Shadow Health - Health History Exam, Questions and answers. Rated A+
Shadow Health - Health History Exam, Questions and answers. Rated A+ Document Content and Description Below Shadow Health - Health History Exam, Questions and answers. Rated A+ Why is it important to obtain a patient's complete health history? - Introduction to Tina - My name is Kayla and I am a nursing student at Wichita St. I will be completing your comprehensive health assessment today. CC - Do you know what brings you to the hospital today? O L D C A R T - Ms. Jones is a pleasant 28-year-old African American woman who presented to the emergency department for evaluation of a right foot injury and was admitted for IV antibiotics. She is a good historian. She hurt the ball of her right foot by scraping it on the edge of a metal step while changing a light bulb. The injury occurred about one week ago. Her pain has worsened, and the swelling has persisted. She tried ibuprofen, but it didn't work well. The foot feels better when she rests, and it hurts more when she walks on it. Her pain is a 9 when she tries to ambulate. She took her temperature at home and reports it was 102. She has not been eating much and has been staying in bed the last few days, per patient report. The scrape is red and swollen with exudate and has no odor; she reports the swelling and exudate started two days ago. She reports diarrhea overnight. Pain improved with oxycodone. Stomach upset. Onset - When did your foot first start to hurt? - Received scrape a week ago and the pain got a lot worse in last few days. Location - Where is the scrape located? Which foot? - On the ball of R foot How did you scrape your foot? - She hurt the ball of her right foot by scraping it on the edge of a metal step while changing a light bulb. Duration - - Constant pain. Characteristics - Pt describes pain as throbbing and sharp with ambulation. Foot is red and swollen, hot Pain Now: 7/10, Best: 4/10 w/ Advil Worst: 9/10 Tolerable: 3/10 Reports no odor. White pus. How to ask tolerable pain - What level of pain is acceptable to you? Reaction to Treatment - Advil helps 4/10, but only for few hours. Pt couldn't stand on foot. Did not find ointment to be effective, pt states foot still caused pain and exudate. Treatment - Bandaged and cleaned wound with Hydrogen Peroxide. Applied topical ointment Neosporin TID after cle
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- May 8, 2023
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- 4
- Written in
- 2022/2023
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- Exam (elaborations)
- Contains
- Questions & answers