NRS 434 Week 4 Comprehensive Shadow Health Assessment

NRS 434 WEEK 4 ASSIGMENT

Shadow Health: Comprehensive Assessment

Assessment Description

Within the Shadow Health platform, complete the Comprehensive Assessment. The estimated average time to complete this assignment each time is 3 hours. Please note, this is an average time. Some students may need longer.

YouTube website.

Optional: Heart and Lung Sounds Reference Guide

For additional information, the following is recommended:

Listen to lung sounds at “Heart and Lung Sounds Reference Guide,”

located on the Practical Clinical Skills website.

https://www.practicalclinicalskills.com/heart-lung-sounds-reference-guide

Collaborative Learning Community: Health Promotion Presentation

1)As a group, develop a 12-15 slide PowerPoint presentation that addresses a childhood disease or illness (infectious, noncontiguous, or congenital) seen in the adult population.

a)Examples of such diseases include:

i)Sickle cell anemia

ii)Cystic fibrosis

iii)Tay Sachs

iv) Juvenile diabetes (Type I)
v) Juvenile rheumatoid arthritis
vi) Hemophilia, congenital heart disease

b)Examples of vaccine preventable adult diseases include:

i)Diphtheria tetanus

ii)Pertussis

iii)Rubella

iv)Measles

v)Mumps

2)Include the following in the presentation:

a)A clinical description and definition of the disease or illness.

b)Pathophysiology and history of the disease or illness.

c)An explanation of the impact of this disease/condition on adults to the health care system and nursing practice.

d)A description of the impact of this disease or illness during childhood.

e)A description of the impact of this disease in adults. Explain why adults live into adulthood with this childhood condition or why adults would contract this childhood illness during adulthood.

f)A validation of the health problem with demographic and health statistics, including citations of sources.

3)Evaluate how this disease or illness impacts the adult client in the following areas:

a)Mentally and emotionally.

b)Physically.

c)Sexually.

d)Economically, specifically as it relates to the ability to access health insurance and health care.

e)Susceptibility to engage in substance abuse.

f)Prenatal care and childbearing.

g)Occupational considerations and hazards.

h)Ability to cope with stress.

4)Develop a care plan that addresses the following:

a)Identify expected outcomes for an adult client living with this childhood condition.

b)Develop health screening, health promotion, health interventions, and education for adults with this condition.

c)Identify a comprehensive set of relevant resources, both community and national, for adults with this condition. Provide description of resources.

5)Post the assignment to the main forum as directed by the instructor.

a)Respond to other learners’ posts in a manner that initiates or contributes to discussion.

b)Each person should make at least three substantive comments.

Functional Health Patterns Community Assessment Guide

Functional Health Pattern (FHP) Template Directions:

This FHP template is to be used for organizing community assessment data in preparation for completion of the topic assignment. Address every bulleted statement in each section with data or rationale for deferral. You may also add additional bullet points if applicable to your community.

Value/Belief Pattern

Predominant ethnic and cultural groups along with beliefs related to health.
Predominant spiritual beliefs in the community that may influence health.
Availability of spiritual resources within or near the community (churches/chapels, synagogues, chaplains, Bible studies, sacraments, self-help groups, support groups, etc.).
Do the community members value health promotion measures? What is the evidence that they do or do not (e.g., involvement in education, fundraising events, etc.)?
What does the community value? How is this evident?
On what do the community members spend their money? Are funds adequate?

Health Perception/Management

Predominant health problems: Compare at least one health problem to a credible statistic (CDC, county, or state).
Immunization rates (age appropriate).
Appropriate death rates and causes, if applicable.
Prevention programs (dental, fire, fitness, safety, etc.): Does the community think these are sufficient?
Available health professionals, health resources within the community, and usage.
Common referrals to outside agencies.

Nutrition/Metabolic

Indicators of nutrient deficiencies.
Obesity rates or percentages: Compare to CDC statistics.
Affordability of food/available discounts or food programs and usage (e.g., WIC, food boxes, soup kitchens, meals-on-wheels, food stamps, senior discounts, employee discounts, etc.).
Availability of water (e.g., number and quality of drinking fountains).
Fast food and junk food accessibility (vending machines).
Evidence of healthy food consumption or unhealthy food consumption (trash, long lines, observations, etc.).
Provisions for special diets, if applicable.
For schools (in addition to above):
- Nutritional content of food in cafeteria and vending machines: Compare to ARS 15-242/The Arizona Nutrition Standards (or other state standards based on residence)
- Amount of free or reduced lunch

Elimination (Environmental Health Concerns)

Common air contaminants’ impact on the community.
Waste disposal.
Pest control: Is the community notified of pesticides usage?
Hygiene practices (laundry services, hand washing, etc.).
Bathrooms: Number of bathrooms; inspect for cleanliness, supplies, if possible.
Universal precaution practices of health providers, teachers, members (if applicable).
Temperature controls (e.g., within buildings, outside shade structures).
Safety (committee, security guards, crossing guards, badges, locked campuses).

Activity/Exercise

Community fitness programs (gym discounts, P.E., recess, sports, access to YMCA, etc.).
Recreational facilities and usage (gym, playgrounds, bike paths, hiking trails, courts, pools, etc.).
Safety programs (rules and regulations, safety training, incentives, athletic trainers, etc.).
Injury statistics or most common injuries.
Evidence of sedentary leisure activities (amount of time watching TV, videos, and computer).
Means of transportation.

Sleep/Rest

Sleep routines/hours of your community: Compare with sleep hour standards (from National Institutes of Health [NIH]).
Indicators of general “restedness” and energy levels.
Factors affecting sleep:
- Shift work prevalence of community members
- Environment (noise, lights, crowding, etc.)
- Consumption of caffeine, nicotine, alcohol, and drugs
- Homework/Extracurricular activities
- Health issues

Cognitive/Perceptual

Primary language: Is this a communication barrier?
Educational levels: For geopolitical communities, use http://www.census.gov and compare the city in which your community belongs with the national statistics.
Opportunities/Programs:
- Educational offerings (in-services, continuing education, GED, etc.)
- Educational mandates (yearly in-services, continuing education, English learners, etc.)
- Special education programs (e.g., learning disabled, emotionally disabled, physically disabled, and gifted)
Library or computer/Internet resources and usage.
Funding resources (tuition reimbursement, scholarships, etc.).

Self-Perception/Self-Concept

Age levels.
Programs and activities related to community building (strengthening the community).
Community history.
Pride indicators: Self-esteem or caring behaviors.
Published description (pamphlets, Web sites, etc.).

Role/Relationship

Interaction of community members (e.g., friendliness, openness, bullying, prejudices, etc.).
Vulnerable populations:
- Why are they vulnerable?
- How does this impact health?
Power groups (church council, student council, administration, PTA, and gangs):
- How do they hold power?
- Positive or negative influence on community?
Harassment policies/discrimination policies.
Relationship with broader community:
- Police
- Fire/EMS (response time)
- Other (food drives, blood drives, missions, etc.)

Sexuality/Reproductive

Relationships and behavior among community members.
Educational offerings/programs (e.g., growth and development, STD/AIDS education, contraception, abstinence, etc.).
Access to birth control.
Birth rates, abortions, and miscarriages (if applicable).
Access to maternal child health programs and services (crisis pregnancy center, support groups, prenatal care, maternity leave, etc.).

Coping/Stress

Delinquency/violence issues.
Crime issues/indicators.
Poverty issues/indicators.
CPS or APS abuse referrals: Compare with previous years.
Drug abuse rates, alcohol use, and abuse: Compare with previous years.
Stress management resources (e.g., hotlines, support groups, etc.).
Prevalent mental health issues/concerns:
- How does the community deal with mental health issues
- Mental health professionals within community and usage
Disaster planning:
- Past disasters
- Drills (what, how often)
- Planning committee (members, roles)
- Policies
- Crisis intervention plan

Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation

Transcript

All Lines (645) Interview Questions (210) Statements (41) Exam Actions (394)

	Hello, my name is Tammy. I will be conducting an interview and a physical exam.	Greet 07/22/20 5:37 PM EDT
	Hey.
	What is your name?	Question 07/22/20 5:37 PM EDT
	Tina Jones.
	What is your date of birth?	Question 07/22/20 5:37 PM EDT
	February 17th.
	How old are you?	Question 07/22/20 5:43 PM EDT
	I’m 28.
	What brings you into the clinic today?	Question 07/22/20 5:43 PM EDT
	I came in because I’m required to have a recent physical exam for the health insurance at my new job.
	Do you have any current health problem?	Question 07/22/20 5:44 PM EDT
	I don’t have anything specific going on today. I mean, I still have asthma and diabetes, but both of those are under control. I’m taking good care of my health these days.
	What is your new job?	Question 07/22/20 5:44 PM EDT
	I’m going to be an Accounting Clerk at Smith, Stevens, Stewart, Silver & Company. I’ll be helping a more experienced accountant with her clients, and then eventually I’ll get more responsibility, and build my own client list. I start in two weeks–I’m really excited!
	That is great.	Empathize 07/22/20 5:45 PM EDT
	Thanks.
	When was your last physical exam?	Question 07/22/20 5:45 PM EDT
	Let’s see . . . I had two doctor’s appointments earlier this year. About five months ago, I came in here for a check-up, and the nurse practitioner got me on metformin. Then a few weeks later I saw a gynecologist for a pap smear.
	What did your gynecologist say?	Question 07/22/20 5:45 PM EDT
	She said everything looked good, except that I had PCOS, which the nurse here had said was possible. She started me on birth control, and it seems to be helping things.
	How often do you take birth control?	Question 07/22/20 5:48 PM EDT
	I take it every morning, with breakfast.
	What is the name of the birth control pill you took?	Question 07/22/20 5:49 PM EDT
	They’re called Yaz.
	Has your menstrual cycle improved since taking Yaz?	Question 07/22/20 5:50 PM EDT
	Now that I’m on the pill I’m getting my period every month.
	That is great. I am glad you are having your period every month.	Empathize 07/22/20 5:50 PM EDT
	Thanks.
	How long have you had asthma?	Question 07/22/20 5:51 PM EDT
	I’ve had asthma a long time. . . since I was really little.
	What age were you diagnosed with asthma?	Question 07/22/20 5:51 PM EDT
	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.
	I am sorry about the experience.	Empathize 07/22/20 5:52 PM EDT
	Thanks.
	How do you manage your asthma?	Question 07/22/20 5:52 PM EDT
	I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler.
	What are your triggers for asthma?	Question 07/22/20 5:53 PM EDT
	Being around cats is the worst, but dust and running up stairs can make my breathing bad, too. I haven’t had a full asthma attack in years, though.
	It is important to stay away from triggers.	Educate 07/22/20 5:54 PM EDT
	Thanks for telling me.
	What happens when you are around dust?	Question 07/22/20 5:54 PM EDT
	I used to have a reaction when I was in a dusty house for a long time. . . I would get allergies, like sneezing and stuff, and then my asthma would act up. But that hasn’t happened since I got my daily inhaler.
	What inhaler do you use?	Question 07/22/20 5:59 PM EDT
	The daily inhaler is Flovent, and the rescue inhaler is Proventil.
	How often do you use Flovent?	Question 07/22/20 6:00 PM EDT
	Twice a day.
	When did you most recently use the Flovent inhaler?	Question 07/22/20 6:01 PM EDT
	I use my Flovent inhaler two times a day.
	When did you last use your inhaler?	Question 07/22/20 6:03 PM EDT
	I used my Flovent inhaler this morning–I have to take it twice a day. My albuterol. . . I’ve maybe used it twice since I came in with those asthma problems. Once three months ago, and before that it had been months, too.
	How much Albuterol do you use?	Question 07

I have a few friends I’ve known since middle or high school, and we’re all pretty close. Plus I have my friends from church.


	What is your relationship like with your family?	Question 07/22/20 7:39 PM EDT
	Things are pretty good between all of us–we’re a tight knit family. I think we’re pretty special, the way we all get along.
	That is great.	Empathize 07/22/20 7:39 PM EDT
	Thanks.
	Are you involved in church?	Question 07/22/20 7:39 PM EDT
	Yeah. We go to First Baptist, and we do a lot with our church community. We socialize before and after church, and I go to Bible study on Wednesdays, too.
	Are you feeling stressed?	Question 07/22/20 7:40 PM EDT
	I’m actually feeling really good lately. . . not stressed at all.
	How do you cope with stress?	Question 07/22/20 7:40 PM EDT
	I’ve realized that I got kind of overwhelmed with everything back when I was having those sleep problems. Just coming in and talking to someone here about it helped a little because I felt like I was doing something. So I’ve been trying to address problems as they come when I can, and that helps. That, plus the stuff I’ve always done–going to church, especially–is all working well for me.
	That is good to hear.	Empathize 07/22/20 7:40 PM EDT
	Thanks.
	Are you feeling depressed?	Question 07/22/20 7:41 PM EDT
	No, I’m actually feeling really good these days.
	How do you feel about your life?	Question 07/22/20 7:41 PM EDT
	Well, I’m starting my new job in two weeks, and I’m really excited about that. I’m going to be an Accounting Clerk at this really nice accounting firm. I’m hoping I’ll learn a lot in that position, and within a couple years, I’ll get promoted and be given new responsibilities. I just always want to be learning new things and getting better at my job.
	Are you feeling anxious?	Question 07/22/20 7:41 PM EDT
	I guess I had anxiety back when I was having those sleep problems. . . I’ve been feeling much better lately, though.
	Do you have sleeping problems?	Question 07/22/20 7:42 PM EDT
	I’m sleeping a lot better now, which is a relief.
	Good to hear.	Empathize 07/22/20 7:42 PM EDT
	Thanks.
	How many hours are you sleeping a night?	Question 07/22/20 7:42 PM EDT
	I’m usually asleep by 11:30, and I wake up at 8, so. . . about 8 or 9 hours a night.
	That is great.	Empathize 07/22/20 7:42 PM EDT
	Thanks.
	Have you ever smoked tobacco?	Question 07/22/20 7:43 PM EDT
	No. I think it’s gross.
	Have you ever used cocaine?	Question 07/22/20 7:43 PM EDT
	No way, I have no interest in that. That stuff can mess you up.
	Have you ever used heroin?	Question 07/22/20 7:49 PM EDT
	Uh, no.
	Have you ever used illegal drugs?	Question 07/23/20 3:17 PM EDT
	Well, I used to smoke pot. . . but I don’t do that anymore.
	What was the last time you smoked pot?	Question 07/23/20 3:17 PM EDT
	I haven’t smoked pot since I was twenty or twenty-one.
	Do you have any family history of mental illness?	Question 07/23/20 3:18 PM EDT
	No. They’re crazy, but nobody’s diagnosed with anything.
	Have you had suicidal thoughts?	Question 07/23/20 3:19 PM EDT
	No, I’ve never done that.
	Any new family medical history report?	Question 07/23/20 3:20 PM EDT
	My mom has some issues, and I think some of my grandparents did, too.
	How old is your mom?	Question 07/23/20 3:21 PM EDT
	Mom is 50.
	What medical problems does your mum have?	Question 07/23/20 3:21 PM EDT
	Mom has high cholesterol and blood pressure, I think. She seems to be doing okay though.
	What medical problems did your father have?	Question 07/23/20 3:22 PM EDT
	He had high blood pressure and cholesterol, and diabetes too…the same kind as me.
	How old is your brother?	Question 07/23/20 3:24 PM EDT
	He’s almost 27.
	Does he have any medical issue? (Clarified to Does your younger sister have health problems?.)	Question 07/23/20 3:25 PM EDT
	She’s pretty healthy. She has asthma too, but she almost never has attacks. (Clarified to if my younger sister has health problems.)
	Does your bother have health issues? (Clarified to Does your brother have medical problems?.)	Question 07/23/20 3:25 PM EDT
	No, I don’t think so. He’s a little big, maybe. (Clarified to if my brother has health issues.)
	How old is your maternal grandmother?	Question 07/23/20 3:26 PM EDT
	Nana was 73 when she died of a stroke about five years ago. I think she had high blood pressure and cholesterol, too.
	How old is your maternal grandfather?	Question 07/23/20 3:27 PM EDT
	Poppa died of a heart attack when he was 80. . . he had some blood pressure and cholesterol issues when he was alive, too.
	Any medical history for your paternal grandmother?	Question 07/23/20 3:30 PM EDT
	She takes some blood pressure pills, and I think she has high cholesterol, but Granny’s doing great for 82.
	Does your dad’s father have health issues?	Question 07/23/20 3:30 PM EDT
	Grandpa Jones had colon cancer, and that caused all kinds of problems for him. Plus, he had high blood pressure, and…I’m pretty sure he had diabetes.
	Have you had any recent illness?	Question 07/23/20 3:31 PM EDT
	No. . . the last time I was sick was when I was having those heartburn problems a while ago.
	Any fever?	Question 07/23/20 3:32 PM EDT
	I haven’t had a fever.
	Any chills?	Question 07/23/20 3:32 PM EDT
	Nope, no chills.
	Any acne?	Question 07/23/20 3:32 PM EDT
	I took something for my acne. . . tetracycline, I think, back in high school. Since then I’ve just washed my face, I haven’t used anything special. But my zits have gotten better, and I think it’s because I’m on birth control now.
	Has your body hair improved?	Question 07/23/20 3:32 PM EDT
	I think I have a little less body hair than I used to.
	Do your eyes feel itchy?	Question 07/23/20 3:33 PM EDT
	They haven’t been itchy lately at all.
	Are you having any redness in your eyes?	Question 07/23/20 3:33 PM EDT
	My eyes haven’t been red lately. . . not since I came in with those allergies a while ago.
	Are your eyes dry?	Question 07/23/20 3:34 PM EDT
	My eyes don’t feel dry.
	Do you have any pain in your eyes?	Question 07/23/20 3:34 PM EDT
	I haven’t had any eye problems lately–I went to the eye doctor a few months ago and got these glasses, and she checked everything out and said it looked good.
	Are you having any ear problems?	Question 07/23/20 3:34 PM EDT
	My ears feel fine.
	Any changes in your hearing?	Question 07/23/20 3:36 PM EDT
	My hearing is good.
	Any ear pain?	Question 07/23/20 3:36 PM EDT
	My ears feel fine.
	Ear drainage? (Clarified to Do you have drainage from your ears?.)	Question 07/23/20 3:36 PM EDT
	Nothing is coming out of my ears. (Clarified to if I have ear drainage.)
	Any changes in your sense of smell?	Question 07/23/20 3:46 PM EDT
	No.
	Any nose bleeds?	Question 07/23/20 3:47 PM EDT
	Nope, my nose isn’t bleeding at all.
	Any sinus pressures?	Question 07/23/20 3:47 PM EDT
	My sinuses have been fine.
	Has your sense of taste changed?	Question 07/23/20 3:47 PM EDT
	No, I think my sense of taste is fine.
	Are you having dry mouth?	Question 07/23/20 3:48 PM EDT
	My mouth hasn’t been dry.
	ANY pain in your mouth?	Question 07/23/20 3:48 PM EDT
	No, my mouth feels fine.
	ANY sore throat?	Question 07/23/20 3:49 PM EDT
	No, it’s fine.
	Any issue with your gums?	Question 07/23/20 3:49 PM EDT
	My gums have been fine.
	Any issue with your tongue?	Question 07/23/20 3:49 PM EDT
	My tongue feels fine.
	Any difficulties when swallowing?	Question 07/23/20 3:50 PM EDT
	I can swallow fine.
	SORE throat?	Question 07/23/20 3:50 PM EDT
	No, it’s fine.
	Any voice changes?	Question 07/23/20 3:50 PM EDT
	My voice has been fine.
	Any swollen lymph nodes?	Question 07/23/20 3:52 PM EDT
	My lymph nodes seem fine.
	Are you having any nausea?	Question 07/23/20 3:52 PM EDT
	No, I haven’t been nauseous at all.
	Any vomiting?	Question 07/23/20 3:53 PM EDT
	No.
	ANY pain in the abdomen?	Question 07/23/20 3:53 PM EDT
	I haven’t really had any stomach problems since I came in with them a while ago.
	Any constipation?	Question 07/23/20 3:53 PM EDT
	I don’t have that problem.
	Any diarrhea?	Question 07/23/20 3:54 PM EDT
	I haven’t had any problems with diarrhea.
	Excessive flatulence?	Question 07/23/20 3:54 PM EDT
	I haven’t been having any gas lately. I had a little when I first started metformin, but I found out I could eat yogurt to help it, and it seems to have worked.
	flatulence is one of the side effect of metformin	Educate 07/23/20 3:55 PM EDT
	Thanks for telling me.
	Any food intolerance	Question 07/23/20 3:56 PM EDT
	I can eat just about anything.
	Any burning sensation when you urinate?	Question 07/23/20 3:56 PM EDT
	No, it doesn’t burn when I pee.
	Any blood in your urine?	Question 07/23/20 3:57 PM EDT
	No! That doesn’t sound like it would be good.
	Are you having any pain right now?	Question 07/23/20 3:57 PM EDT
	I don’t have any pain anywhere.
	Any vaginal discharge?	Question 07/23/20 3:58 PM EDT
	My discharge is normal, I think. . . I have a little, and it’s kind of clear, sometimes white-ish.
	Any vaginal itching?	Question 07/23/20 3:58 PM EDT
	No, it feels normal.
	Do you have any problem with your breasts?	Question 07/23/20 3:59 PM EDT
	No, my breasts feel fine.
	Any pain in the breasts?	Question 07/23/20 3:59 PM EDT
	No, my breasts feel fine.
	Are you having any dizziness/	Question 07/23/20 3:59 PM EDT
	I haven’t been getting dizzy at all.
	Any lightheadedness?	Question 07/23/20 4:00 PM EDT
	No, I don’t really get lightheaded.
	Any tingling?	Question 07/23/20 4:00 PM EDT
	Nope, no tingling.
	Any loss of balance?	Question 07/23/20 4:00 PM EDT
	My balance is fine.
	Any changes in sensation?	Question 07/23/20 4:00 PM EDT
	I haven’t noticed any changes.
	Any seizures?	Question 07/23/20 4:01 PM EDT
	No, I’ve still never had problems with seizures, fortunately.
	Do you have memory problems?	Question 07/23/20 4:01 PM EDT
	I think my memory has been fine.
	Any muscle pain?	Question 07/23/20 4:01 PM EDT
	My muscles have felt great, especially since I started exercising more.
	Joint pain?	Question 07/23/20 4:02 PM EDT
	My joints always seem fine.
	Any muscle weakness?	Question 07/23/20 4:02 PM EDT
	No, I haven’t felt weak at all.
	Any swelling?	Question 07/23/20 4:03 PM EDT
	Nothing is swollen.
	Performed pulse oximetry	Exam Action 07/24/20 10:01 AM EDT
	Performed spirometry	Exam Action 07/24/20 10:01 AM EDT
	Inspected scalp	Exam Action 07/24/20 10:01 AM EDT
	Inspected scalp	Exam Action 07/24/20 10:01 AM EDT
	Inspected hair on scalp	Exam Action 07/24/20 10:01 AM EDT
	Inspected scalp	Exam Action 07/24/20 10:01 AM EDT
	Inspected right eyebrow and orbital area	Exam Action 07/24/20 10:02 AM EDT
	Inspected left eyebrow and orbital area	Exam Action 07/24/20 10:02 AM EDT
	Inspected mouth: Oral mucosa moist. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation	Exam Action 07/24/20 10:02 AM EDT

Also Read: NRS 434 Week 3 Assignment Health Screening

NRS 434 Week 4 Comprehensive Shadow Health Assessment