Skin, Hair, and Nails _ Completed _ Shadow Health.pdf - Skin Hair and Nails | Completed | Shadow Health Skin Hair and Nails Results | Completed N190

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Unformatted text preview: 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health Skin, Hair, and Nails Results | Completed N190 Physical Assessment - January 2019 - March 2019, nurs190-ie_nurs190_201901spi_4w Return to Assignment Your Results Overview Turn In Transcript Transcript Subjective Data Collection Lab Pass Started: Jan 18, 2019 | Patient Exam Time: 61 min All Lines (139) Interview Questions (40) Statements (0) Exam Actions (99) Objective Data Collection Documentation Hello! Student Survey Question 01/18/19 6:19 PM PST Hi. I'm Preceptor Diana. I will explain the details of this assignment and your objectives, just as a preceptor would in real life. Pay close attention to this information as it will help guide your exam. At the end of this prebrief, you will answer a short question about the upcoming assignment. During the simulation, you may return to these instructions at any time by scrolling to the top of your transcript. What is the situation? Question 01/18/19 6:20 PM PST It's 4 p.m. on Tina Jones' second day as a patient here at Shadow General Hospital. In anticipation of Ms. Jones being discharged from the hospital, your role in this simulation is that of a healthcare provider who will assess her skin, hair, and nails for any additional wounds or signs of impaired healing. What are my objectives in this assessment? Question 01/18/19 6:20 PM PST 1/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health In your interview with Ms. Jones, you will gather subjective data by asking about her skin, hair, and nails. These features, which help make up the integumentary system, are often an indicator of overall health. If you discover any disease states, ask about symptoms and the patient's experiences of them. Your questioning should cover a broad array of the symptoms' characteristics. You will also inquire into the health history of Ms. Jones' family with regards to skin, hair, and nails so you can determine her genetic predisposition to any diseases. Regardless of whether you have assessed Tina previously, ask all questions that are medically relevant to her hair, skin, and nails. In addition to collecting subjective data, you will also examine Ms. Jones' skin, hair, and nails to gather objective data. While you should communicate with patients using accessible, everyday language, it is standard practice to use professional medical terminology everywhere else, such as in documenting physical findings and nursing notes. You may complete the exam activities in any order and move between them as needed. What else will this exam involve? Question 01/18/19 6:22 PM PST You will complete nursing tasks to protect the patients safety, privacy, and health. You can document your findings, including vital signs, in the Electronic Health Record. This record provides necessary information for healthcare professionals who will continue patient care. Activities other than Subjective and Objective Data Collection, such as Documentation and Education and Empathy, provide valuable practice for their real-world counterparts. However, they are not automatically graded by the simulation. How will I be evaluated? Question 01/18/19 6:22 PM PST In this assignment, you will be evaluated on your Subjective and Objective Data Collection. The evaluation of your interview is dependent on how you word your questions therapeutically and precisely and explore all relevant topics with comprehensive breadth and depth. The evaluation of your physical exam is based on how successfully you report on your physical findings by selecting among clinical terms in the Electronic Health Record. This assignment takes on average between 50 and 70 minutes. You can pause and resume the assignment at any time; your work is always saved automatically. How does this assignment prepare me for the real world? Question 01/18/19 6:23 PM PST In this assessment, you will become familiarized with the structure and content of skin, hair, and nail exams so that with real-life patients, you can: º ask effective and comprehensive questions º use therapeutic language º evaluate the patient's risk of disease, infection, injury, and complications º and obtain and assess objective data. 2/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: What effect might a patient's diabetes have on their skin? Itching associated with yeast infections. Poor circulation can cause scaly skin on the front of their legs Statement 01/18/19 6:48 PM PST Time to begin. Hello Tina, I am karen and I will be your student nurse today. I will be doing an assessment on your skin, hair and nails Greet 01/18/19 6:49 PM PST Hey. How is your foot wound feeling Question 01/18/19 6:53 PM PST I'm in less pain today, yeah. Do you have a history of slow wound healing Question 01/18/19 6:53 PM PST Usually I heal up fine. . . I'm really surprised this scrape has taken so long to get better. But being in the hospital has helped it. Do you have any history of skin conditions Question 01/18/19 6:54 PM PST No, unless acne counts. I suppose my dry skin counts, too. do you use any treatment for your acne Question 01/18/19 6:55 PM PST I went to a doctor in high school for my acne, and she gave me antibiotics, I think. I also tried some prescription creams, but nothing really seemed to work. What do you usually do at home for your dry skin (Clarified to What do you use for your dry skin?.) Question 01/18/19 6:56 PM PST I put lotion on my skin a lot, and that helps keep it from getting dry, it least for a while. (Clarified to what I do for my dry skin.) 3/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health where do you usually get acne (Clarified to Where do you get acne?.) Question 01/18/19 6:56 PM PST My face breaks out a lot. . . and sometimes my back does, too. (Clarified to where I get acne.) do you have any moles Question 01/18/19 6:56 PM PST I have some moles, yeah. do the moles change in size Question 01/18/19 6:57 PM PST I haven't noticed anything different about them. what about appearance (Clarified to What do your moles look like?.) Question 01/18/19 6:57 PM PST I don't know. . . they're just regular moles. (Clarified to what my moles look like.) where are your moles located Question 01/18/19 6:58 PM PST I think most of my moles are on my back. have you noticed any darkening of your skin (Clarified to Have areas of your skin darkened?.) Question 01/18/19 6:58 PM PST I think the skin on my neck has been darker lately, actually. (Clarified to if areas of my skin have darkened.) Do you have any sensation on the skin of your neck (No matching questions found.) Question 01/18/19 6:58 PM PST Do you have any sensation changes on your neck Question 01/18/19 6:59 PM PST No, I don't think so. do you still have sensation on the skin of your neck 4/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health Question 01/18/19 6:59 PM PST No, I don't think so. Do you notice any changes of body hair Question 01/18/19 6:59 PM PST Yeah, actually, I definitely have more hair places I didn't used to lately. Where do you have more hair Question 01/18/19 7:00 PM PST Ugh, this is embarrassing. I definitely have more hair on my belly than I used to. Plus I have some on my face that didn't used to be there, too. Checked vitals Exam Action 01/18/19 7:00 PM PST do you feel any pain Question 01/18/19 7:01 PM PST My foot still hurts a bit, but it's much better than it was when I came in. I think the medicine they've been giving me has helped. on a scale of 0 to 10 with 0 being no pain, where do you say you are at (Clarified to Can you rate your current pain level on a scale of 0 to 10?.) Question 01/18/19 7:02 PM PST Now? I guess I would rate it about a five. (Clarified to how I would rate my pain on a scale.) are you feeling any discomfort at all (Clarified to Are you having discomfort?.) Question 01/18/19 7:02 PM PST My foot still hurts a bit, but it's much better than it was when I came in. I think the medicine they've been giving me has helped. (Clarified to if I have discomfort.) Palpated scalp: No tenderness reported, no masses Exam Action 01/18/19 7:03 PM PST do you have any history on scalp problems (No matching questions found.) 5/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health Question 01/18/19 7:04 PM PST Do you have any scalp troubles like dandruff (Clarified to DO you have problems with your hair and scalp?.) Question 01/18/19 7:04 PM PST No, I think my scalp and head hair are pretty normal. (Clarified to If I have hair and scalp problems.) Inspected hairline and top scalp Exam Action 01/18/19 7:05 PM PST Inspected left side of head Exam Action 01/18/19 7:05 PM PST Inspected hairline and top scalp Exam Action 01/18/19 7:05 PM PST Inspected right side of head Exam Action 01/18/19 7:05 PM PST Inspected hairline and top scalp Exam Action 01/18/19 7:05 PM PST Inspected general face Exam Action 01/18/19 7:06 PM PST Inspected nose and mouth Exam Action 01/18/19 7:07 PM PST Inspected right side of head Exam Action 01/18/19 7:07 PM PST Inspected general face Exam Action 01/18/19 7:07 PM PST Inspected left side of head Exam Action 01/18/19 7:07 PM PST Inspected general face Exam Action 01/18/19 7:07 PM PST 6/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health Inspected left orbital area and sclera Exam Action 01/18/19 7:07 PM PST Inspected upper conjunctiva Exam Action 01/18/19 7:07 PM PST Inspected lower conjunctiva Exam Action 01/18/19 7:07 PM PST Inspected right orbital area and sclera Exam Action 01/18/19 7:07 PM PST Inspected lower conjunctiva Exam Action 01/18/19 7:07 PM PST Inspected front of neck Exam Action 01/18/19 7:08 PM PST Inspected right side of neck Exam Action 01/18/19 7:08 PM PST Inspected front of neck Exam Action 01/18/19 7:08 PM PST Inspected left side of neck Exam Action 01/18/19 7:08 PM PST Inspected front of neck Exam Action 01/18/19 7:08 PM PST Inspected left foot Exam Action 01/18/19 7:09 PM PST Inspected top of feet Exam Action 01/18/19 7:09 PM PST Inspected right foot Exam Action 01/18/19 7:09 PM PST Inspected soles of feet Exam Action 01/18/19 7:09 PM PST 7/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health Checked capillary refill in toenails Exam Action 01/18/19 7:10 PM PST Checked capillary refill in toenails Exam Action 01/18/19 7:10 PM PST Checked capillary refill in toenails Exam Action 01/18/19 7:10 PM PST Checked capillary refill in toenails Exam Action 01/18/19 7:10 PM PST Checked capillary refill in toenails Exam Action 01/18/19 7:10 PM PST Inspected right toenails Exam Action 01/18/19 7:10 PM PST Inspected left toenails Exam Action 01/18/19 7:10 PM PST Checked capillary refill in toenails Exam Action 01/18/19 7:10 PM PST Checked capillary refill in toenails Exam Action 01/18/19 7:11 PM PST Checked capillary refill in toenails Exam Action 01/18/19 7:11 PM PST Checked capillary refill in toenails Exam Action 01/18/19 7:11 PM PST Checked capillary refill in toenails Exam Action 01/18/19 7:11 PM PST Checked capillary refill in toenails Exam Action 01/18/19 7:11 PM PST Assessed wound location Exam Action 01/18/19 7:11 PM PST 8/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health Assessed wound exudate: Serosanguineous and purulent exudate noted; no odor noted Exam Action 01/18/19 7:13 PM PST Assessed for necrotic tissue Exam Action 01/18/19 7:14 PM PST Assessed peripheral tissue: Red with slight edema Exam Action 01/18/19 7:15 PM PST Assessed for necrotic tissue Exam Action 01/18/19 7:17 PM PST do you have family history of hair problems Question 01/18/19 7:17 PM PST I don't think so. What about skin conditions Question 01/18/19 7:17 PM PST I don't think anyone in the family has skin problems. Do you have any problems with your nails Question 01/18/19 7:17 PM PST I haven't had any problems with my nails. What about any tanning or sun exposure (Clarified to How much sun do you get?.) Question 01/18/19 7:18 PM PST I don't sunbathe or tan or any of that. (Clarified to how much sun I get.) has the skin on your neck thickened Question 01/21/19 10:55 AM PST I think maybe it's thicker. . . it's definitely gotten darker. does the skin on your neck feel itchy Question 01/21/19 10:55 AM PST 9/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health No, it's not itchy. does the skin on your neck hurt Question 01/21/19 10:56 AM PST The skin on my neck doesn't hurt at all. . . it just looks weird. has the skin on your neck changed Question 01/21/19 10:56 AM PST Yeah, I guess the skin on my neck has been looking kind of weird. when did the skin on your neck change Question 01/21/19 10:57 AM PST I only noticed the skin getting darker pretty recently, like in the last few months. But then I saw some photos of myself from a few years ago and it was getting darker then, so I guess it's been that way for a while without my realizing it. When did you notice the appearance of more body hair Question 01/21/19 10:58 AM PST I've had at least some hair there for a really long time, but it seems like it gets worse and worse every year. do you have a history of eczema Question 01/21/19 10:58 AM PST I've never had eczema, I don't think. do you have a history of psoriasis Question 01/21/19 10:58 AM PST I don't really know what psoriasis is, so I guess I probably don't have it. Do you have a history of diabetes Question 01/21/19 11:01 AM PST Yeah, I was diagnosed a few years ago. 10/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health Inspected front of legs Exam Action 01/21/19 11:02 AM PST Inspected left leg Exam Action 01/21/19 11:02 AM PST Inspected back of legs Exam Action 01/21/19 11:02 AM PST Inspected right leg Exam Action 01/21/19 11:02 AM PST Inspected front of legs Exam Action 01/21/19 11:02 AM PST Inspected front of knees Exam Action 01/21/19 11:02 AM PST Inspected left ankle Exam Action 01/21/19 11:03 AM PST Tested skin turgor on forearm Exam Action 01/21/19 11:04 AM PST Inspected anterior chest wall Exam Action 01/21/19 11:04 AM PST Inspected left side of chest wall Exam Action 01/21/19 11:04 AM PST Inspected anterior chest wall Exam Action 01/21/19 11:04 AM PST Inspected right side of chest wall Exam Action 01/21/19 11:04 AM PST Inspected anterior chest wall Exam Action 01/21/19 11:05 AM PST Inspected left side of abdomen Exam Action 01/21/19 11:05 AM PST 11/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health Inspected left arm Exam Action 01/21/19 11:05 AM PST Inspected right arm Exam Action 01/21/19 11:05 AM PST Inspected right elbow Exam Action 01/21/19 11:06 AM PST Inspected left elbow Exam Action 01/21/19 11:06 AM PST Inspected left hand Exam Action 01/21/19 11:06 AM PST Inspected right hand Exam Action 01/21/19 11:06 AM PST Checked capillary refill in fingernails Exam Action 01/21/19 11:07 AM PST Checked capillary refill in fingernails Exam Action 01/21/19 11:07 AM PST Checked capillary refill in fingernails Exam Action 01/21/19 11:07 AM PST Checked capillary refill in fingernails Exam Action 01/21/19 11:07 AM PST Checked capillary refill in fingernails Exam Action 01/21/19 11:07 AM PST Checked capillary refill in fingernails Exam Action 01/21/19 11:07 AM PST Checked capillary refill in fingernails Exam Action 01/21/19 11:07 AM PST Checked capillary refill in fingernails Exam Action 01/21/19 11:07 AM PST 12/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health Inspected fingernails of left hand Exam Action 01/21/19 11:07 AM PST Inspected fingernails of right hand Exam Action 01/21/19 11:08 AM PST Inspected upper back Exam Action 01/21/19 11:08 AM PST Inspected mole closely Exam Action 01/21/19 11:08 AM PST Inspected right shoulder Exam Action 01/21/19 11:08 AM PST Inspected upper back Exam Action 01/21/19 11:09 AM PST Inspected left shoulder Exam Action 01/21/19 11:09 AM PST Inspected back Exam Action 01/21/19 11:09 AM PST Inspected sacrum closely Exam Action 01/21/19 11:09 AM PST Inspected back Exam Action 01/21/19 11:09 AM PST Inspected front of hips Exam Action 01/21/19 11:10 AM PST Inspected upper back Exam Action 01/21/19 11:12 AM PST Inspected left side of abdomen Exam Action 01/21/19 11:12 AM PST Inspected back Exam Action 01/21/19 11:12 AM PST 13/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health Inspected front of hips Exam Action 01/21/19 11:13 AM PST Inspected front of legs Exam Action 01/21/19 11:13 AM PST Inspected front of knees Exam Action 01/21/19 11:13 AM PST Inspected left knee Exam Action 01/21/19 11:13 AM PST Inspected back of knees Exam Action 01/21/19 11:13 AM PST Inspected right knee Exam Action 01/21/19 11:14 AM PST Inspected front of knees Exam Action 01/21/19 11:14 AM PST Inspected front of legs Exam Action 01/21/19 11:14 AM PST Inspected left leg Exam Action 01/21/19 11:14 AM PST Inspected back of legs Exam Action 01/21/19 11:14 AM PST Inspected right leg Exam Action 01/21/19 11:14 AM PST Inspected front of legs Exam Action 01/21/19 11:14 AM PST Comments If your instructor provides individual feedback on this assignment, it will appear here. 14/15 3/6/2019 Skin, Hair, and Nails | Completed | Shadow Health © Shadow Health® 2018 15/15 ...
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