Tina Jones _ Respiratory Results _Turned In | NR 509 W2 Transcript_Asthma_Respiratory

Respiratory Results | Turned In Advanced Health Assessment - Chamberlain, NR509-June-2018 Return to Assignment Your Results Lab Pass Lab Pass Started: Jul 21, 2018 | Patient Exam Time: 738 min Transcript Greet 07/21/18 11:17 PM CDT Question 07/21/18 11:18 PM CDT Question 07/21/18 11:18 PM CDT Question 07/21/18 11:19 PM CDT Overview Transcript Subjective Data Collection Objective Data Collection Education & Empathy Documentation Student Pre-Survey Lifespan Review Questions Self-Reflection Interview Questions (216) Interview Questions (216) Statements (23) Statements (23) Exam Actions (58) Exam Actions (58) Tina, it's good to see you again. If you don't remember me, I'm Scott, your nurse practitioner. I'll be doing your examination today. Hey. What brings you in today? I came in because I've been having breathing problems, and my inhaler just isn't working the way it normally does. Tell me about the breathing issues your experiencing? It feels like it's been hard to take in air. My chest feels all tight and I've been wheezing... I've had to use my inhaler a lot, and it doesn't feel like it's totally working. To make sure I understand, you feel like you can't get enough air? (No matching questions found.) All Lines (297) All Lines (297)Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/21/18 11:19 PM CDT Empathize 07/21/18 11:20 PM CDT Educate 07/21/18 11:22 PM CDT Question 07/21/18 11:22 PM CDT Question 07/21/18 11:22 PM CDT Question 07/21/18 11:22 PM CDT Question 07/21/18 11:23 PM CDT Question 07/21/18 11:23 PM CDT You can't get enough air in to your lungs? (No matching questions found.) I'm sorry, thats a terrible feeling. Thanks for saying that. I know that we have been through these same set of questions, so I'm sorry I'm going to ask them again. I'm not really insulting your intelligence, although it may seem like I am. Alright, thanks for letting me know. When did your breathing issues begin? All of these breathing problems started two days ago, at my cousin's house. Were you around cats? Two days ago, at my cousin's house. She has three of them, and my asthma always goes crazy when I'm there. Because your allergic to cats, right? Definitely. Cats make my asthma go crazy. How long were you exposed to these cats? (No matching questions found.) Has your asthma gotten worse since you were exposed to the cats?Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/21/18 11:24 PM CDT Question 07/21/18 11:24 PM CDT Question 07/21/18 11:25 PM CDT Question 07/21/18 11:25 PM CDT Question 07/21/18 11:26 PM CDT Question 07/21/18 11:26 PM CDT Question 07/21/18 11:27 PM CDT No, my asthma has definitely got better since I was little. It used to be really bad--I would get asthma attacks all the time. Just lately, though, it's been worse than usual. Did anything make you asthma feel better? (No matching questions found.) Your inhaler didn't help your asthma? (Clarified to what do you do if your inhaler doesn't work.) I guess I don't really have a backup plan; it's always worked in the past, though lately I've needed more puffs than usual. How many puffs do you need? Sometimes I have to take three puffs instead of two, and the past couple days, always three. [Nurse confirmed with Pharmacy: albuterol 90mcg/spray MDI] How many times did you use your inhaler the past two days? (Clarified to how many times have you used your inhaler in the past two days.) I've been needing my inhaler about every four hours, I'd say. What have you done to treat your asthma? (Clarified to how do you manage your asthma.) I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler. Why didn't you avoid the cats this time? I haven't been sleeping as well because my asthma has been getting a little worse at night, and it's been waking me up, too. How many times to you wake up with asthma?Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/21/18 11:27 PM CDT Question 07/21/18 11:28 PM CDT Question 07/21/18 11:28 PM CDT Question 07/24/18 11:37 AM CDT Question 07/24/18 11:39 AM CDT Question 07/24/18 11:41 AM CDT Empathize 07/24/18 11:42 AM CDT I feel like I've woken up at least twice each night with breathing problems the past two nights. Are you able to fall back asleep? (No matching questions found.) Have you been sick lately? No, I'm usually healthy. Have you been exposed to any dust lately? No. . . I'm not around dust much. It mostly happens if I'm at someone's house and they don't keep it very clean, and that hasn't happened in a while. How often have you been having trouble breathing? Maybe as much as every four hours? It's a lot. When is the last time you were hospitalized because of an asthma attack? I used to go to the hospital a lot for asthma attacks, but not since I was sixteen. What have you done to avoid hospitalizations due to asthma? (No matching questions found.) That's awesome - to be able to avoid going to the hospital since 16 years old. I appreciate you saying that.Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/24/18 11:42 AM CDT Question 07/24/18 11:42 AM CDT Question 07/24/18 11:43 AM CDT Question 07/24/18 11:44 AM CDT Question 07/24/18 11:44 AM CDT Question 07/24/18 11:45 AM CDT Question 07/24/18 11:46 AM CDT How have you been treating your asthma? I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler. How often have you been using your inhaler lately? I don't usually use it every day, but I've used it a bunch the past couple days. How many times a day do you sue your inhaler? I don't usually use it every day, but I've used it a bunch the past couple days. How many puffs do you need to help you breath better? (Clarified to How many inhaler puffs do you need.) Sometimes I have to take three puffs instead of two, and the past couple days, always three. [Nurse confirmed with Pharmacy: albuterol 90mcg/spray MDI] How many inhaler puffs are you prescribed? I'm supposed to just do two puffs. [Nurse confirmed with Pharmacy: albuterol 90mcg/spray MDI] How effective has your inhaler been? (No matching questions found.) Is your inhaler been functioning abnormally lately? I don't usually use it every day, but I've used it a bunch the past couple days.Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/24/18 11:46 AM CDT Question 07/24/18 11:47 AM CDT Question 07/24/18 11:48 AM CDT Question 07/24/18 11:48 AM CDT Question 07/24/18 11:49 AM CDT Question 07/24/18 11:50 AM CDT Question 07/24/18 11:51 AM CDT Do you use any other medications for your asthma? My inhaler is the only prescription I always have, but I usually don't need it everyday, except for recently. . . Do you take any other medications? (Clarified to are you taking other medications.) No, all I really use is my inhaler. Have you ever been prescribed with a corticosteroid? Yeah, when I was diagnosed they gave me a medicine to try. What medication did they give you when you were first diagnosed with asthma? (Clarified to how old were you when you were diagnosed with asthma.) 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. Which medication did your doctor first diagnosed with asthma? (No matching questions found.) Which medications have you tried for asthma in the past? It's just a regular Proventil inhaler. Do you get asthma symptoms when you exercise? (Clarified to Do you have asthma when you exercise.) Well, I don't exercise, really. I mean, I'm active -- I'm on my feet all day -- but I don't go running or stuff like that. I bet I'd get winded pretty fast, and I'd probably need my inhaler.Respiratory | Completed | Shadow Health 7/26/18, 2)22 PM Question 07/24/18 11:51 AM CDT Question 07/24/18 11:53 AM CDT Question 07/24/18 11:54 AM CDT Empathize 07/24/18 12:00 PM CDT Question 07/24/18 12:00 PM CDT Question 07/24/18 12:01 PM CDT Question 07/24/18 12:01 PM CDT Question 07/24/18 12:02 PM CDT Do you get winded while going up a flight of stairs? (Clarified to Do you get short of breath when you go up a flight of stairs?.) Only when I'm in a rush and have to hurry up them. Do you have shortness of breath while doing normal activities around the house? It's definitely been harder to move around without worrying my asthma was going to act up again. Have you ever had an asthma attack that was so severe that you nearly died? (Clarified to How many asthma attacks have you had.) I haven't had a full attack, but I've had a lot of breathing problems-- probably. . . ten times since I was at my cousin's house two days ago. I'm sorry, that's rough and a but scary. Thanks for saying that. Are you experiencing any chest pain? My chest has been feeling tight, but it doesn't hurt or anything. Do you feel increased tightness when you take a slow deep breath? (No matching questions found.) Do you have an increase in chest tightness when you take a deep breath? (Clarified to do you have pain when you breathe.) No, my chest feels tight when I have breathing problems, but it doesn't hurt. On a scale from 0 to 10, ten being the worst chest tightness you've ever felt, how would you rate your chest tightness right now? - - - - - Continued