What Are the Purposes of The Shadow Health Physical Assessment Assignments

1. Skill Development: These assignments provide an opportunity for healthcare students to develop and enhance their physical assessment skills. By using the Shadow Health platform, students can practice performing a comprehensive physical examination on virtual patients, which helps them gain proficiency in various assessment techniques.

2. Application of Knowledge: The assignments allow students to apply their theoretical knowledge of physical assessment in a practical setting. Students can bridge the gap between theory and practice by engaging with virtual patients and conducting assessments, reinforcing their understanding of anatomy, physiology, and assessment techniques.

3. Clinical Reasoning: The assignments encourage students to think critically and develop their clinical reasoning skills. They are presented with patient cases and are required to gather relevant information, analyze findings, and make appropriate clinical judgments. This process helps students develop the ability to assess patient conditions accurately and formulate effective care plans.

4. Communication Skills: Effective communication is crucial in healthcare settings. The assignments provide an opportunity for students to practice their communication skills, including patient interviewing, active listening, and documentation. By engaging with virtual patients, students can refine their ability to gather information, establish rapport, and convey their findings to the healthcare team.

5. Assessment Standardization: The Shadow Health platform offers a standardized environment for physical assessment training. It ensures that all students have access to the same patient scenarios, assessment tools, and feedback, promoting consistency and fairness in evaluating students’ performance.

Overall, the Shadow Health Physical Assessment Assignments aim to facilitate the development of essential clinical skills, enhance critical thinking and clinical reasoning abilities, and improve communication proficiency among healthcare students.

NURS6512 Week 7

Interaction with patient

602 minutes

Transcript

	Hi Mr Foster, My name is , I am going to examine you today.	Greet 10/05/20 1:18 PM MDT
	Good morning.
	What brought you here today ?	Question 10/05/20 1:18 PM MDT
	I have been having some troubling chest pain in my chest now and then for the past month.
	Oh I’m sorry to hear that, it should be very uncomfortable to have that pain for a whole month.	Empathize 10/05/20 1:22 PM MDT
	Thanks. I appreciate that.
	? (No matching questions found.)	Question 10/05/20 1:22 PM MDT
	What is the onset of your pain ?	Question 10/05/20 1:23 PM MDT
	I first noticed it earlier this month. I thought it might just be heartburn and it passed after about a couple of minutes.
	What is the exact location of the pain ?	Question 10/05/20 1:24 PM MDT
	When the pain happens, I feel it mostly in the middle of my chest, over my heart.
	When did you chest pain start ?	Question 10/05/20 1:25 PM MDT
	I first noticed it earlier this month. I thought it might just be heartburn and it passed after a couple of minutes.
	What is the exact location of the pain ?	Question 10/05/20 1:25 PM MDT
	When the pain happens, I feel it mostly in the middle of my chest, over my heart.
	Sorry to hear that	Empathize 10/05/20 1:26 PM MDT
	Thanks. I appreciate that.
	Easter pain radiates anywhere ? (Clarified to Is your pain radiating?.)	Question 10/05/20 1:26 PM MDT
	The pain doesn’t radiate anywhere. It’s mostly just right in the middle of my chest. (Clarified to if the pain is radiating.)
	If your arm hurts (Clarified to Do you have pain in your arm?.)	Question 10/05/20 1:26 PM MDT
	No, when I am having the chest pain, it’s mostly just in middle of my chest. (Clarified to if I have pain in my arm.)
	Do you have a pain in your shoulder ?	Question 10/05/20 1:27 PM MDT
	No, the pain hasn’t been in my shoulder.
	Do you have a back pain ?	Question 10/05/20 1:27 PM MDT
	I haven’t had back pain, no.
	Can you tell me the duration of the pain ? (No matching questions found.)	Question 10/05/20 1:28 PM MDT
	Can you describe the duration of the pain ? (Clarified to Can you tell me what the pain is like?.)	Question 10/05/20 1:28 PM MDT
	Well, it mostly feels tight and uncomfortable right in the middle of my chest. (Clarified to if I can tell you what the pain is like.)
	How often pain occurs ? (Clarified to How often do you have pain?.)	Question 10/05/20 1:29 PM MDT
	Well, it has happened three times the past month. It usually goes away after about a couple of minutes. (Clarified to how often I have pain.)
	Can you describe your pain from 0 to 10 scale ?	Question 10/05/20 1:29 PM MDT
	I’d say maybe a . . . 5? It’s just really uncomfortable . . . like there’s nothing I can do about it. Right now it’s like a zero though.
	Sorry to hear that	Empathize 10/05/20 1:30 PM MDT
	Thanks. I appreciate that.
	Can you describe your pain ?	Question 10/05/20 1:31 PM MDT
	Well, it mostly feels tight and uncomfortable right in the middle of my chest.
	ASA pain crashing ? (Clarified to Do you take aspirin?.)	Question 10/05/20 1:31 PM MDT
	I usually just take Tylenol or ibuprofen. (Clarified to if I take aspirin.)
	What is the dosage of Tylenol are you taking ?	Question 10/05/20 2:35 PM MDT
	Just whatever the bottle recommends for an adult.
	What is the dosage of ibuprofen you taking ? (Clarified to What is the strength of the ibuprofen you take?.)	Question 10/05/20 2:35 PM MDT
	Just whatever the bottle recommends for an adult. (Clarified to What strength ibuprofen I take.)
	Is it Tylenol helps ?	Question 10/05/20 2:35 PM MDT
	Just a couple when I get a headache, which is not very often.
	How often do you take Tylenol ?	Question 10/05/20 2:36 PM MDT
	I took some today . . . maybe every couple days for mild pain.
	What is the reason you’re taking ibuprofen ?	Question 10/05/20 2:36 PM MDT
	Just when I need it for various aches and pains. Probably not more than 3 or 4 times a month.
	Where else do you have a pain ?	Question 10/05/20 2:36 PM MDT
	No, when I am having the chest pain, it’s mostly just in middle of my chest.
	Do you have a pain somewhere else in your body ?	Question 10/05/20 2:37 PM MDT
	No, when I am having the chest pain, it’s mostly just in middle of my chest.
	What is the aggravating factors ? (Clarified to Are there any aggravating factors?.)	Question 10/05/20 2:37 PM MDT
	Well, the pain seems to start when I’m doing something physical . . . the first time it happened while I was doing yard work, and the second time . . . I had to take the stairs at work because the elevator broke. Both times it got better if I took a break or sat down to rest. (Clarified to if there are aggravating factors.)
	What activity triggers pain ?	Question 10/05/20 2:39 PM MDT
	If I’m up and moving around I definitely notice it more and it makes me feel like I should sit down and take a deep breath or something.
	He’s a pain worse when you eat ?	Question 10/05/20 2:40 PM MDT
	I don’t think eating has anything to do with it. One episode did happen when my wife and I were out for dinner, but it seemed to happen before we even settled. The episodes don’t seem all that related, to be honest.
	It can be a lot of triggers in your diet which would aggravate and trigger your pain Mr.Foster.	Educate 10/05/20 2:43 PM MDT
	Good to know. Thank you.
	Do you like spicy food ?	Question 10/05/20 2:43 PM MDT
	Sure, I like spicy food. I don’t eat it very often, though. Maybe once or twice a month.
	Do you like high-fat food ? (Clarified to Do fatty foods cause the pain?.)	Question 10/05/20 2:44 PM MDT
	I don’t think that has anything to do with it, but I guess I don’t know. (Clarified to if fatty foods cause the pain.)
	What relieves your pain ?	Question 10/05/20 2:44 PM MDT
	I’m not sure. I think lying still seems to help a little.
	Take anything for chest pain ?	Question 10/05/20 2:46 PM MDT
	No, not yet.
	Do you take medication for hypertension ?	Question 10/05/20 2:46 PM MDT
	I take metoprolol, yes. [AUDIO COMING SOON]
	Is a dosage of Metoprolol ? (Clarified to What dose of Lopressor do you take?.)	Question 10/05/20 2:47 PM MDT
	I think it’s 100 mg, once a day. (Clarified to what dose of Lopressor I take.)
	Do you take any medication for hyperlipidemia ?	Question 10/05/20 2:47 PM MDT
	I take atorvastatin. [AUDIO COMING SOON]
	What is the dosage of atorvastatin are you taking ?	Question 10/05/20 2:48 PM MDT
	I think it’s twenty milligrams a day.
	Do you take over-the-counter medications ?	Question 10/05/20 2:48 PM MDT
	Oh, just ibuprofen or Tylenol occasionally for pain.
	Do you take any supplements ?	Question 10/05/20 2:48 PM MDT
	I take fish oil, that’s it.
	How frequently you take medication for hyperlipidemia ? (Clarified to Do you take cholesterol medication?.)	Question 10/05/20 2:49 PM MDT
	I take atorvastatin. [AUDIO COMING SOON] (Clarified to if I take cholesterol medication.)
	How often do you take atorvastatin ?	Question 10/05/20 2:50 PM MDT
	I take them daily. I’m pretty good about following the doctor’s orders.
	When have you been diagnosed with high blood pressure ?	Question 10/05/20 2:51 PM MDT
	Yes, I supposedly have moderately high blood pressure.
	When you started to take metoprolol ?	Question 10/05/20 2:51 PM MDT
	I think it’s been about one year.
	When have you been diagnosed with hyperlipidemia ? (Clarified to Do you have an anxiety disorder?.)	Question 10/05/20 2:51 PM MDT
	I’ve never had any anxiety problems before. [AUDIO COMING SOON] (Clarified to if I have an anxiety disorder.)
	When have you been diagnosed with hyperlipidemia ? (Clarified to Are you diagnosed with high blood pressure?.)	Question 10/05/20 2:52 PM MDT
	Yes, I supposedly have moderately high blood pressure. (Clarified to if I have been diagnosed with hypertension.)
	I’m sorry to hear that	Empathize 10/05/20 2:52 PM MDT
	Thanks. I appreciate that.
	Do you do exercise ?	Question 10/05/20 2:53 PM MDT
	Well I used to ride my bike a lot but it got stolen a couple years ago. I guess I haven’t had much regular exercise since then. I want to get a new bike if the doctor says it is OK to exercise with this chest pain I’ve been having.
	I’m sorry to hear that your bike was stolen	Empathize 10/05/20 2:53 PM MDT
	Thanks. I appreciate that.
	When did the exercise last time ?	Question 10/05/20 2:53 PM MDT
	Well I used to ride my bike a lot but it got stolen a couple years ago. I guess I haven’t had much regular exercise since then. I want to get a new bike if the doctor says it is OK to exercise with this chest pain I’ve been having.
	What type of food do you like ?	Question 10/05/20 2:54 PM MDT
	Um, let’s see . . . For breakfast I usually eat a granola bar and drink an instant breakfast shake. I’ve been doing that a while since it saves time in the morning. Most days for lunch I get a sandwich from the sub shop near work. That’s usually a turkey sub, but sometimes I get a spicy Italian sub. My wife and I grill a lot, and usually have some grilled meat with veggies for dinner.
	United include a lot of processed and fast food which is not good for your body. To have the same fast food diet may affect you over the time. You need to change your diet.	Educate 10/05/20 2:57 PM MDT
	Good to know. Thank you.
	You need to exercise.Not essential to do that with a bike. You can do sit ups, running or just simple indoor exercises in your home.	Educate 10/05/20 2:59 PM MDT
	Good to know. Thank you.
	Did you lose any weight ? (Clarified to Have you lost weight?.)	Question 10/05/20 2:59 PM MDT
	Not exactly . . . I’ve gained about fifteen to twenty pounds in the last couple years. (Clarified to if I have lost weight.)
	It’s not good to gain the weight. You need to change the diet and start doing the exercises.	Educate 10/05/20 3:10 PM MDT
	Good to know. Thank you.
	What’s what’s your fathers health ?	Question 10/05/20 3:14 PM MDT
	He really wasn’t doing so great in the last few years. He died when he was 75 of colon cancer, but even before that, his weight and his blood pressure and cholesterol were getting the best of him. It was rough. He didn’t last too long after the cancer diagnosis, unfortunately. I think he was tired of fighting.
	I’m sorry to hear that it should be very difficult to lose the father	Empathize 10/05/20 3:15 PM MDT
	Thanks. I appreciate that.
	How did you cope with a losing father ? (No matching questions found.)	Question 10/05/20 3:15 PM MDT
	How did you cope after you lost your father ?	Question 10/05/20 3:16 PM MDT
	Yeah. He died of colon cancer. He also had high blood pressure and high cholesterol.
	Sorry to hear that	Empathize 10/05/20 3:16 PM MDT
	Thanks. I appreciate that.
	Who’s your mother’s health ?	Question 10/05/20 3:16 PM MDT
	She has type 2 diabetes and some high blood pressure, but I think she’s doing pretty well for 80.
	Do you have a brothers and sisters ?	Question 10/05/20 3:17 PM MDT
	I have a sister, and I had a brother but he died many years ago.
	Sorry to hear that	Empathize 10/05/20 3:17 PM MDT
	Thanks. I appreciate that.
	How was your maternal grandmother ? (Clarified to How is the health of your maternal grandmother?.)	Question 10/05/20 3:17 PM MDT
	She had breast cancer. She was in her 60s when she died. (Clarified to how my maternal grandmother’s health is.)
	About maternal grandfather ?	Question 10/05/20 3:18 PM MDT
	My grandfather on my mom’s side died of a heart attack. He was in his mid-fifties.
	Sorry to hear that	Empathize 10/05/20 3:18 PM MDT
	Thanks. I appreciate that.
	How is your paternal grandfather ?	Question 10/05/20 3:18 PM MDT
	He was healthy right up until he died. He went in his sleep at 85, and we just called it old age.
	Sorry to hear that	Empathize 10/05/20 3:19 PM MDT
	Thanks. I appreciate that.
	How about fraternal grandmother ? (No matching questions found.)	Question 10/05/20 3:19 PM MDT
	How about paternal grandmother ?	Question 10/05/20 3:19 PM MDT
	She died of pneumonia when she was almost 80. 78 or 79, I think.
	Sorry to hear that	Empathize 10/05/20 3:20 PM MDT
	Thanks. I appreciate that.
	Do you have children ?	Question 10/05/20 3:20 PM MDT
	Yes, I have two great kids. Well, they’re not kids. Sam is 26 and Allie is 19.
	Does it have any medical conditions ?	Question 10/05/20 3:20 PM MDT
	The doctors told me I have a little bit of high blood pressure and cholesterol, but that’s it.
	Is your daughter healthy ?	Question 10/05/20 3:21 PM MDT
	Allie’s doing great. She has asthma, but she’s got a handle on it. [AUDIO COMING SOON]
	How is your son doing ?	Question 10/05/20 3:21 PM MDT
	He’s 26.
	Do you smoke ?	Question 10/05/20 3:21 PM MDT
	Nope, I had a lot of friends who did but I never started.
	Do you drink ?	Question 10/05/20 3:21 PM MDT
	Sure, but never more than two or three beers on a weekend.
	Do you do drugs ?	Question 10/05/20 3:22 PM MDT
	Nope.
	Do you have any hobby ?	Question 10/05/20 3:22 PM MDT
	I like to fish, I like sports . . . let’s see, I do some small electronics repair sometimes, and I go to my son’s bodybuilding competitions when I can.
	Did you have any surgeries ?	Question 10/05/20 3:23 PM MDT
	I’ve never had any surgeries.
	It is very good that you dont have any surgeries	Empathize 10/05/20 3:23 PM MDT
	Thanks. I appreciate that.
	Do you have any allergy ?	Question 10/05/20 3:24 PM MDT
	No, well . . . I’ve had a bad reaction to codeine before, but that is all I know of.
	What type of reaction do you have to codeine ?	Question 10/05/20 3:24 PM MDT
	It makes me nauseous and I vomit.
	How was your immunizations ? (Clarified to What immunizations have you had?.)	Question 10/05/20 3:25 PM MDT
	I don’t remember exactly . . . maybe it’s on my chart. (Clarified to what vaccines I have had.)
	She hasn’t been told that your cholesterol is always high ?	Question 10/06/20 6:29 AM MDT
	I’ve been told it’s moderately high. I’ve never noticed any actual symptoms from that though.
	Have you been tested for diabetes ?	Question 10/06/20 6:29 AM MDT
	My mom and my sister both have diabetes, but I don’t have it.
	Have you been monitoring your blood pressure ?	Question 10/06/20 6:29 AM MDT
	Not usually. They check it when I get checkups. My doctor has never seemed overly concerned about it.
	Do you remember your last blood pressure reading ? (Clarified to Do you know your blood pressure number?.)	Question 10/06/20 6:30 AM MDT
	No, not offhand. (Clarified to if I know my blood pressure number.)
	You need to monitor your blood pressure and you need to know your Baseline.	Educate 10/06/20 6:30 AM MDT
	Good to know. Thank you.
	Have you done any EKG recently ? (No matching questions found.)	Question 10/06/20 6:31 AM MDT
	Did your doctor do any EKG ? (No matching questions found.)	Question 10/06/20 6:31 AM MDT
	Any electrocardiogram ? (No matching questions found.)	Question 10/06/20 6:32 AM MDT
	EKG done ? (Clarified to When was your last EKG?.)	Question 10/06/20 6:32 AM MDT
	I had one about three months ago. They usually put one on me at my annual physical. (Clarified to when my last EKG was.)
	Well, EKG shows your heart monitoring, it will give us an idea how is your heart works.	Educate 10/06/20 6:34 AM MDT
	Good to know. Thank you.
	What was the result of EKG ?	Question 10/06/20 6:34 AM MDT
	I don’t remember the actual results, but as far as I know, it was normal.
	Do you have a primary care provider ?	Question 10/06/20 6:34 AM MDT
	Dr. Melinda Smith.
	It is Good that you have one.	Educate 10/06/20 6:35 AM MDT
	Good to know. Thank you.
	When your last visit your primary care provider ?	Question 10/06/20 6:35 AM MDT
	I had a physical about 3 months ago.
	Do you have stress ?	Question 10/06/20 6:36 AM MDT
	Not usually, but I’m feeling pretty anxious not knowing what’s going on with my chest.
	I’m sorry to hear that	Empathize 10/06/20 6:36 AM MDT
	Thanks. I appreciate that.
	Do your exercise ?	Question 10/06/20 6:37 AM MDT
	Well I used to ride my bike a lot but it got stolen a couple years ago. I guess I haven’t had much regular exercise since then. I want to get a new bike if the doctor says it is OK to exercise with this chest pain I’ve been having.
	I’m sorry that chest pain makes you not exercise	Empathize 10/06/20 6:37 AM MDT
	Thanks. I appreciate that.
	Do you drink water regularly ?	Question 10/06/20 6:37 AM MDT
	I usually drink water all day at work. At least four glasses, probably more. [AUDIO COMING SOON]
	Let’s go to take water	Educate 10/06/20 6:38 AM MDT
	Good to know. Thank you.
	Do you drink alcohol ?	Question 10/06/20 6:39 AM MDT
	Sure, but never more than two or three beers on a weekend.
	That’s moderate drinking	Educate 10/06/20 6:39 AM MDT
	Good to know. Thank you.
	Do you have a fever ?	Question 10/06/20 6:40 AM MDT
	I haven’t had a fever, no.
	They have a chills ?	Question 10/06/20 6:40 AM MDT
	I haven’t had chills, no.
	Do you have fatigue ?	Question 10/06/20 6:40 AM MDT
	I’m not more tired than normal.
	Do you have night sweats ?	Question 10/06/20 6:41 AM MDT
	Nope, no night sweats.
	Do you have thought the dacianpalpitations ?	Question 10/06/20 6:41 AM MDT
	Nah, I don’t think about stuff like that. I’m happy with my life.
	Do you have palpitations ?	Question 10/06/20 6:41 AM MDT
	I don’t think so. I haven’t noticed any.
	Do you have angina ?	Question 10/06/20 6:42 AM MDT
	I’ve never been diagnosed with angina. [AUDIO COMING SOON]
	Have you ever had edema ?	Question 10/06/20 6:42 AM MDT
	I haven’t noticed any swelling.
	Have you had any blood clots ?	Question 10/06/20 6:42 AM MDT
	Not that I know of.
	Any history of rheumatic fever ?	Question 10/06/20 6:43 AM MDT
	No, I never had that.
	Any history of heart murmur ?	Question 10/06/20 6:43 AM MDT
	No, none that I know of.
	? (No matching questions found.)	Question 10/06/20 6:43 AM MDT
	Do you have a cough ?	Question 10/06/20 6:43 AM MDT
	I don’t have a cough.
	Do you have difficulty breathing ?	Question 10/06/20 6:44 AM MDT
	My breathing’s fine.
	Do you have sore throat ?	Question 10/06/20 6:44 AM MDT
	I haven’t had a sore throat in a long time.
	Do you have change in sense of taste ?	Question 10/06/20 6:45 AM MDT
	I can still taste things fine.
	Do you have any dysphasia ? (No matching questions found.)	Question 10/06/20 6:45 AM MDT
	Do you have problem with swallowing ?	Question 10/06/20 6:45 AM MDT
	I haven’t had any trouble swallowing.
	Do you have nausea ?	Question 10/06/20 6:45 AM MDT
	No, I haven’t felt nauseous. I just had pain in my chest.
	Do you have diarrhea ?	Question 10/06/20 6:46 AM MDT
	I have, but it is very rare for me.
	Do you have constipation ?	Question 10/06/20 6:46 AM MDT
	I haven’t had problems with that. I wish it were only that.
	Do you have any family history of heart attack ?	Question 10/06/20 6:46 AM MDT
	Well, my mom’s dad died of a heart attack. He was pretty young too.
	Do you have a family history of a stroke ?	Question 10/06/20 6:47 AM MDT
	No, none that I know of.
	Measured vitals	Exam Action 10/06/20 6:49 AM MDT
	Mr. Foster, Thank you for answering my questions now I’m going to do physical examination	Educate 10/06/20 6:49 AM MDT
	Good to know. Thank you.
	Tested blood pressure in left arm with cuff	Exam Action 10/06/20 6:51 AM MDT
	Tested blood pressure in right arm with cuff	Exam Action 10/06/20 6:51 AM MDT
	Measured vitals	Exam Action 10/06/20 6:51 AM MDT
	Inspected face	Exam Action 10/06/20 6:51 AM MDT
	Inspected for jugular venous distension: No jugular venous distention; JVP 3 cm above sternal angle	Exam Action 10/06/20 6:52 AM MDT
	Inspected anterior chest wall	Exam Action 10/06/20 6:52 AM MDT
	Inspected left side of abdomen	Exam Action 10/06/20 6:53 AM MDT
	Inspected front of abdomen	Exam Action 10/06/20 6:53 AM MDT
	Inspected left side of abdomen	Exam Action 10/06/20 6:53 AM MDT
	Inspected right hand: no visible abnormal findings	Exam Action 10/06/20 6:54 AM MDT
	Inspected left hand: no visible abnormal findings	Exam Action 10/06/20 6:54 AM MDT
	Inspected fingernails of right hand	Exam Action 10/06/20 6:55 AM MDT
	Inspected fingernails of left hand	Exam Action 10/06/20 6:55 AM MDT
	Inspected left leg	Exam Action 10/06/20 6:56 AM MDT
	Inspected right leg	Exam Action 10/06/20 6:56 AM MDT
	Inspected toenails on left foot	Exam Action 10/06/20 6:56 AM MDT
	Inspected toenails on right foot	Exam Action 10/06/20 6:57 AM MDT
	Inspected left leg	Exam Action 10/06/20 6:57 AM MDT
	Inspected right leg	Exam Action 10/06/20 6:57 AM MDT
	Inspected right leg for edema: No edema	Exam Action 10/06/20 6:58 AM MDT
	Inspected left leg for edema: No edema	Exam Action 10/06/20 6:58 AM MDT
	Checked capillary refill in fingernails	Exam Action 10/06/20 6:58 AM MDT
	Checked capillary refill in fingernails	Exam Action 10/06/20 6:58 AM MDT
	Checked capillary refill in fingernails	Exam Action 10/06/20 6:58 AM MDT
	Checked capillary refill in fingernails	Exam Action 10/06/20 6:58 AM MDT
	Checked capillary refill in fingernails	Exam Action 10/06/20 6:59 AM MDT
	Checked capillary refill in fingernails	Exam Action 10/06/20 6:59 AM MDT
	Checked capillary refill in fingernails	Exam Action 10/06/20 6:59 AM MDT
	Auscultated right carotid pulse: Bruit present	Exam Action 10/06/20 6:59 AM MDT
	Auscultated left carotid pulse	Exam Action 10/06/20 6:59 AM MDT
	Auscultated right carotid pulse: Bruit present	Exam Action 10/06/20 6:59 AM MDT
	Auscultated left carotid pulse	Exam Action 10/06/20 7:00 AM MDT
	Auscultated right carotid pulse: Bruit present	Exam Action 10/06/20 7:00 AM MDT
	Auscultated aortic area with the bell	Exam Action 10/06/20 7:01 AM MDT
	Auscultated pulmonic area with the bell	Exam Action 10/06/20 7:01 AM MDT
	Auscultated Erb’s point with the bell	Exam Action 10/06/20 7:01 AM MDT
	Auscultated tricuspid area with the bell	Exam Action 10/06/20 7:01 AM MDT
	Auscultated mitral area with the bell	Exam Action 10/06/20 7:01 AM MDT
	Auscultated breath sounds in anterior right upper lobe	Exam Action 10/06/20 7:02 AM MDT
	Auscultated breath sounds in anterior left upper lobe	Exam Action 10/06/20 7:02 AM MDT
	Auscultated breath sounds in anterior right middle lobe	Exam Action 10/06/20 7:02 AM MDT
	Auscultated breath sounds in anterior left mid-chest (upper lobe)	Exam Action 10/06/20 7:02 AM MDT
	Auscultated breath sounds in anterior right lower lobe	Exam Action 10/06/20 7:02 AM MDT
	Auscultated breath sounds in anterior left lower lobe	Exam Action 10/06/20 7:02 AM MDT
	Auscultated aorta in abdomen	Exam Action 10/06/20 7:03 AM MDT
	Auscultated right renal pulse	Exam Action 10/06/20 7:03 AM MDT
	Auscultated left renal pulse	Exam Action 10/06/20 7:04 AM MDT
	Auscultated right iliac pulse	Exam Action 10/06/20 7:04 AM MDT
	Auscultated left iliac pulse	Exam Action 10/06/20 7:04 AM MDT
	Auscultated left femoral pulse	Exam Action 10/06/20 7:04 AM MDT
	Auscultated right femoral pulse	Exam Action 10/06/20 7:04 AM MDT
	Auscultated right upper quadrant	Exam Action 10/06/20 7:04 AM MDT
	Auscultated left upper quadrant	Exam Action 10/06/20 7:04 AM MDT
	Auscultated left lower quadrant	Exam Action 10/06/20 7:04 AM MDT
	Auscultated right lower quadrant	Exam Action 10/06/20 7:04 AM MDT
	Auscultated over liver	Exam Action 10/06/20 7:05 AM MDT
	Auscultated over spleen	Exam Action 10/06/20 7:05 AM MDT
	Palpated right carotid pulse: Thrill, 3+	Exam Action 10/06/20 7:05 AM MDT
	Palpated left carotid pulse: No thrill, 2+	Exam Action 10/06/20 7:06 AM MDT
	Palpated PMI: Displaced laterally; brisk and tapping; less than 3 cm	Exam Action 10/06/20 7:06 AM MDT
	Palpated right brachial pulse: No thrill, 2+	Exam Action 10/06/20 7:07 AM MDT
	Palpated left brachial pulse: No thrill, 2+	Exam Action 10/06/20 7:07 AM MDT
	Palpated right radial pulse: No thrill, 2+	Exam Action 10/06/20 7:18 AM MDT
	Palpated left radial pulse: No thrill, 2+	Exam Action 10/06/20 7:19 AM MDT
	Palpated right femoral pulse: No thrill, 2+	Exam Action 10/06/20 7:19 AM MDT
	Palpated left femoral pulse: No thrill, 2+	Exam Action 10/06/20 7:19 AM MDT
	Palpated right popliteal pulse: No thrill, 1+	Exam Action 10/06/20 7:20 AM MDT
	Palpated left popliteal pulse: No thrill, 1+	Exam Action 10/06/20 7:20 AM MDT
	Palpated right tibial pulse: No thrill, 1+	Exam Action 10/06/20 7:22 AM MDT
	Palpated right tibial pulse: No thrill, 1+	Exam Action 10/06/20 7:23 AM MDT
	Palpated left tibial pulse: No thrill, 1+	Exam Action 10/06/20 7:23 AM MDT
	Palpated right dorsalis pedis pulse: No thrill, 1+	Exam Action 10/06/20 7:23 AM MDT
	Palpated left dorsalis pedis pulse: No thrill, 1+	Exam Action 10/06/20 7:23 AM MDT
	Palpated right upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension	Exam Action 10/06/20 7:25 AM MDT
	Palpated left upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension	Exam Action 10/06/20 7:26 AM MDT
	Palpated left lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension	Exam Action 10/06/20 7:26 AM MDT
	Palpated right lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension.	Exam Action 10/06/20 7:26 AM MDT
	Percussed right upper quadrant	Exam Action 10/06/20 7:27 AM MDT
	Percussed left upper quadrant	Exam Action 10/06/20 7:27 AM MDT
	Percussed right lower quadrant	Exam Action 10/06/20 7:27 AM MDT
	Percussed left lower quadrant	Exam Action 10/06/20 7:27 AM MDT
	Percussed spleen	Exam Action 10/06/20 7:27 AM MDT
	Percussed for liver span: 7 cm in the mid-clavicular line	Exam Action 10/06/20 7:28 AM MDT
	Performed EKG	Exam Action 10/06/20 7:28 AM MDT
	Thank you Mr. Foster. I’m done with physical evaluation	Educate 10/06/20 7:30 AM MDT
	Good to know. Thank you.
	Houston Foster how old are you ? (No matching questions found.)	Question 10/07/20 4:13 AM MDT
	Mr.Foster how old are you ?	Question 10/07/20 4:13 AM MDT
	I’m 58 going on 30.
	Early happy birthday	Empathize 10/07/20 4:14 AM MDT
	Thanks. I appreciate that.
	Is it physical activity activates the pain ?	Question 10/07/20 4:53 AM MDT
	Well I used to ride my bike a lot but it got stolen a couple years ago. I guess I haven’t had much regular exercise since then. I want to get a new bike if the doctor says it is OK to exercise with this chest pain I’ve been having.
	Sorry to hear that	Empathize 10/07/20 4:53 AM MDT
	Thanks. I appreciate that.
	What aggravates your pain ?	Question 10/07/20 4:54 AM MDT
	Well, I think it’s when I’m doing something physical most of the time. The first time it happened, my chest started hurting after I was doing some yard work. The second time happened when the elevator broke at work so I had to take the stairs. My office is on the 5th floor.
	Do you like red meat ?	Question 10/07/20 5:59 AM MDT
	Yes, yes I do.
	Do you like vegetables and fruits ?	Educate 10/07/20 5:59 AM MDT
	Good to know. Thank you.
	Do you like fruits and vegetables ? (No matching questions found.)	Question 10/07/20 5:59 AM MDT
	If your diet include fruits and vegetables ? (No matching questions found.)	Question 10/07/20 6:00 AM MDT
	You need to cut to read me like a beef pork and lamb because this meat is saturated with a bad cholesterol or fat. More than chicken and fish. Saturated and transfat can raise your blood cholesterol and make your heart disease worse.	Educate 10/07/20 6:05 AM MDT
	Good to know. Thank you.
	You can replace the red meat by chicken or fish like a salmon which has a good cholesterol which which will help you to reduce your bad cholesterol and help you with your heart and cholesterol problems.	Educate 10/07/20 6:07 AM MDT
	Good to know. Thank you.
	You need to start light exercising.	Educate 10/07/20 6:07 AM MDT
	Good to know. Thank you.
	You need to include fresh vegetables and fruit in your diet.	Educate 10/07/20 6:08 AM MDT
	Good to know. Thank you.
	You also need to continue taking your medications as prescribed.	Educate 10/07/20 6:08 AM MDT
	Good to know. Thank you.
	You also need to wait yourself daily in the same clothes in the same time.	Educate 10/07/20 6:09 AM MDT
	Good to know. Thank you.
	You need to do light exercise has three to four times a week.	Educate 10/07/20 6:09 AM MDT
	Good to know. Thank you.
	Mister Foster you need to follow up with a primary care physician and a cardiologist. (No matching questions found.)	Question 10/07/20 6:10 AM MDT
	Mister Foster you need to follow up with a primary care physician and a cardiologist.	Educate 10/07/20 6:10 AM MDT
	Good to know. Thank you.
	You also need to eliminate you alcoholic beverages.	Educate 10/07/20 6:11 AM MDT
	Good to know. Thank you.
	What is your height and weight ?	Question 10/07/20 6:13 AM MDT
	I’m five foot eleven.
	What is your weight ?	Question 10/07/20 6:14 AM MDT
	As of this morning, a buck ninety-seven.
	I am done with your exam Mr.Foster. Thank you for letting me to examine you. Have a good day. (No matching questions found.)	Question 10/09/20 7:43 AM MDT
	I am done with your exam Mr.Foster. Thank you for letting me to examine you. Have a good day.	Educate 10/09/20 7:43 AM MDT
	EducateSpeech
	Mr. Foster I just wanted to partially examine you again (No matching questions found.)	Question 10/12/20 1:39 AM MDT
	Mr. Foster I just wanted to partially examine you again	Educate 10/12/20 1:40 AM MDT
	EducateSpeech
	Auscultated over liver	Exam Action 10/12/20 1:40 AM MDT
	Auscultated over spleen	Exam Action 10/12/20 1:41 AM MDT
	Auscultated over liver	Exam Action 10/12/20 1:41 AM MDT
	Percussed right upper quadrant	Exam Action 10/12/20 1:43 AM MDT
	Percussed left upper quadrant	Exam Action 10/12/20 1:43 AM MDT
	Percussed right lower quadrant	Exam Action 10/12/20 1:43 AM MDT
	Percussed left lower quadrant	Exam Action 10/12/20 1:43 AM MDT
	Thank you Mr. Foster. I am done.	Educate 10/12/20 1:50 AM MDT
	EducateSpeech
	Percussed spleen	Exam Action 10/18/20 5:58 PM MDT
	Percussed spleen	Exam Action 10/18/20 5:58 PM MDT
	Inspected left leg	Exam Action 10/18/20 6:24 PM MDT
	Inspected right leg	Exam Action 10/18/20 6:24 PM MDT
	Inspected toenails on left foot	Exam Action 10/18/20 6:24 PM MDT
	Inspected left leg	Exam Action 10/18/20 6:24 PM MDT
	Inspected right leg	Exam Action 10/18/20 6:24 PM MDT
	Inspected toenails on right foot	Exam Action 10/18/20 6:25 PM MDT
	Inspected left leg	Exam Action 10/18/20 6:25 PM MDT
	Inspected right leg	Exam Action 10/18/20 6:25 PM MDT
	Inspected toenails on left foot	Exam Action 10/18/20 6:25 PM MDT
	Inspected right leg for edema: No edema	Exam Action 10/18/20 6:25 PM MDT
	Inspected left leg for edema: No edema	Exam Action 10/18/20 6:25 PM MDT
	Auscultated aortic area with the bell	Exam Action 10/18/20 6:26 PM MDT
	Auscultated pulmonic area with the bell	Exam Action 10/18/20 6:26 PM MDT
	Auscultated Erb’s point with the bell	Exam Action 10/18/20 6:26 PM MDT
	Auscultated tricuspid area with the bell	Exam Action 10/18/20 6:26 PM MDT
	Auscultated mitral area with the bell	Exam Action 10/18/20 6:26 PM MDT
	Auscultated aortic area with the bell	Exam Action 10/18/20 6:27 PM MDT
	Auscultated pulmonic area with the bell	Exam Action 10/18/20 6:27 PM MDT
	Auscultated Erb’s point with the bell	Exam Action 10/18/20 6:27 PM MDT
	Auscultated tricuspid area with the bell	Exam Action 10/18/20 6:27 PM MDT
	Auscultated mitral area with the bell	Exam Action 10/18/20 6:27 PM MDT
	Percussed right upper quadrant	Exam Action 10/18/20 6:28 PM MDT
	Percussed left upper quadrant	Exam Action 10/18/20 6:28 PM MDT
	Percussed right lower quadrant	Exam Action 10/18/20 6:28 PM MDT
	Percussed left lower quadrant	Exam Action 10/18/20 6:28 PM MDT
	Inspected left leg	Exam Action 10/18/20 6:31 PM MDT
	Inspected right leg	Exam Action 10/18/20 6:31 PM MDT
	Inspected toenails on left foot	Exam Action 10/18/20 6:31 PM MDT
	Inspected toenails on right foot	Exam Action 10/18/20 6:31 PM MDT
	Inspected toenails on left foot	Exam Action 10/18/20 6:32 PM MDT
	Inspected toenails on right foot	Exam Action 10/18/20 6:32 PM MDT
	Inspected left leg	Exam Action 10/18/20 6:32 PM MDT
	Inspected right leg	Exam Action 10/18/20 6:32 PM MDT
	Inspected right leg for edema: No edema	Exam Action 10/18/20 6:32 PM MDT
	Inspected left leg for edema: No edema	Exam Action 10/18/20 6:32 PM MDT
	Measured vitals	Exam Action 10/18/20 6:39 PM MDT
	Palpated right carotid pulse: Thrill, 3+	Exam Action 10/18/20 6:39 PM MDT
	Palpated left carotid pulse: No thrill, 2+	Exam Action 10/18/20 6:39 PM MDT
	Palpated right carotid pulse: Thrill, 3+	Exam Action 10/18/20 6:40 PM MDT
	Palpated right carotid pulse: Thrill, 3+	Exam Action 10/18/20 6:41 PM MDT
	Palpated left carotid pulse: No thrill, 2+	Exam Action 10/18/20 6:41 PM MDT
	Palpated left carotid pulse: No thrill, 2+	Exam Action 10/18/20 6:41 PM MDT
	Auscultated aortic area with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated pulmonic area with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated Erb’s point with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated tricuspid area with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated mitral area with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated mitral area with the diaphragm	Exam Action 10/18/20 6:42 PM MDT
	Auscultated mitral area with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated tricuspid area with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated Erb’s point with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated pulmonic area with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated aortic area with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated pulmonic area with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated Erb’s point with the bell	Exam Action 10/18/20 6:42 PM MDT
	Auscultated tricuspid area with the bell	Exam Action 10/18/20 6:43 PM MDT
	Auscultated tricuspid area with the diaphragm	Exam Action 10/18/20 6:43 PM MDT
	Auscultated mitral area with the diaphragm	Exam Action 10/18/20 6:43 PM MDT
	Auscultated mitral area with the bell	Exam Action 10/18/20 6:43 PM MDT
	Auscultated tricuspid area with the bell	Exam Action 10/18/20 6:43 PM MDT
	Auscultated Erb’s point with the bell	Exam Action 10/18/20 6:43 PM MDT
	Auscultated pulmonic area with the bell	Exam Action 10/18/20 6:43 PM MDT
	Auscultated aortic area with the bell	Exam Action 10/18/20 6:43 PM MDT
	Measured vitals	Exam Action 10/18/20 6:44 PM MDT
	Inspected right hand: no visible abnormal findings	Exam Action 10/18/20 6:44 PM MDT
	Inspected left hand: no visible abnormal findings	Exam Action 10/18/20 6:44 PM MDT
	Inspected left leg	Exam Action 10/18/20 6:44 PM MDT
	Inspected right leg	Exam Action 10/18/20 6:44 PM MDT
	Inspected toenails on left foot	Exam Action 10/18/20 6:44 PM MDT
	Inspected toenails on right foot	Exam Action 10/18/20 6:44 PM MDT
	Inspected right hand: no visible abnormal findings	Exam Action 10/18/20 6:45 PM MDT
	Inspected left hand: no visible abnormal findings	Exam Action 10/18/20 6:45 PM MDT
	Inspected fingernails of left hand	Exam Action 10/18/20 6:45 PM MDT
	Inspected fingernails of right hand	Exam Action 10/18/20 6:45 PM MDT
	Inspected fingernails of left hand	Exam Action 10/18/20 6:46 PM MDT
	Inspected fingernails of right hand	Exam Action 10/18/20 6:46 PM MDT
	Inspected right hand: no visible abnormal findings	Exam Action 10/18/20 7:19 PM MDT
	Inspected left hand: no visible abnormal findings	Exam Action 10/18/20 7:19 PM MDT
	Inspected left leg	Exam Action 10/18/20 7:20 PM MDT
	Inspected right leg	Exam Action 10/18/20 7:20 PM MDT
	Are you working ?	Question 10/18/20 9:42 PM MDT
	I work at a civil engineering firm here in town.
	Do your sit a lot at work ? (Clarified to Do you sit down for long periods of time at work?.)	Question 10/18/20 9:43 PM MDT
	Well, yes, that’s the job. Unless I’m on site. [AUDIO COMING SOON] (Clarified to if I spend a lot of time sitting at work.)
	What is the hours of working ?	Question 10/18/20 9:46 PM MDT
	I’m an engineer.
	What is the working hours ?	Question 10/18/20 9:46 PM MDT
	My work life is pretty stable and generally low stress, I’d say.
	It’s really good	Empathize 10/18/20 9:46 PM MDT
	EmpathizeSpeech
	Do you like your job ?	Question 10/18/20 9:47 PM MDT
	Yeah, I like it. I’ve been there sixteen years.
	It’s awesome	Empathize 10/18/20 9:47 PM MDT
	EmpathizeSpeech
	Do you have a friends ?	Question 10/18/20 9:47 PM MDT
	Yep.
	What type of social support do you have ? (No matching questions found.)	Question 10/18/20 9:48 PM MDT
	Where your socialize ?	Question 10/18/20 9:48 PM MDT
	My social life is mostly my family now. My wife and I are together all the time, and my son and his family lives in town. My daughter is in college so she’s home at least once a month. We try to have big family dinners when she’s home. I go fishing with my friend Smitty and his brother every once in a while.
	How often do you go to fishing ? (Clarified to How often do you go to church?.)	Question 10/18/20 9:51 PM MDT
	I don’t usually go unless it’s on a holiday when my mother is in town. (Clarified to how often I go to church.)
	How often do mother comes in town ?	Question 10/18/20 9:51 PM MDT
	I think I pee a normal amount. Every couple of hours or so.