Exam (elaborations) NR 509 GASTROINTESTINAL RESULTS Transcript Shadow Health

Exam (elaborations) NR 509 GASTROINTESTINAL RESULTS Transcript Shadow Health ll LLiinneess (()) 5/29/2018 Gastrointestinal | Completed | Shadow Health Empathize 05/29/18 10:38 AM CDT Question 05/29/18 10:41 AM CDT Question 05/29/18 10:42 AM CDT Question 05/29/18 10:43 AM CDT Question 05/29/18 10:44 AM CDT Question 05/29/18 11:00 AM CDT Question 05/29/18 11:00 AM CDT Sorry you are feeling so bad Thanks for understanding. when do you notice the pain? (Clarified to when does the pain start.) It starts pretty quickly after I finish eating. Like within ten or fifteen minutes. when did the pain start? Probably at least a month ago. Maybe longer. It started out really minor so it took me awhile to realize it was getting bad. Where is the pain located? It's like... my upper stomach. Like right below my breastbone, in the middle. describe how the pain feels? Um, it feels like heartburn. But sometimes, if it's bad, it's sharper than that. Does the pain increase? Yeah, it's getting worse over time. I get these stomach pains every day. Is there an increase in pain? (Clarified to Did the pain change?.) Yeah, it's getting worse over time. I get these stomach pains every day. How many times a week are you getting this PAIN 5/29/2018 Gastrointestinal | Completed | Shadow Health Question 05/29/18 11:01 AM CDT Question 05/29/18 11:03 AM CDT Question 05/29/18 11:04 AM CDT Question 05/29/18 11:07 AM CDT Question 05/29/18 11:07 AM CDT Question 05/29/18 11:08 AM CDT Question 05/29/18 11:09 AM CDT Question 05/29/18 11:09 AM CDT Every time I eat it hurts a little, but 3 or 4 times a week, it'll be a lot worse. do you have this pain every day? (Clarified to Do you have abdominal pain every day.) Yeah, it's getting worse over time. I get these stomach pains every day. when does your abdominal pain begin (Clarified to When did the abdominal discomfort begin?.) Probably at least a month ago. Maybe longer. It started out really minor so it took me awhile to realize it was getting bad. When does the pain begin? It starts pretty quickly after I finish eating. Like within ten or fifteen minutes. How long does the pain last? For a few hours after I eat. Will you rate your pain on a Pain Scale 0 out of 10 Right now, it's like a 1 or 2. But after I eat, it's like a. . . 5? Rate your pain when lying down? If I've eaten and try to lie down, that's when it's the worst. Like a 6 or 7. Is the pain crushing? 5/29/2018 Gastrointestinal | Completed | Shadow Health Question 05/29/18 11:10 AM CDT Question 05/29/18 11:10 AM CDT Question 05/29/18 11:10 AM CDT Question 05/29/18 11:55 AM CDT Question 05/29/18 11:55 AM CDT Question 05/29/18 11:58 AM CDT Question 05/29/18 11:59 AM CDT No. Is the pain gnawing? No, it's not like that. Is the pain cramping? No, it's not like stomach cramps. Does your abdomen tender to touch? No. My stomach pain's not tender like that. Where is your pain located It's like... my upper stomach. Like right below my breastbone, in the middle. Does your pain radiate? No, it's right in the center of my stomach, like between my belly button and my ribs. Does your pain radiate? No, it's right in the center of my stomach, like between my belly button and my ribs. Shoulder pain? No. 5/29/2018 Gastrointestinal | Completed | Shadow Health Question 05/29/18 11:59 AM CDT Question 05/29/18 11:59 AM CDT Question 05/29/18 11:59 AM CDT Question 05/29/18 12:00 PM CDT Question 05/29/18 12:00 PM CDT Question 05/29/18 12:00 PM CDT Question 05/29/18 12:00 PM CDT Empathize 05/29/18 12:03 PM CDT Any back pain? My back feels fine. Arm pain? (Clarified to do you have pain in your arm.) No, it's right in the center of my stomach, like between my belly button and my ribs. Any flank pain? No -- my pain is like, on my front. In the middle of my stomach. What side of your stomach? I feel pain after I eat, multiple times throughout the day. It kinda feels like burning, like heartburn. What side is your pain on (No matching questions found.) On what side do you feel the pain? (No matching questions found.) Is the pain on your right side? (Clarified to Do you have sharp pain in your right lower abdomen?.) No, it's not at all like that. It's in the middle of my stomach. I'm sorry you're feeling so bad Thanks for saying that. Your pain occurs after eating? 5/29/2018 Gastrointestinal | Completed | Shadow Health Question 05/29/18 12:04 PM CDT Question 05/29/18 12:04 PM CDT Question 05/29/18 12:04 PM CDT Educate 05/29/18 12:05 PM CDT Question 05/29/18 12:05 PM CDT Empathize 05/29/18 12:05 PM CDT Question 05/29/18 12:06 PM CDT Educate 05/29/18 12:07 PM CDT Yes. Every time I eat it hurts. I've been eating less because I don't like being in pain. Your pain is with larger meals? If I eat too much, or if I have something spicy. But I quit eating spicy food already. Do fatty foods make it worse? (Clarified to do you eat a lot of fatty food.) Not too much. I mean, I like French fries and stuff, but I try not to eat them too often. French fries are considered a fatty food. Let's try to cut down on those french fries Alright, thanks for letting me know. Is the pain worse when you bend over? Yeah. It gets worse when I bend over -- I noticed that at work. Sorry to hear that I appreciate you saying that. Does it hurt when you lie flat Yeah. Try to refrain from bending over at work 5/29/2018 Gastrointestinal | Completed | Shadow Health Question 05/29/18 12:07 PM CDT Question 05/29/18 12:07 PM CDT Question 05/29/18 12:09 PM CDT Question 05/29/18 12:09 PM CDT Educate 05/29/18 12:10 PM CDT Question 05/29/18 12:10 PM CDT Question 05/29/18 12:11 PM CDT Thanks for telling me. Is your pain decreased between meals? No, it's gotten worse and worse over time. How do you feel between meals? Yeah, I usually have a couple of snacks during the day. Is your pain better when you sit up? Usually, yeah. Any decrease in appetite? Yeah, I haven't been wanting to eat lately. It is important that you still eat 3 times a day That makes sense. You eat out? I try not to eat out too much, but with my schedule I end up having to. Are you eating smaller meals? (Clarified to Have you been eating smaller meals than usual.) Yeah, I've been trying to eat really little meals. I haven't been that hungry, and I don't want to have the pain of eating a big meal. 5/29/2018 Gastrointestinal | Completed | Shadow Health Question 05/29/18 12:11 PM CDT Question 05/29/18 12:13 PM CDT Question 05/29/18 12:13 PM CDT Exam Action 05/29/18 12:24 PM CDT Exam Action 05/29/18 12:25 PM CDT Exam Action 05/29/18 12:25 PM CDT Exam Action 05/29/18 12:25 PM CDT Exam Action 05/29/18 12:25 PM CDT Exam Action 05/29/18 12:28 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Are you eating spicy foods? Well, I used to eat spicy food sometimes, but in the last few weeks I can't. It makes my stomach pain too bad. Any increase in burping? Yeah, that's been happening after I eat. Any recent weight loss? No, I don't think so. Tested skin turgor on forearm Inspected right side of abdomen Inspected front of abdomen Inspected left side of abdomen Inspected front of abdomen Auscultated breath sounds in anterior right upper lobe Auscultated breath sounds in anterior left upper lobe Auscultated breath sounds in anterior left mid-chest (upper lobe) 5/29/2018 Gastrointestinal | Completed | Shadow Health Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:29 PM CDT Exam Action 05/29/18 12:30 PM CDT Exam Action 05/29/18 12:30 PM CDT Auscultated breath sounds in anterior right middle lobe Auscultated breath sounds in anterior left lower lobe Auscultated breath sounds in anterior right lower lobe Auscultated breath sounds in posterior left upper lobe Auscultated breath sounds in posterior right upper lobe Auscultated breath sounds in posterior right mid-back (lower lobe) Auscultated breath sounds in posterior left mid-back (lower lobe) Auscultated breath sounds in posterior left lower lobe Auscultated breath sounds in posterior right lower lobe Auscultated breath sounds in posterior right lower lobe on side Auscultated breath sounds in posterior right lower lobe near spine Auscultated breath sounds in posterior left lower lobe near spine Auscultated breath sounds in posterior left lower lobe on side 5/29/2018 Gastrointestinal | Completed | Shadow Health Exam Action 05/29/18 12:31 PM CDT Exam Action 05/29/18 12:31 PM CDT Exam Action 05/29/18 12:31 PM CDT Exam Action 05/29/18 12:31 PM CDT Exam Action 05/29/18 12:31 PM CDT Exam Action 05/29/18 12:31 PM CDT Exam Action 05/29/18 12:31 PM CDT Exam Action 05/29/18 12:32 PM CDT Exam Action 05/29/18 12:34 PM CDT Exam Action 05/29/18 12:34 PM CDT Exam Action 05/29/18 12:34 PM CDT Exam Action 05/29/18 12:35 PM CDT Exam Action 05/29/18 12:36 PM CDT Auscultated aortic area with the bell Auscultated aortic area with the diaphragm Auscultated pulmonic area with the diaphragm Auscultated Erb's point with the diaphragm Auscultated tricuspid area with the diaphragm Auscultated tricuspid area with the bell Auscultated mitral area with the bell Auscultated right upper quadrant Auscultated left upper quadrant Auscultated left lower quadrant Auscultated right lower quadrant Auscultated aorta in abdomen Auscultated left renal artery 5/29/2018 Gastrointestinal | Completed | Shadow Health Exam Action 05/29/18 12:36 PM CDT Exam Action 05/29/18 12:36 PM CDT Exam Action 05/29/18 12:36 PM CDT Exam Action 05/29/18 12:37 PM CDT Exam Action 05/29/18 12:37 PM CDT Exam Action 05/29/18 12:39 PM CDT Exam Action 05/29/18 12:39 PM CDT Exam Action 05/29/18 12:39 PM CDT Exam Action 05/29/18 12:39 PM CDT Exam Action 05/29/18 12:40 PM CDT Exam Action 05/29/18 12:40 PM CDT Exam Action 05/29/18 12:41 PM CDT Exam Action 05/29/18 12:42 PM CDT Auscultated right renal artery Auscultated left iliac artery Auscultated right iliac artery Auscultated left femoral artery Auscultated right femoral artery Percussed left lower quadrant Percussed left upper quadrant Percussed right lower quadrant Percussed right upper quadrant Percu