Danny Riviera Shadow Health: Focused Exam: Cough Results

Danny Riviera Shadow Health: Focused Exam: Cough Results

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Status

Student Response Model Answer Explanation Points Earned
is at risk for is at risk for The correct status for the nursing diagnosis is “is at risk for,” because Danny’s most pressing vulnerability is to an infection that he has not yet, but could, develop. 0.5 out of 0.5

Diagnosis

Student Response Model Answer Explanation Points Earned
infection infection While a cough can be unpleasant, the most alarming thing it indicates about Danny’s health is that he is at risk for an infection. 0.5 out of 0.5

Etiologies

Student Response Model Answer Explanation Points Earned
played w/ sick peer played w/ sick peer Danny Rivera is at risk for infection as evidenced by: his playing with a sick peer; how he touches his face often, especially his eyes/nose/mouth; how rarely he washes his hands; and his exposure to secondhand smoke. 0.5 out of 0.5
touches face often touches face often Danny Rivera is at risk for infection as evidenced by: his playing with a sick peer; how he touches his face often, especially his eyes/nose/mouth; how rarely he washes his hands; and his exposure to secondhand smoke. 0.5 out of 0.5
rare hand washing rare hand washing Danny Rivera is at risk for infection as evidenced by: his playing with a sick peer; how he touches his face often, especially his eyes/nose/mouth; how rarely he washes his hands; and his exposure to secondhand smoke. 0.5 out of 0.5
secondhand smoke secondhand smoke Danny Rivera is at risk for infection as evidenced by: his playing with a sick peer; how he touches his face often, especially his eyes/nose/mouth; how rarely he washes his hands; and his exposure to secondhand smoke. 0.5 out of 0.5

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Signs & Symptoms

Student Response Model Answer Explanation Points Earned
N/A N/A Because the infection that Danny may develop hasn’t happened yet, he is not currently presenting with any signs or symptoms, so the correct answer here is “N/A.” 0.5 out of 0.5

Self Assessment

Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor.

Prompt Student Response Model Answer Explanation
Why would a nursing diagnosis of a cough be incorrect, compared to a risk for infection? Consider the difference between nursing and medical diagnoses. Whereas the cough can be unpleasant and a bother, it is a symptom of something more severe in the sense that it shows that the immune system could be at risk of getting an infection. The most effective nursing care you should prioritize is to educate the patient on avoiding the more serious outcome. While a cough can be unpleasant and frequent, it is actually a symptom of something more alarming: the immune system being at risk for an infection. The most effective nursing care you should prioritize is to educate your patient on avoiding this more serious outcome. Your nursing diagnosis should always take into account what condition is most serious, receiving the greatest benefit from your help. This diagnosis may not be the most obvious physical symptom to you or your patient, so always consider what is jeopardizing a patient’s health the most.

Planning

3.5 out of 4

Short-Term Goal

Student Response Model Answer Explanation Points Earned
To have patient report decreased discomfort and coughing by end of clinic visit. To have the patient and his guardian verbalize and agree to their instructions on how to avoid infection & practice respiratory hygiene, by end of the healthcare visit. A risk-based diagnosis does not require medical interventions as the problem is hypothetical; the goal that does suit the diagnosis involves teaching the patient and his guardian about risk-reduction methods. 0 out of 0.5

Interventions

Student Response Model Answer Explanation Points Earned
Instruct family and patient on washing hands or using hand sanitizer before eating and after using the restroom Instruct family and patient on washing hands or using hand sanitizer before eating and after using the restroom Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again. 0.5 out of 0.5
Instruct family and patient that patient should increase fluid intake Instruct family and patient that patient should increase fluid intake Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again. 0.5 out of 0.5
Instruct family to keep their house smoke-free (reducing exposure to environmental pathogens) Instruct family to keep their house smoke-free (reducing exposure to environmental pathogens) Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again. 0.5 out of 0.5
Instruct patient on washing hands or using hand sanitizer after coughing or being near someone sick Instruct patient on washing hands or using hand sanitizer after coughing or being near someone sick Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again. 0.5 out of 0.5
Instruct patient to avoid touching fingers to eyes, nose, or mouth Instruct patient to avoid touching fingers to eyes, nose, or mouth Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again. 0.5 out of 0.5
Instruct patient to cough into tissue, or sleeve if tissue is unavailable Instruct patient to cough into tissue, or sleeve if tissue is unavailable Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again. 0.5 out of 0.5

Intervention Rationale

Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor.

Prompt Student Response Model Answer Explanation
In 1 or 2 sentences, explain how your selected interventions work to accomplish your goal. Ask patients and family memebers to verbalize and agree to their instructions on infection prevention and respiratory hygiene. These interventions will teach Danny and his guardian how to keep their hands and lungs clean in a variety of ways, so that Danny’s risk for infection is reduced as pathogens are eliminated. Infection can be caused by multiple culprits, so it’s important that your patient teaching covers a thorough and specific array of anti-infection habits.

Data Collections

Student Response Model Answer Explanation Points Earned
Ask patient and family members to verbalize and agree to their instructions on infection prevention & respiratory hygiene Ask patient and family members to verbalize and agree to their instructions on infection prevention & respiratory hygiene It is important that your patient and his guardian agree to their instructions, as changing lifestyle habits can be intimidating but necessary for the patient’s health. Having Danny and his father verbalize back their instructions also assures they remember and understand the details. 0.5 out of 0.5

Discussion Of Care

Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor.

Prompt Student Response Model Answer Explanation
Explain the rationale behind your nursing diagnosis. Hello Danny, since you have been feeling unwell for the last three days, it is my responsibility to ensure that you get in the habit of practicing hand hygiene. Because you are at risk for developing an upper respiratory infection. My goal to you is to you and your family to avoid unnecessary infections by following these instructions. Some of the things that make you sicker are being near sick friend, being exposed to second hand smoke, washing your hands more, and touching your face with hands. I know it sounds like a lot of things but working together, we can reduce the infections in an effective manner. Danny, given that you aren’t feeling well, we want to make sure you don’t develop an infection, which for you just means getting even sicker. We’re going to talk about the ways we can work to prevent that, especially focusing on your risk factors, which are just things that give you a bigger chance of being sick. Some of your risk factors are that you were near a sick friend, have been exposed to cigar smoke, could stand to wash your hands more, and have touched your face with your fingers. I know that sounds like a lot, but if we work together, reducing your risk factors for infection can be easy and effective. A patient should understand their nursing diagnosis and the rationale behind it to increase their sense of involvement and to identify areas for future improvement.
Explain your goal for Danny and the interventions and data collections through which you will achieve it. All right. In order to talk to you about how you are not going to get sicker, I will have a conversation with you and your father. Him, you and myself are going to work together to discuss and then have to agree to your goals. And then I am going to have you and your father repeat what you have learned so we can make sure that you have got it down pat. Let’s talk about how we’re going to help you not get sicker! So, I’m going to have a conversation with you and your father about things to do to ensure your health. You, he, and I will work together to discuss, and then have you agree to your goals. Then I’m going to have you and your father repeat what you’ve learned, so we can make extra sure you’ve got it down pat! You should communicate the Care Plan to the patient, allowing them to exercise involvement and agency in their own healthcare.
Explicitly ask for Danny’s consent to the Care Plan. Does this sound like a plan? Does this plan I just talked about sound good to you? A patient must consent to all interventions in their Care Plan. Disagreements are opportunities to provide further patient education and to consider alternative options.
Inform Danny you will now begin educating him and will then call to educate his guardian. Now, Danny, if you lack other questions, we can start now! Danny, if you don’t have any other questions, we can start our discussion now! It’s time to begin your education interventions, so let your patient know!

Intervention & Evaluation

2.5 out of 2.5

Student Response Model Answer Explanation Points Earned
Partially Partially While Danny correctly verbalizes and agrees to his instructions for reducing infection risks, his father only agrees to some of his instructions, expressing apprehension toward not smoking inside the house. Your goal has been partially achieved. 2.5 out of 2.5

Intervention & Evaluation Rationale

Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor.

Prompt Student Response Model Answer Explanation
Did you achieve your goal for your patient and his guardian by the end of the visit, getting each of them to agree to and verbalize your instructions for avoiding infection and practicing respiratory hygiene? Whereas Danny agrees to his instructions and has verbalized a complete and correct understanding of what to do, his father expresses reluctance about reducing his smoking inside of his house. One of his instructions was to keep the house smoke free so as to reduce Danny’s risk of infection so this aspect of the goal has not been achieved. However, the paties verbally agree to most of the other interventions, which implies that the overall goal has been achieved partially. While Danny agrees to his instructions and has verbalized a complete and correct understanding of what to do, his father expresses reluctance about reducing his smoking inside of the house. One of his instructions was to keep the house smoke-free in order to reduce Danny’s risk of infection, so this aspect of your goal has not been achieved. However, both parties verbally agree to most of their other instructions, so your overall goal has been partially achieved. Even with progress being made in almost all aspects of your patient teaching, you must adhere to your goal and consider your work incomplete if certain agreements have not been reached.

Assessment Description

Attachments

Hello!	Question 02/22/20 10:52 PM MST
	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 02/22/20 10:53 PM MST
	Your patient is Danny Rivera, an 8-year-old Puerto Rican boy presenting with a cough in the Shadowville Elementary nurse’s office. Your role in this simulation is that of a healthcare provider who will perform a focused history and physical examination in order to collect data, assess Danny’s condition, and transfer care. In this simulation, you will be able to perform procedures not always typical to a school setting so you can gather as much data as possible.
	What are my objectives in this assessment?	Question 02/22/20 10:53 PM MST
	Danny is very health literate and a good historian of his own health history; he can answer questions that not every child may be able to. In your interview with Danny, you will ask about the history of his presenting illness and the functioning of relevant systems in order to obtain subjective data related to his cough. 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 Danny’s family so you can determine his genetic predisposition to any diseases. In addition to collecting subjective data, you will perform a physical exam on Danny to gather objective data about his health and physiology. Throughout the conversation, you should educate and empathize with Danny when appropriate to increase his health literacy and sense of well-being. 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 02/22/20 10:55 PM MST
	Because Danny is a pediatric patient, you will also be required to make a phone call to his guardian’s home to gather additional information. 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. After the exam, you will transfer care of the patient to me, Preceptor Diana, communicating key information about the Situation, Background, Assessment, and Recommendation, or SBAR. Activities other than Subjective and Objective Data Collection, 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 02/22/20 10:56 PM MST
	In this assignment, you will be evaluated on your Subjective and Objective Data Collection, as well as Education and Empathy. 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. Your success in Education and Empathy is based on whether you promptly respond after identifying a moment worthy of therapeutic communication. This assignment takes on average between 40 and 60 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 02/22/20 10:57 PM MST
	In this assessment, you will become familiarized with the structure and content of a cough focused exam so that with real-life patients, you can: º ask effective and comprehensive questions º educate and empathize with the patient º evaluate the patient’s risk of disease, infection, injury, and complications º obtain and assess objective data. º and transfer patient care using SBAR.
	In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: What strategies can you use to develop rapport with a pediatric patient?
	The most important strategy would be deploy effective communication that would make the patient to feel comfortable	Statement 02/22/20 10:58 PM MST
	Time to begin.
	Hello, my name is Constantine and I will be conducting this session.	Greet 02/22/20 10:59 PM MST
	Hi.
	Do you have cough?	Question 02/22/20 10:59 PM MST
	I guess I’m kind of sick. . . I’ve been coughing a lot.
	I am so sorry to hear that. It must be tough on you.	Empathize 02/22/20 11:00 PM MST
	Thanks.
	How long have you had a cough?	Question 02/22/20 11:00 PM MST
	I think the cough started two . . . No, it started three days ago.
	Is your cough a wet cough?	Question 02/22/20 11:01 PM MST
	Yeah . . . my cough seems kind of gurgly and watery.
	Do you have any phlegm or sputum with your cough? (Clarified to Do you produce any phlegm or sputum with your cough?.)	Question 02/22/20 11:01 PM MST
	Sometimes I cough up this slimy, clear stuff. (Clarified to if I produce phlegm or sputum when I cough.)
	how frequently are you coughing?	Question 02/22/20 11:02 PM MST
	I just keep feeling like I have to cough every couple minutes or so. I think it gets w PLACE THIS ORDER OR A SIMILAR ORDER WITH SUPERIOR NURSING PAPERS TODAY AND GET AN AMAZING DISCOUNT © 2023 Search Search for: Go to top