Assignment 10.2: Shadow Health-
Focused Exam: Hypertension and
Type 2 Diabetes
Course
Assignment 10.2: Shadow Health-Focused Exam:
Hypertension and Type 2 Diabetes
1. Focused Subjective Assessment
Chief Concern
The patient presents for evaluation and management of hypertension and type 2 diabetes
mellitus, with emphasis on current symptoms, medication adherence, lifestyle factors, and risk
for complications.
History of Present Illness
Ask:
1. When were you first diagnosed with hypertension?
2. When were you diagnosed with type 2 diabetes?
3. What symptoms led to your original diagnosis?
4. How have your blood pressure readings been recently?
5. Do you monitor your blood glucose at home?
6. What are your usual fasting glucose readings?
7. Have you experienced unusually high or low glucose readings?
8. Have you noticed increased thirst or urination?
9. Have you experienced increased hunger or unexplained weight changes?
10. Have you had headaches, dizziness, blurred vision, chest pain, or shortness of breath?
11. Have you experienced numbness or tingling in your feet?
12. Have you noticed wounds that heal slowly?
13. Have you experienced swelling in your legs?
14. Have you had episodes of weakness, sweating, shakiness, or confusion?
,Expected findings: The clinician should determine whether hypertension and diabetes are
controlled and identify symptoms suggesting hyperglycemia, hypoglycemia, cardiovascular
disease, renal disease, or diabetic neuropathy.
2. Hypertension Assessment
Important Questions
Question: How often do you check your blood pressure?
Expected answer: The patient should describe the frequency of home monitoring and provide
recent readings if available.
Rationale: Home blood-pressure measurements can help determine whether hypertension is
adequately controlled and may identify patterns that are not apparent from a single clinic
reading.
Symptoms to Assess
Ask about:
Headaches
Dizziness
Visual changes
Chest pain
Palpitations
Dyspnea
Weakness
Neurologic changes
Rationale: Hypertension may be asymptomatic, but these symptoms can indicate
cardiovascular, neurologic, or other complications requiring further evaluation.
3. Type 2 Diabetes Assessment
Important Questions
Question: How frequently do you check your blood glucose?
, Expected answer: The patient should describe their monitoring schedule and typical glucose
values.
Rationale: Monitoring patterns and glucose results help assess diabetes control and identify
possible treatment problems.
Ask About Hyperglycemia
Increased thirst
Frequent urination
Increased hunger
Fatigue
Blurred vision
Recurrent infections
Unintentional weight loss
Rationale: These can occur with hyperglycemia and may indicate inadequate glycemic control.
Ask About Hypoglycemia
Shaking
Sweating
Hunger
Dizziness
Confusion
Weakness
Palpitations
Rationale: Patients taking glucose-lowering medications may experience hypoglycemia.
Recognizing symptoms early allows prompt treatment.
4. Medication Assessment
Ask the patient:
1. What medications do you currently take for blood pressure?
Focused Exam: Hypertension and
Type 2 Diabetes
Course
Assignment 10.2: Shadow Health-Focused Exam:
Hypertension and Type 2 Diabetes
1. Focused Subjective Assessment
Chief Concern
The patient presents for evaluation and management of hypertension and type 2 diabetes
mellitus, with emphasis on current symptoms, medication adherence, lifestyle factors, and risk
for complications.
History of Present Illness
Ask:
1. When were you first diagnosed with hypertension?
2. When were you diagnosed with type 2 diabetes?
3. What symptoms led to your original diagnosis?
4. How have your blood pressure readings been recently?
5. Do you monitor your blood glucose at home?
6. What are your usual fasting glucose readings?
7. Have you experienced unusually high or low glucose readings?
8. Have you noticed increased thirst or urination?
9. Have you experienced increased hunger or unexplained weight changes?
10. Have you had headaches, dizziness, blurred vision, chest pain, or shortness of breath?
11. Have you experienced numbness or tingling in your feet?
12. Have you noticed wounds that heal slowly?
13. Have you experienced swelling in your legs?
14. Have you had episodes of weakness, sweating, shakiness, or confusion?
,Expected findings: The clinician should determine whether hypertension and diabetes are
controlled and identify symptoms suggesting hyperglycemia, hypoglycemia, cardiovascular
disease, renal disease, or diabetic neuropathy.
2. Hypertension Assessment
Important Questions
Question: How often do you check your blood pressure?
Expected answer: The patient should describe the frequency of home monitoring and provide
recent readings if available.
Rationale: Home blood-pressure measurements can help determine whether hypertension is
adequately controlled and may identify patterns that are not apparent from a single clinic
reading.
Symptoms to Assess
Ask about:
Headaches
Dizziness
Visual changes
Chest pain
Palpitations
Dyspnea
Weakness
Neurologic changes
Rationale: Hypertension may be asymptomatic, but these symptoms can indicate
cardiovascular, neurologic, or other complications requiring further evaluation.
3. Type 2 Diabetes Assessment
Important Questions
Question: How frequently do you check your blood glucose?
, Expected answer: The patient should describe their monitoring schedule and typical glucose
values.
Rationale: Monitoring patterns and glucose results help assess diabetes control and identify
possible treatment problems.
Ask About Hyperglycemia
Increased thirst
Frequent urination
Increased hunger
Fatigue
Blurred vision
Recurrent infections
Unintentional weight loss
Rationale: These can occur with hyperglycemia and may indicate inadequate glycemic control.
Ask About Hypoglycemia
Shaking
Sweating
Hunger
Dizziness
Confusion
Weakness
Palpitations
Rationale: Patients taking glucose-lowering medications may experience hypoglycemia.
Recognizing symptoms early allows prompt treatment.
4. Medication Assessment
Ask the patient:
1. What medications do you currently take for blood pressure?
