Shadow Health Bipolar Disorder Lucas Callahan . 1
Shadow Health Focused Exam: Bipolar
Disorder Lucas Callahan
Subjective Data (page 1-27)
Education/Empathy (pages 27-
28)
SBAR (page 28-29)
Chief Complaint
•
Finding:
Asked about chief complaint
•
Finding:
Reports being brought in by police
Why are you in the emergency department tonight?
History of Present Illness
•
Finding:
Followed up on incident
•
Finding:
Reports looking into cars for government agents chasing
him What were you doing when the police found you?
•
Finding:
Reports having been in a grocery store parking
lot Where were you when the police found you?
,Shadow Health Bipolar Disorder Lucas Callahan . 2
•
Finding:
Reports knowing the police stopped him for running around and looking in
cars Do you know why the police brought you in?
•
Finding:
Denies having hurt himself or
others Were you hurting anyone?
•
Finding:
Denies having done anything
illegal Were you doing anything
illegal?
•
Finding:
Followed up on government agents
•
Finding:
Reports government is trying to imprison him for being
enlightened Why are the government agents following you?
•
Finding:
Reports government sees his enlightenment as a threat to their
secrets Why are the government agents following you?
•
Finding:
Asked about anxiety or paranoia
•
Finding:
Denies anxiety or paranoia
Are you feeling anxious or paranoid?
•
Finding:
Reports high awareness of government agents chasing
him What is making you anxious?
, Shadow Health Bipolar Disorder Lucas Callahan . 3
•
Finding:
Asked about hallucinations
•
Finding:
Denies hallucinations
Do you ever see things others can't?
•
Finding:
Asked about most recent substance use
•
Finding:
Reports last substance use was about four days
ago When was the last time you used substances?
•
Finding:
Reports last substance use was cocaine
What substance did you use four days
ago?
•
Finding:
Asked about recent sleep history
•
Finding:
Reports not having slept for four
days When was the last time you
slept?
•
Finding:
Asked about current energy levels
•
Finding:
Reports current extremely high energy
How would you describe your energy right now?
•
Finding:
Asked about current mood
•
Finding:
Reports current euphoria
What kind of mood are you
in?
Shadow Health Focused Exam: Bipolar
Disorder Lucas Callahan
Subjective Data (page 1-27)
Education/Empathy (pages 27-
28)
SBAR (page 28-29)
Chief Complaint
•
Finding:
Asked about chief complaint
•
Finding:
Reports being brought in by police
Why are you in the emergency department tonight?
History of Present Illness
•
Finding:
Followed up on incident
•
Finding:
Reports looking into cars for government agents chasing
him What were you doing when the police found you?
•
Finding:
Reports having been in a grocery store parking
lot Where were you when the police found you?
,Shadow Health Bipolar Disorder Lucas Callahan . 2
•
Finding:
Reports knowing the police stopped him for running around and looking in
cars Do you know why the police brought you in?
•
Finding:
Denies having hurt himself or
others Were you hurting anyone?
•
Finding:
Denies having done anything
illegal Were you doing anything
illegal?
•
Finding:
Followed up on government agents
•
Finding:
Reports government is trying to imprison him for being
enlightened Why are the government agents following you?
•
Finding:
Reports government sees his enlightenment as a threat to their
secrets Why are the government agents following you?
•
Finding:
Asked about anxiety or paranoia
•
Finding:
Denies anxiety or paranoia
Are you feeling anxious or paranoid?
•
Finding:
Reports high awareness of government agents chasing
him What is making you anxious?
, Shadow Health Bipolar Disorder Lucas Callahan . 3
•
Finding:
Asked about hallucinations
•
Finding:
Denies hallucinations
Do you ever see things others can't?
•
Finding:
Asked about most recent substance use
•
Finding:
Reports last substance use was about four days
ago When was the last time you used substances?
•
Finding:
Reports last substance use was cocaine
What substance did you use four days
ago?
•
Finding:
Asked about recent sleep history
•
Finding:
Reports not having slept for four
days When was the last time you
slept?
•
Finding:
Asked about current energy levels
•
Finding:
Reports current extremely high energy
How would you describe your energy right now?
•
Finding:
Asked about current mood
•
Finding:
Reports current euphoria
What kind of mood are you
in?
