Description

Shadow Health Focused Exam COUGH - Danny Rivera. Latest 2023.Experience Overview: FOCUSED EXAM: COUGH Patient: Danny Rivera Digital Clinical Experience Score 100% Student Performance Index 34 out of 34 Subjective Data Collection 19 out of 19 Objective Data Collection 15 out of 15 Subjective Data Collection: 19 of 19 (100.0%) 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 (Found) 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 (Found) 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 (Found) 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 (Found) 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