Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Transcript
Started: Jan 23, 2021 | Total Time: 185 min
All Lines (135)Interview Questions (76)Statements (29)Exam Actions (30)
Begin by confirming the patient’s name and date of birth. Which of the following is the most appropriate way to do so?
Hello. I’ll be taking care of you tonight. Can you tell me your name and when you were born?
Question
01/23/21 6:33 PM PST
Hey . . . Gabriel . . . I’m 8 . . .”
His name is Gabriel Martinez. Gabriel is 8. Gabriel Martinez Asthma Exacerbation Shadow health Transcript
You should also confirm Ms. Martinez’s relationship with Gabriel. Which of the following questions is the most appropriate way to do so?
Hello. Are you Gabriel’s guardian?
ORDER A PLAGIARISM-FREE PAPER OR SHADOW HEALTH HELP HERE
Question
01/23/21 6:34 PM PST
Yes. I’m his mother.
Which of the following actions should you perform first?
I want to interview the patient and guardian to establish Chief Complaint.
Question
01/23/21 6:37 PM PST
What brings you in today?
Question
01/23/21 6:38 PM PST
It’s really hard to breathe . . . I have asthma . . .
Yes, my son started having difficulty breathing after school today. It’s been about 4 hours or so.
What should you do next?
Now that I have established Gabriel’s chief complaint, I need to take his vitals and conduct a pediatric asthma severity (PAS) score to better understand the severity of the patient’s condition.
Question
01/23/21 6:39 PM PST
Perform all of the following assesments and record the vitals in your EHR. Use the PAS Score tab in the EHR to calculate Gabriel’s total score and choose the appropriate exacerbation severity for Assessed PAS – PreIntervention in the Objective Data tab. Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Auscultated breath sounds: expiratory and inspiratory wheezing
Exam Action
01/23/21 6:40 PM PST
Select your next course of action.
Inpected chest: Mild intercostal retractions visible
Exam Action
01/23/21 6:43 PM PST
Select your next course of action.
You observe so far during the assessment that Gabriel is speaking in partial sentences before having to take a breath.
Exam Action
01/23/21 6:44 PM PST
Select your next course of action.
Assessed vitals
Exam Action
01/23/21 6:45 PM PST
Select your next course of action.
Now choose the corresponding severity description under Assessed PAS-PreIntervention in the Objective Data tab.
You now know the patient’s chief complaint, and you have collected his vitals and determined a PAS score. What should you do next?
Now that I have determined Gabriel’s chief complaint, vitals, and PAS score, I have enough information to initiate the Asthma Exacerbation Protocol and finally relieve Gabriel’s respiratory distress.
Question
01/23/21 7:14 PM PST
Unfortunately, you have not collected enough information about Gabriel’s condition to initiate a protocol at this time.
You have not selected the most critical and necessary action. The incorrect response you selected has been removed. Try again with the remaining responses.
You now know the patient’s chief complaint, and you have collected his vitals and determined a PAS score. What should you do next?
I want to get a spirometer reading to confirm my findings so far. Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Question
01/23/21 7:14 PM PST
I did one before we came in.
Your second choice is not the most critical and necessary action, either. The incorrect responses you have selected have been removed. Select the correct response, and you will move on to the next question.
You now know the patient’s chief complaint, and you have collected his vitals and determined a PAS score. What should you do next?
I want to ask about allergies to medication.
Question
01/23/21 7:15 PM PST
No, he doesn’t have medicine allergies.
You’ve determined the patient’s chief complaint, collected vitals and a PAS score, and inquired about medicine allergies. What should you do next?
In order to rule out additional respiratory complications, I need to ask a handful of key history of present illness questions.
Question
01/23/21 7:15 PM PST
At this stage you have collected the necessary and critical information to safely initiate the asthma exacerbation protocol. Any other assessments or tests are unnecessary at this time.
You have not selected the most critical and necessary action. The incorrect response you selected has been removed. Try again with the remaining responses.
You’ve determined the patient’s chief complaint, collected vitals and a PAS score, and inquired about medicine allergies. What should you do next?
I want to inform the patient and his guardian that I have determined that Gabriel is experiencing a moderate asthma exacerbation and am ready to begin treatment. I will ask them if they have any questions or anything else they’d like to tell me before I order the initiation of the Shadowville General Hospital Asthma Exacerbation Protocol. Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Question
01/23/21 7:16 PM PST
No. No questions, thank you.
Your assessment of Gabriel has determined he is currently experiencing a moderate asthma exacerbation. Your protocol order is approved and you administer albuterol via nebulizer and prednisone orally.
Hello Gabriel, I am Nurse xxxx and I will be interviewing you and later perform a physical assessment
Greet
01/23/21 7:23 PM PST
Hey.
How are you feeling?
Question
01/23/21 7:24 PM PST
I feel better now . . . I can definitely breathe better, but my chest is kinda sore.
Sorry about your chest being sore
Empathize
01/23/21 7:25 PM PST
Everyone is really nice here. Thank you very very very much!
How does your chest feel?
Question
01/23/21 7:26 PM PST
My chest doesn’t feel as tight now. It’s still a little sore though. Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Do you feel any wheezing?
Question
01/23/21 7:26 PM PST
My breath was squeaky earlier, but I can’t hear it anymore.
Okay, got it
Empathize
01/23/21 7:26 PM PST
Thanks, that makes me feel better.
When did the breathing problem start?
Question
01/23/21 7:27 PM PST
My attack started after kickball . . . and it got worse and worse when we got home.
Sorry about that Gabriel
Empathize
01/23/21 7:27 PM PST
Oh wow, thanks.
What worsens the breathing problem?
Question
01/23/21 7:27 PM PST
Ummmm smokers. Smoke makes my breathing a lot worse.
Sorry about that
Empathize
01/23/21 7:28 PM PST
Ok, thanks.
Are you normally around smoke?
Question
01/23/21 7:28 PM PST
I try to stay away from it. But these new kids were smoking by the kickball field after school today.
It is good to stay away from anyone smoking
Educate
01/23/21 7:29 PM PST
I guess that makes sense.
What triggers your asthma?
Question
01/23/21 7:29 PM PST
Smoke bothers me a lot. I try to stay away from it. But today some kids I’ve never seen before were smoking at my afterschool program.
What action did you take after the asthma attacK
Question
01/23/21 7:30 PM PST
Well I . . . I guess I’m supposed to take my emergency inhaler, but . . . I threw it away. So we don’t have it anymore.
Ooh, you should always ensure you have the inhaler at a safe and accessible place
Educate
01/23/21 7:31 PM PST
Ohhh, yeah. Good . . . to . . . know.
What is the name of the inhaler you were using?
Question
01/23/21 7:31 PM PST
I dunno. I think my mom does.
Why did you throw away the inhaler?
Question
01/23/21 7:32 PM PST
I hate the way that inhaler makes me all . . . shaky. It makes my heart beat too fast. That’s why, when my mom told me to clean out my backpack, I threw it in the trash.
Sometimes I give him an over the counter antihistamine, when his allergies are bad or the pollen count is high.
What are some of your son’s allergies? (No matching questions found.)
Question
01/23/21 8:09 PM PST
alleges? (No matching questions found.) Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Question
01/23/21 8:09 PM PST
Any allergies?
Question
01/23/21 8:09 PM PST
I don’t, no. Just my son does. [AUDIO COMING SOON]
What allergies does your son have?
Question
01/23/21 8:10 PM PST
Pets, dust, pollen. He’s not allergic to any of the other obvious stuff. No food or medicine or latex or anything.
How does your son’s environmental allergies impact his asthma?
Question
01/23/21 8:11 PM PST
Gabriel’s allergies always make his asthma worse. I can and do keep dust and dander out of the house, but pollen is a different story. The last time he had trouble with his asthma like this was during pollen season.
It is always good to keep the allergy triggers away
Educate
01/23/21 8:12 PM PST
Yeah . . . Yeah, I get it. We’ll work on that.
Has your son been hospitalized before?
Question
01/23/21 8:13 PM PST
Yes, he went to the hospital a year ago, because of his asthma.
Sorry about that. Being hospitalized can really take a toll on any parent Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Empathize
01/23/21 8:14 PM PST
Thank you for saying that.
Why was your son last hospitalized?
Question
01/23/21 8:14 PM PST
He was hospitalized last year because of his asthma. The night before, he was around some smoke — cigarette smoke, and maybe smoke from fireworks . . . We tried his rescue inhaler at home, but it wasn’t working, so I brought him to the ER. Kind of similar to this time, actually.
Sorry about that ordeal.
Empathize
01/23/21 8:15 PM PST
Thank you. I’m . . . I’m just doing the best I can.
Please let him always keep away from triggers such as smoke
Educate
01/23/21 8:16 PM PST
Alright, I understand.
How does exercise impact your son’s asthma?
Question
01/23/21 8:16 PM PST
Too much exercise could trigger an asthma attack. He knows the rules. He can walk, but he isn’t supposed to run.
Does anyone in your family use tobacco?
Question
01/23/21 8:17 PM PST
No, none of us do.
That is great. Smoking is really bad for health, especially in people with respiratory problems such as asthma
Educate
01/23/21 8:18 PM PST
That makes a lot of sense, thank you.
What is your childcare situation?
Question
01/23/21 8:18 PM PST
I work 55 hours a week. Gabriel goes to after-school clubs, so I pick him up around 5:30. He’s really close to my parents, so sometimes on the weekends he spends the night with his Lito and Lita. Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Raising a child alone is really challenging. I know you are a great parent. Even Gabriel really appreciates you. But I am aware being a single parent can be difficult. You are really doing a great job by taking care of your son alone
Empathize
01/23/21 8:22 PM PST
Thank you for saying that.
What is your childcare situation?
Question
01/23/21 8:23 PM PST
I work 55 hours a week. Gabriel goes to after-school clubs, so I pick him up around 5:30. He’s really close to my parents, so sometimes on the weekends he spends the night with his Lito and Lita.
What health problems run in your family?
Question
01/23/21 8:23 PM PST
There’s nothing like asthma in the family. But my father has heart disease and my brother has diabetes.
Sorry about your father and brother’s conditions.
Empathize
01/23/21 8:24 PM PST
Thank you. I’m . . . I’m just doing the best I can.
Also sorry about your son’s asthma. He will get better.
Empathize
01/23/21 8:24 PM PST
Thanks, I appreciate that.
Checked ID band
Exam Action
01/23/21 8:27 PM PST
Assessed vitals
Exam Action
01/23/21 8:27 PM PST
Auscultated top right chest breath sounds: normal breathing
Exam Action
01/23/21 11:10 PM PST
Auscultated top left chest breath sounds: normal breathing
Exam Action
01/23/21 11:10 PM PST
Auscultated upper right chest breath sounds: normal breathing
Exam Action
01/23/21 11:10 PM PST
Auscultated upper left chest breath sounds: normal breathing
Exam Action
01/23/21 11:10 PM PST
Auscultated lower right chest breath sounds: normal breathing
Exam Action
01/23/21 11:10 PM PST
Auscultated lower left chest breath sounds: normal breathing
Exam Action
01/23/21 11:10 PM PST
Auscultated top left back breath sounds: normal breathing
Exam Action
01/23/21 11:10 PM PST
Auscultated top right back breath sounds: normal breathing
Exam Action
01/23/21 11:10 PM PST
Auscultated upper left back breath sounds: normal breathing
Exam Action
01/23/21 11:11 PM PST
Auscultated upper right back breath sounds: normal breathing
Exam Action
01/23/21 11:11 PM PST
Auscultated lower left back breath sounds: normal breathing
Exam Action
01/23/21 11:11 PM PST
Auscultated lower right back breath sounds: normal breathing
Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Exam Action
01/23/21 11:11 PM PST
Auscultated lower left chest breath sounds: normal breathing
Exam Action
01/23/21 11:11 PM PST
Auscultated lower right chest breath sounds: normal breathing
Exam Action
01/23/21 11:11 PM PST
Auscultated upper right chest breath sounds: normal breathing
Exam Action
01/23/21 11:11 PM PST
Auscultated upper left chest breath sounds: normal breathing
Exam Action
01/23/21 11:11 PM PST
Auscultated top left chest breath sounds: normal breathing
Exam Action
01/23/21 11:11 PM PST
Auscultated top right chest breath sounds: normal breathing
Exam Action
01/23/21 11:11 PM PST
No abnormal findings
Exam Action
01/23/21 11:11 PM PST
Assessed dyspnea
Exam Action
01/23/21 11:13 PM PST
PAS Score: determine the PAS Score using the EHR tab
Exam Action
01/23/21 11:19 PM PST
Assessed growth
Exam Action
01/23/21 11:21 PM PST
Assessed vitals Gabriel Martinez Asthma Exacerbation Shadow health Transcript
Exam Action
01/23/21 11:23 PM PST
