesn't hurt. . . it's just hard to breathe, but there's no pain. Havve yyou had anyy coughiing fifittss llattellyy? I've been coughing a lot, yeah. When do yyou ussuallllyy cough tthe mosstt? I've been coughing all day, but. . . I guess it gets a little worse at night. Doess yyourr coughiing gett worrsse anyy ttiime yyou llayy down? Yeah, it's like, as soon as I lie down in bed the cough gets worse. It's making it harder to sleep. When diid yyourr asstthma ssyympttomss ssttarrtt? I think I was about two and a half? I used to have a lot of trouble with asthma attacks back then. How manyy ttiimess havve yyou had brreatthiing prrobllemss iin tthe passtt ttwo dayyss? 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. IIss yyou asstthma kkeepiing yyou up att niightt? My asthma doesn't usually wake me up, but it has the past couple nights. Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/24/18 12:44 PM CDT Question 07/24/18 12:44 PM CDT Question 07/24/18 12:45 PM CDT Question 07/24/18 12:45 PM CDT Question 07/24/18 12:46 PM CDT Question 07/24/18 12:47 PM CDT How manyy ttiimess do yyou wakke up durriing tthe niightt? I feel like I've woken up at least twice each night with breathing problems the past two nights. How ssevverre iiss yyourr asstthma? 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. IIss ttherre anyytthiing yyou can''tt do becausse off yyourr asstthma? There usually isn't anything I can't do because of my asthma. . . 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. Havve yyou miissssed worrkk becausse off yyourr asstthma? ((Cllarriifified tto Havve yyou had tto miissss worrkk becausse off yyourr asstthma?..)) Luckily I haven't been expected in at work the past two days, or else I probably would have had to call in sick. . . my asthma's never kept me home from work before this, though. Havve yyou had tto miissss sschooll becausse off yyourr asstthma? ((Cllarriifified tto Havve yyou had tto miissss worrkk becausse off yyourr asstthma?..)) Luckily I haven't been expected in at work the past two days, or else I probably would have had to call in sick. . . my asthma's never kept me home from work before this, though. Hass yyourr chesstt been ttiightt tthesse passtt ttwo dayyss? ((Cllarriifified tto how manyy dayyss hass yyourr chesstt ffelltt ttiightt iin tthe passtt weekk..)) Just the past two days, since I was around those cats. Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/24/18 12:47 PM CDT Question 07/24/18 12:48 PM CDT Question 07/24/18 12:48 PM CDT Question 07/24/18 12:50 PM CDT Question 07/24/18 12:51 PM CDT Question 07/24/18 12:51 PM CDT Question 07/24/18 12:52 PM CDT How bad iiss yyourr chesstt ttiighttnessss rriightt now? It's not so bad right this second, but it's been pretty tight lately, like I can't take in air. Whyy iiss yyourr chesstt ttiighttnessss ffeelliing a lliittttlle betttterr rriightt tthiiss ssecond? It's not so bad right this second, but it's been pretty tight lately, like I can't take in air. Diid yyou do anyytthiing tto hellp rrelliievve yyourr chesstt ttiighttnessss? ((No mattchiing quessttiionss ffound..)) How do yyou rrelliievve yyourr chesstt