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Focused Exam: COPD Results | Turned In Advanced Pharmacology - Summer 2019, NURS 5304 Return to Assignment
Your Results
Overview
Lab Pass
Subjective Data Collection: 32 of 32 (100.0%)
Transcript Subjective Data Collection
Hover To Reveal... Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions.
Objective Data Collection Education & Empathy
Indicates an item that you found. Indicates an item that is available to be found.
Documentation Debrief
Category Scored Items
Not Scored
Medication Selection Patient Teaching Prescription Writing
Patient Data
Experts selected these topics as essential components of a strong, thorough interview with this patient.
A combination of open and closed questions will yield better patient data. The following details are facts of the patient's case.
Chief Complaint
Established chief complaint and reason for admittance
Reports a bronchospasm three days ago Reports increased difficulty breathing Reports desire for smoking cessation aids
History of Present Illness
Asked about additional symptoms
Reports fatigue and weakness Reports purulent sputum Reports cough Reports feeling anxious about symptoms and worsening health issues
Asked about onset and duration of Reports most severe fatigue and difficulty This study source was downloaded by 100000840946462 from CourseHero.com on 02-16-2022 01:43:11 GMT -06:00breathing began three days ago symptoms https://www.coursehero.com/file/44245362/Focused-Exam-COPD-Subjective-Data-Collectionpdf/
Reports purulent sputum production started two weeks ago Reports respiratory symptoms increased in the last four months
Followed up on characteristics of respiratory distress
Reports sputum is mostly clear with occasional yellow, gray, or dark color Reports wheezing Reports cough sounds like crackling
Asked about aggravating factors
Reports exertion worsens symptoms Reports coughing fits after smoking
Asked about treatment and relieving factors of respiratory symptoms
Reports trying to hold off on smoking cigarettes as long as possible
Asked about severity of respiratory distress
Reports breathing difficulty and associated discomfort is a 6/10
Asked about effects of health on social activity
Reports low social activity - doesn't feel up to getting out and about
Past Medical History
Asked about existing health conditions
Followed up on chronic bronchitis COPD diagnosis
Asked about ER visits or hospitalizations
Reports chronic bronchitis related to COPD
Reports diagnosed with "Class B" COPD Reports diagnosed after respiratory distress episode
Reports hospitalization after miscarriage at age 24 Reports most recent hospitalization was two years ago Reports most recent hospitalization was for respiratory distress episode
Home Medications
Asked about home medications
Followed up on LABA
Reports taking a long-acting beta-agonist (LABA)
Reports the LABA is formoterol inhaler
This study source was downloaded by 100000840946462 from CourseHero.com on 02-16-2022 01:43:11 GMT -06:00 Reports formoterol dose of 12 micrograms
https://www.coursehero.com/file/44245362/Focused-Exam-COPD-Subjective-Data-Collectionpdf/
Reports only using once every 12 hours, once in the morning and once at night Reports using LABA this morning Reports the LABA is not very effective Denies medication side effects
Asked about supplements and vitamins
Denies use of supplements or vitamins
Asked about medication regimen adherence
Asked about spirometry
Denies missing doses
Reports sporadic spirometry readings at home Reports most recent FEV1 reading was 1.37 L, 49% of her predicted FEV1
Asked about oxygen use
Denies oxygen therapy due to cigarette smoking
Asked about allergies
Denies allergies
Asked about vaccines
Denies recent influenza vaccine Denies recent pneumococcal vaccines
Social History
Asked about living environment
Reports she lives with her daughter Reports recently moving in with her daughter because of her declining health Reports stress from arguments with daughter over smoking
Asked about substance use
Reports cigarette smoking Denies drinking alcohol Denies using illegal substances
Followed up on current cigarette smoking
Reports three to five cigarettes a day for the past four months Reports stressful situations trigger her smoking Reports daughter convinced her to quit smoking because of declining health issues Reports husband's death of lung cancer makes her want to quit
This study source was downloaded by 100000840946462 from CourseHero.com on 02-16-2022 01:43:11 GMT -06:00
https://www.coursehero.com/file/44245362/Focused-Exam-COPD-Subjective-Data-Collectionpdf/