NURSING 4130 shadow health preeclampsia exam (elaborations) graded A

Category Scored Items Experts selected these topics as essential components of a strong, thorough interview with this patient. Patient Data Not Scored A combination of open and closed questions will yield better patient data. The following details are facts of the patient's case. Chief Complaint • Finding: Asked about chief complaint • Finding: Reports headaches (Found) Pro Tip: Use open questions to ask a patient why they're here today so they can tell you in their own words and inform you of the situation. Example Question: Do you have headaches? • Finding: Reports excessive weight gain (Found) Pro Tip: Use open questions to ask a patient why they're here today so they can tell you in their own words and inform you of the situation. Example Question: Have you had changes to your weight? • Finding: Reports swelling (Found) Pro Tip: Use open questions to ask a patient why they're here today so they can tell you in their own words and inform you of the situation. Example Question: Do you have swelling anywhere? • Finding: Reports test results the physician said were problematic (Found) Pro Tip: Use open questions to ask a patient why they're here today so they can tell you in their own words and inform you of the situation. Example Question: What did the physician say about your test results? Patient Comfort • Finding: Asked about patient comfort • Finding: Reports feeling comfortable (Found) Pro Tip: Asking patients, especially pregnant ones, about their comfort lets you know if they are ready for a long conversation, and how you can make them readier. Example Question: Are you comfortable? • Finding: Reports concern over symptoms (Found) Pro Tip: Asking patients, especially pregnant ones, about their comfort lets you know if they are ready for a long conversation, and how you can make them readier. Example Question: How do you feel about your symptoms? History of Present Illness • Finding: Asked about test results • Finding: Reports high blood pressure reading today (Found) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable. Example Question: What were the results of your high blood pressure tests? • Finding: Reports moderately high blood pressure 1 week ago (Found) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable. Example Question: What were the results of your high blood pressure tests? • Finding: Reports urinalysis showed proteinuria (Found) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable. Example Question: What were the results of your urine tests? • Finding: Asked about duration of symptoms • Finding: Reports excessive swelling started a week ago (Found) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable. Example Question: When did your swelling start? • Finding: Reports weight gain occurred over last month (Found) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable. Example Question: When did your weight gain start? • Finding: Reports headaches starting 4 or 5 days ago (Found) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable. Example Question: When did your headaches start? • Finding: Asked if headache is currently present • Finding: Denies current headache (Found) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable. Example Question: Do you have a headache right now? • Finding: Followed up on headache patterns • Finding: Reports headaches are dull and annoying (Found) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable. Example Question: What are your headaches like? • Finding: Reports headaches occur daily (Found) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable. Example Question: How often do you get headaches? • Finding: Asked about vision disturbances • Finding: Denies vision disturbances (Available) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable. Example Question: Do you have vision disturbances? • Finding: Asked about aggravating factors for headaches • Finding: Denies aggravating factors (Found) Pro Tip: Ask patients everything you can about their current illness, from its characteristics to its frequency to its causes, so you can determine its nature and what treatments are recommendable.