NRS 434 Shadow Health Focused Exam Cough Results
NRS 434 Shadow Health Focused Exam Cough Results
Within the Shadow Health platform, complete the Focused Exam: Cough Results. The estimated average time to complete this assignment each time is 1 hour and 15 minutes. Please note, this is an average time. Some students may need longer.
This clinical experience is a focused exam. Students must score at the level of “Proficiency” in the Shadow Health Digital Clinical Experience. Students have three opportunities to complete this assignment and score at the Proficiency level. Upon completion, submit the lab pass through the assignment dropbox.
Each of you will be completing a Shadow Health Assessments each week. You will need to sign into the account, and please make sure you register under the correct date. You will get all your information under the Course Materials.
If you have problems signing in, you will need to call the Help Desk for them. Make sure you are reading the rubric for each Shadow Health assignment, because sometimes you will only have 1 try to pass, and other times you may only have 3, but with significant point reduction each try.
You do not need a PIN to sign in. Go to PATH, then Course Material. You will see: Shadow Health Digital Clinical Experience. Go there and follow the instructions. Thanks
Please upload all assignment completions under your assignment due area. Thanks
- Students successfully scoring within the Proficiency level in the Digital Clinical Experience on the first attempt will earn a grade of 10 points
- Students successfully scoring at the Proficiency level on the second attempt will earn a grade of 90 points
- Students successfully scoring at the Proficiency level on the third attempt will earn a grade of 80 points.
- Students who do not pass the performance-based assessment by scoring within the Proficiency level in three attempts will receive a failing grade (68 points).
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If Proficiency is not achieved on the first attempt, it is recommended that you review your answers with the correct answers on the Experience Overview page. Review the report by clicking on each tab to the left titled Transcript, Subjective Data Collection, Objective Data Collection, Documentation, and SBAR to compare your work. Reviewing this overview and the course resources may help you improve your score.
NRS 434 Shadow Health Focused Exam Cough Results
Subjective Data
Scored Items
- Experts selected these topics as essential components of a strong, thorough interview with this patient.
Patient Data
Not Scored
- A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.
Chief Complaint
Finding: Established chief complaint
Finding: Reports cough (Found)
Pro Tip: Asking a patient broadly about their chief complaint allows them to answer in their own words and confirm information that you may have already received from another source.
Example Question: Do you have a cough?
History of Presenting Illness
- Finding: Asked about onset of cough
Finding: Reports cough started 3 days ago (Found)
Pro Tip: Whenever you are assessing a symptom or a health condition, in this case the patient’s cough, inquiring about onset assesses the severity and the progression of the problem.
Example Question: How long have you had a cough?
- Finding: Asked about characteristics of cough
Finding: Reports cough is wet (Available)
Pro Tip: The characteristics of a cough, such as whether it is dry or wet, can indicate key information about the type of illness the patient has.
Example Question: Is your cough a wet cough?
Finding: Reports clear sputum with cough (Available)
Pro Tip: The characteristics of a cough, such as whether it is productive, can indicate key information about the type of illness the patient has.
Example Question: Do you produce any phlegm or sputum with your cough?
- Finding: Asked about frequency and duration of cough
Finding: Reports coughing every few minutes (Available)
Pro Tip: Establishing how frequently Danny coughs will illustrate how long he has been suffering these particular symptoms and might indicate possible triggers.
Example Question: How frequently are you coughing?
Finding: Reports coughs last a few seconds (Available)
Pro Tip: Establishing how long Danny’s coughs last will illustrate how long he has been suffering these particular symptoms and might indicate possible triggers.
Example Question: How long do your coughs last?
- Finding: Asked about aggravating factors for cough
Finding: Reports cough is worse at night (Available)
Pro Tip: Establishing a timeline for Danny’s coughing will illustrate how long he has been suffering these particular symptoms and might indicate possible triggers.
Example Question: Is the cough worse at night?
Finding: Denies smoking (Available)
Pro Tip: Tobacco use puts the patient at risk for many medical conditions. Asking even young patients about whether they consume tobacco products helps you assess this risk factor.
Example Question: Do you smoke?
Finding: Reports being exposed to secondhand smoke through father (Available)
Pro Tip: Tobacco use puts the patient at risk for many medical conditions. Asking about whether a patient is exposed to secondhand smoke allows you to assess this risk factor.
Example Question: Are you ever around cigarette smoke?
Finding: Reports he doesn’t know what triggers the cough (Available)
Pro Tip: Asking about aggravating factors of Danny’s cough will allow you to determine potential causes and educate the patient on what to avoid.
Example Question: What makes your cough worse?
- Finding: Asked about relieving factors for cough
Finding: Reports cough is temporarily relieved by cough medicine (Found)
Pro Tip: Asking about how the patient has been managing their pain assesses their current condition and their approach to self-care. The results of their previous treatment may be helpful in your diagnosis and the development of their new treatment plan, as well as a good opportunity to educate the patient on effective self-care practices.
Example Question: Have you done anything to treat your cough?
- Finding: Followed up on cough medicine
Finding: Reports cough medicine was purple (Available)
Pro Tip: The type of cough medicine a patient takes, and how they take it, can impact its effectiveness. Following up on the cough medicine’s color may help you identify the type of medication it is.
Example Question: What color was the cough medicine?
Finding: Reports taking one spoonful of cough medicine (Available)
Pro Tip: The type of cough medicine a patient takes, and how they take it, can impact its effectiveness. Following up on the dose of cough medicine allows you to determine whether it is being taken correctly.
Example Question: How much medicine did you take?
Finding: Reports mother gave him the medicine (Found)
Pro Tip: Children should only take medication under the supervision of an adult who can assure it is taken as directed. You should ask younger patients whether the medicine was given to them and by whom.
Example Question: Who gave you the medicine for your cough?
Finding: Reports only took the medicine this morning (Found)
Pro Tip: The type of cough medicine a patient takes, and how they take it, can impact its effectiveness. Following up on the frequency Danny took cough medicine allows you to determine whether it is being taken correctly.
Example Question: How many times have you taken the cough medicine? Shadow Health: Focused Exam: Cough Results Danny Riviera
Finding: Denies home remedies (Available)
Pro Tip: Patients sometimes try non-medicinal home remedies to treat coughs, such as breathing steam, or drinking tea with honey. Not all home remedies are effective or advisable, so it’s important to find out what remedies the patient has tried.
Example Question: Have you tried any home remedies for your cough?
- Finding: Asked about typical medication use
Finding: Denies taking medication (Available)
Pro Tip: Knowing a patient’s current medication regimen helps you determine if any future treatments will be safe and effective.
Example Question: Do you take any medications from a doctor?
Finding: Reports taking daily vitamin (Available)
Pro Tip: Some symptoms can occur as a result of a vitamin deficiency, and others as a result of vitamin excess. Vitamins can also interfere with some treatments, so it’s important to know what your patient is taking.
Example Question: Do you take vitamins?
- Finding: Asked about activity level
Finding: Reports typical high activity level (Available)
Pro Tip: Establishing a patient’s typical activity level is an important baseline to help you determine how an illness is affecting his life.
Example Question: Are you usually active?
Finding: Reports activity level low since getting sick (Available)
Pro Tip: Establishing a patient’s activity level, and whether it has been impacted since becoming ill, is an important baseline to help you determine how an illness is affecting his life.
Example Question: Have you been less active since getting sick?
Finding: Reports still able to run or play (Available)
Pro Tip: Ability to remain active indicates that the patient’s breathing is not dangerously affected, and that the patient isn’t seriously fatigued.
Example Question: Are you able to keep up when you play with your classmates?
Finding: Reports focusing in class is difficult (Available)
Pro Tip: Mental lethargy and difficulty concentrating are common symptoms when a patient is sick.
Example Question: Are you able to focus in class?
- Finding: Asked about nasal symptoms
Finding: Reports current runny nose (Found)
Pro Tip: Asking your patient if his nose is running will allow you to determine the symptoms he is experiencing and possible triggers.
Example Question: Do you currently have a runny nose?
Finding: Denies sneezing (Available)
Pro Tip: Asking your patient if he has been sneezing will allow you to determine the symptoms he is experiencing and possible triggers.
Example Question: Have you been sneezing?
- Finding: Followed up on nasal discharge
Finding: Reports nasal discharge is clear (Available)
Pro Tip: The color of a patient’s nasal discharge can provide you key information as to the type of condition the patient has.
Example Question: What color is your snot?
Finding: Reports nasal discharge is thin (Available)
Pro Tip: The consistency of a patient’s nasal discharge can provide you key information as to the type of condition the patient has.
Example Question: What is the consistency of your nasal discharge?
- Finding: Asked about ear symptoms
Finding: Denies ear pain (Available)
Pro Tip: Ear pain is often coincident with coughs and sinus problems. Asking about them allows you to ascertain if Danny needs follow-up care for his ears.
Example Question: Do you have any ear pain?
Finding: Reports history of frequent ear infections (Available)
Pro Tip: Asking about Danny’s history of ear infections allows you to ascertain his risk for current and future ear infections.
Example Question: Have you ever had ear infections?
Finding: Denies ear discharge (Available)
Pro Tip: Asking Danny about ear discharge, which are often coincident with of ear infections, allows you to ascertain his risk for current and future ear infections.
Example Question: Do you have any ear discharge?
Finding: Denies hearing problems (Available)
Pro Tip: Simply talking with the patient assesses his hearing; however, some types of hearing loss are only apparent in specific settings such as noisy environments. Asking the patient about hearing problems identifies conditions that may not be readily apparent.
Example Question: Do you have any hearing problems? Shadow Health: Focused Exam: Cough Results Danny Riviera
- Finding: Asked about throat symptoms
Finding: Reports sore throat (Available)
Pro Tip: Sore throats are often coincident with coughs and sinus problems. Asking about them allows you to ascertain if Danny needs follow-up care for his throat.
Example Question: Is your throat sore?
Finding: Reports a little pain with swallowing (Available)
Pro Tip: Pain when swallowing helps you understand how severe the patient’s sore throat is.
Example Question: Does it hurt when you swallow?
Past Medical History
- Finding: Asked about relevant medical history
Finding: Reports frequent runny noses (Available)
Pro Tip: Asking how often Danny experiences runny noses like the one he has now may help you determine the source of the problem.
Example Question: Do you get runny noses often?
Finding: Reports past frequent coughs (Available)
Pro Tip: A patient experiencing a cough should be asked about their history of coughs so you can determine whether their current condition fits into a recurring pattern.
Example Question: Do you have coughs very often?
Finding: Reports past pneumonia (Available)
Pro Tip: Pneumonia is a serious medical condition that can be life-threatening if not managed appropriately. Regardless of the patient’s presenting illness, it is critical to identify current medical conditions in order to treat the patient appropriately. Specific questions should be asked about previous medical problems, even if the patient doesn’t notice current symptoms.
Example Question: Have you had pneumonia?
Finding: Denies asthma diagnosis (Available)
Pro Tip: Asthma is a serious medical condition that can be life-threatening if not managed appropriately. Regardless of the patient’s presenting illness, it is critical to identify current medical conditions in order to treat the patient appropriately. Specific questions should be asked about previous medical problems, even if the patient doesn’t notice current symptoms.
Example Question: Do you have asthma?
Finding: Reports immunizations as current (Available)
Pro Tip: A health assessment should include an evaluation of the patient’s immunization status in order to identify diseases to which the patient is vulnerable.
Example Question: Do you have current immunizations?
- Finding: Asked about allergies
Finding: Denies seasonal allergies (Available)
Pro Tip: Seasonal allergies can cause symptoms like runny nose, cough, and discomfort. Asking Danny if he has seasonal allergies can help you to ascertain possible triggers for symptoms.
Example Question: Do you have seasonal allergies?
Finding: Denies food allergies (Available)
Pro Tip: Knowing if your patient has food allergies is important and relevant medical history. Asking your patient about food allergies will allow you to most effectively treat him.
Example Question: Do you have food allergies?
Finding: Denies medication allergies (Available)
Pro Tip: Knowing if your patient has allergies to medicine is important and relevant medical history. Asking your patient about medicine allergies will allow you to most effectively treat him.
Example Question: Are you allergic to any medication?
- Finding: Asked relevant family history
Finding: Reports father has history of asthma (Available)
Pro Tip: Medical problems such as asthma that are present in a patient’s immediate family can represent increased risk factors to respiratory conditions such as the ones the patient currently has.
Example Question: Do you have a family history of asthma?
Finding: Denies family history of allergies (Available)
Pro Tip: Medical problems such as allergies that are present in a patient’s immediate family can represent increased risk factors to respiratory conditions such as the ones the patient currently has.
Example Question: Do you have a family history of allergies?
Review of Systems
- Finding: Asked about constitutional health
Finding: Denies chills (Available)
Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has chills will illustrate the way his symptoms manifest.
Example Question: Do you have chills?
Finding: Denies fever (Available)
Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has a fever will illustrate the way his symptoms manifest.
Example Question: Do you have a fever?
Finding: Reports feeling somewhat fatigued (Found)
Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has fatigue will illustrate the way his symptoms manifest.
Example Question: Do you have fatigue?
Finding: Denies night sweats (Available)
Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has night sweats will illustrate the way his symptoms manifest.
Example Question: Do you have night sweats?
Finding: Reports cough makes it difficult to sleep (Available)
Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has had difficulty sleeping will illustrate the way his symptoms manifest.
Example Question: Have you been sleeping okay?
Finding: Denies swelling (Available)
Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has had swelling will illustrate the way his symptoms manifest.
Example Question: Have you noticed any swelling?
- Finding: Asked about additional review of systems for HEENT
Finding: Reports frequent colds (Available)
Pro Tip: A patient such as Danny who is presenting with a cough and a runny nose may have a cold, so you should ask about his history of colds to determine whether this is part of a larger pattern.
Example Question: Do you have unusually frequent colds?
Finding: Denies headaches (Available)
Pro Tip: Headaches are a common complaint that can be caused by a variety of benign conditions. However, headaches can be an indicator of serious underlying neurological conditions such as cerebral hemorrhage, meningitis, or brain tumors. They may also be a symptom of sinus infection.
Example Question: Do you get headaches?
Finding: Denies nosebleeds (Available)
Pro Tip: When a patient presents with symptoms that are often seen with respiratory infections, you should ask about similar signs of respiratory infections such as nosebleeds.
Example Question: Do you have nosebleeds?
Finding: Denies vision difficulty (Available)
Pro Tip: Eye or vision problems can lower one’s ability to function and can be a major safety risk.
Example Question: Do you have any problems with your vision?
Finding: Denies dizziness (Available)
Pro Tip: Asking about dizziness helps you assess the risk for inner ear, neurological, or cardiovascular problems.
Example Question: Do you have any dizziness?
Finding: Denies watery eyes (Available)
Pro Tip: Whether a patient has watery eyes may help you indicate the type of sinus problem he is experiencing.
Example Question: Do you have watery eyes?
Finding: Denies eye redness (Available)
Pro Tip: Whether a patient has eye redness may help you indicate the type of sinus problem he is experiencing.
Example Question: Do you have eye redness?
Finding: Denies eye pain (Available)
Pro Tip: Eye pain can lower one’s ability to function and can be a major safety risk.
Example Question: Do you have any eye pain?
Finding: Denies sinus pain (Available)
Pro Tip: Patients with sinus problems such as a runny nose may be at greater risk for sinus pain.
Example Question: Do you have any sinus pain?
- Finding: Asked about review of systems for respiratory
Finding: Denies chest tightness (Available)
Pro Tip: Chest pain may indicate cardiac conditions, muscular inflammation, gastric upset, or respiratory distress. If chest tightness is present, asking about its location, characteristics, and related factors helps to determine the cause of the discomfort.
Example Question: Do you have chest tightness?
Finding: Denies chest pain (Available)
Pro Tip: Chest pain may indicate cardiac conditions, muscular inflammation, gastric upset, or respiratory distress. If chest pain is present, asking about its location, characteristics, and related factors helps to determine the cause of the discomfort.
Example Question: Do you have any chest pain?
- Finding: Denies difficulty breathing.
Also Read:
NRS-434VN Topic 1: The Health Assessment of Infants
NRS 434 Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child
NRS 434 Patient Safety: Help Patients Understand
Nrs 434 Infant Assessment
NRS 434 Shadow Health Focused Exam Cough Results Instructions
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized.
Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
- Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
- Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
- One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
- I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
- Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
- In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
- Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
- Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
- Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
- Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
- I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
- I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
- As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
- It is best to paraphrase content and cite your source.
LopesWrite Policy
- For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
- Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
- Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
- Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
- The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
- Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
- If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
- I do not accept assignments that are two or more weeks late unless we have worked out an extension.
- As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me:
- Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
- Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
NRS 434 Shadow Health Focused Exam Cough Results
Qualitative data have been described as voluminous and sometimes overwhelming to the researcher. Discuss two strategies that would help a researcher manage and organize the data.
JANAE
In qualitative research, non-numerical data are gathered and analyzed to better comprehend ideas, viewpoints, or experiences. It might be utilized to discover intricate details about an issue or come up with new research ideas or concepts.
To analyze qualitative data, transcripts are analyzed and compare or contrast before identifying themes and creating categories. The goal of qualitative research is to provide a thorough account of some event or unit using a number of techniques, such as in-depth interviews or in-depth analysis of historical sources (Aspers & Corte, 2019).
The qualitative material is vast and occasionally overwhelming. Two methods that would aid in managing and organizing the data for a researcher are creating a clear identification system and coding. For example, when a clear identification system is obtained the researcher can more easily categorize the files and folders by giving it a consistent name.
Overall, the method of classifying and labeling related data types in order to facilitate the creation of themes and data analysis allows for simple retrieval in data. Coding is the process of categorizing and identifying related data kinds to make it easier to develop themes and conduct data analysis.
Coding is the process of dissecting qualitative text data to examine what it can reveal before reassembling the data in a meaningful fashion (Elliott, 2018). It helps organize data as researchers dissect the data collected to produce new knowledge. It makes it easier for researchers to better evaluate and compile the research into a whole set of findings.
References:
- Aspers, P., & Corte, U. (2019). What is Qualitative in Qualitative Research. Qualitative sociology, 42(2), 139–160. https://doi.org/10.1007/s11133-019-9413-7
- Elliott, V. (2018). Thinking About the Coding Process in Qualitative Data Analysis.https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=3560&context=tqr