Advanced Health Assessment - Chamberlain - October 2019, NR509-October-2019
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Overview Self-Reflection Activity Time:
Transcript
Explain the clinical reasoning behind your decisions and tasks.
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Subjective Data Collection
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Objective Data Collection
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Student Response: Patient presented with intermittent chest pain. My decisions were based on ruling out the
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Education & Empathy most serious diagnoses. I systematically eliminated the most life threatening diagnoses with the appropriate
diagnostic exams including an EKG, auscultation of the lungs, abdomen for bowel sounds as well as for the
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Documentation patency of the patient's vascular system, among others. This allowed me to create some differential diagnoses
Self-Reflection
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to perform further and more specific tests.
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Explicitly describe the tasks you undertook to complete this exam.
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Student Response: Auscultation of the lungs were done to determine if there was any fluid/consolidation.
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Auscultation of the cardiovascular system was done to determine if there was a possibility for artherlosclerosis
or issues with heart to include heart failure or valvular (same for EKG to determine arrhythmia). Palpation of
the organs helped to assess for enlarged organs. Assessing neurovascularity of hands and feet demonstrate
any insufficiency of circulation of blood to the body's periphery.
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What data did you use to base your decisions on for this patient assessment?
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Student Response: Based on the intermittent chest pain x 1 month of Mr. Foster's chief complaint, that is
what directed the assessment. Other information including his current use of Lopressor for diagnosed stage II
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hypertension, family history of hypertension as well as the death of his grandfather from a heart attack also
helped foster direction. Mr. Foster's vital signs also were indicative of cardiovascular issues as his HR was 104
and his BP was still elevated to 149/90 even after he took his medications. Mr. Foster's use of Lipitor also
raised suspicion as high cholesterol can seriously contribute to cardiovascular diseases, sign and symptoms.
Comments
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