Week 4 Shaddowhealth HTN DM Attempt 1 - Feedback PDF

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SH HTN DM...

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ATTEMPT 1

Experience Overview Patient: Arun Patel

Digital Clinical Experience Score

76.4% This score measures your performance on the Student Performance Index in relation to other students in comparable academic programs. Your instructor has chosen to scale your Student Performance Index score so that the average score on the index is a 80.0%. This score may not be your final grade if your instructor chooses to include additional components, such as documentation or time spent.

St udentPer f or manceI ndex

50. 5 outof

76 =============

hi my name is Mary. How are you doing today

Greet 08/02/21 8:54 PM CDT

Hey.

What brings you in today

Question 08/02/21 8:56 PM CDT

I'm here to check up on some numbers that I have for my diabetes and my hypertension. Guess they're not looking too hot. I know your condition can be frightening and that keep you're keeping your diabetes under control is somewhat difficult and stressful however it is a manageable condition and you have the chance to improve your situation with exercise and diet

Empathize 08/02/21 8:58 PM CDT

Well, gee. Thanks.

How long have you had this conditions

Question 08/02/21 8:58 PM CDT

I was diagnosed with high blood pressure a year ago.

Do you regularly check your blood sugar

Question 08/02/21 8:58 PM CDT

I check my blood sugar . . . sometimes. I know with diabetes, you have to check it every day, but I don't have a lot of time, and needles are tough for me. You have any allergies

Question 08/02/21 8:59 PM CDT

I don't have any allergies that I know of.

Any hospitalization

Question 08/02/21 8:59 PM CDT

I haven't ever been hospitalized in that sense of the word. But I have seen a doctor before, about my hypertension and diabetes numbers, and I'm here to check in about them. Can you tell me the medications that you take

Question 08/02/21 8:59 PM CDT

Hydrochlorothiazide for my hypertension, metformin for diabetes, and escitalopram for anxiety.

What are the doses for your medication

Question 08/02/21 9:00 PM CDT

Let's see . . . the water pill is a 50 milligram . . . the anxiety pill is a 20 milligram . . . and the metformin is an 500 milligram tablet. [AUDIO COMING SOON] What are the doses of your medication

Question 08/02/21 9:00 PM CDT

Let's see . . . the water pill is a 50 milligram . . . the anxiety pill is a 20 milligram . . . and the metformin is an 500 milligram tablet. [AUDIO COMING SOON] Do you miss taking your medication (Clarified to Why have you been missing doses of your medication?.)

Question 08/02/21 9:01 PM CDT

I don't really ever miss doses. I've only forgotten to take my escitalopram once or twice ever, and in the five years I've been on metformin, I haven't missed a single dose. (Clarified to why I have been missing doses of medication.) Do you exercise

Question 08/02/21 9:02 PM CDT

I don't exercise. I just don't have the time.

Tell me about your diet

Question 08/02/21 9:02 PM CDT

My diet could be better, to be honest. I eat a lot of carbs and fried foods, and I tend to go for pizza when I've had a really bad day. I don't feel like my diet is out of control exactly, but I've been thinking about cutting down. Do you drink

Question 08/02/21 9:03 PM CDT

I never drink.

What kind of work do you do

Question 08/02/21 9:03 PM CDT

I'm in graduate school. I have a pretty typical stipend. Not a lot of money, but I make it work.

Can you tell me your family history

Question 08/02/21 9:03 PM CDT

My folks have some stuff going on, which is probably why I've got some stuff going on. My dad has hypertension like me, and my mom has diabetes like me. She has high cholesterol, too. I'm so sorry you having a difficult time with your family which is adding stress to you

Empathize 08/02/21 9:04 PM CDT

Thank you.

Sorry to hear about your financial difficulties

Empathize 08/02/21 9:05 PM CDT

Ha, thanks.

Any difficulty urinating

Question 08/02/21 9:05 PM CDT

I can pee just fine. In fact, I've been having to pee way more these days.

Do you have any chest pain

Question 08/02/21 9:05 PM CDT

I never really have chest pain.

How do you deal with anxiety

Question 08/02/21 9:06 PM CDT

Usually when I'm anxious, I just breathe slow and take a few minutes, but I've been so much more worried lately it doesn't work very well. Honestly, the only new thing I've been doing to deal with all this stress is eat comfort food. I've probably gained 15 pounds since I last came to the doctor three months ago. Managing anxiety can be challenging I'm sorry that this is what it does to you

Empathize 08/02/21 9:06 PM CDT

I appreciate that.

The diet is important in managing your hypertension and diabetes

Educate 08/02/21 9:07 PM CDT

Alright. I get it.

In order to manage your hypertension and diabetes who need to manage your weight

Educate 08/02/21 9:07 PM CDT

I hadn't thought of that.

I would like to educate you about your medication (No matching questions found.)

Question 08/02/21 9:07 PM CDT

I need to educate you on your medication

Question 08/02/21 9:08 PM CDT

Nope, I'm good right now.

I need to educate you on your new medications (No matching questions found.)

Question 08/02/21 9:08 PM CDT

Its important that you know about your medications

Question 08/02/21 9:09 PM CDT

Oh, I'm clear on how serious my diabetes is. That class I took when I was first diagnosed was very traumatic. And I know I could probably do more to stay on top of it. You would need to take it at the same time everyday

Educate 08/02/21 9:09 PM CDT

Ok, got it.

Please stop taking your previous medications (No matching questions found.)

Question 08/02/21 9:09 PM CDT

You may stop taking your previous medications (No matching questions found.)

Question 08/02/21 9:10 PM CDT

You need to stop taking your other previous medication (Clarified to Did you stop taking you diabetes medication?.)

Question 08/02/21 9:10 PM CDT

I'm still on metformin. (Clarified to if I stopped taking my diabetes medication.)

Stop taking your previous medication

Question 08/02/21 9:11 PM CDT

I'm still on metformin.

Signs for low blood sugar (No matching questions found.)

Question 08/02/21 9:11 PM CDT

You need to monitor signs for blow blood sugar

Educate 08/02/21 9:12 PM CDT

Yeah, youre probably right.

Monitor signs for any allergic reaction

Educate 08/02/21 9:12 PM CDT

Good to know. Very important to check your blood sugar regularly (Clarified to Do you check your blood sugar at home?.)

Question 08/02/21 9:12 PM CDT

I check my blood sugar . . . sometimes. I know with diabetes, you have to check it every day, but I don't have a lot of time, and needles are tough for me. (Clarified to if I check my blood sugar.) Very important to check your blood sugars regularly

Educate 08/02/21 9:13 PM CDT

Alright. I get it.

I mention the signs and symptoms of low blood sugar are fatigue, headache, tremors

Educate 08/02/21 9:13 PM CDT

Ok, got it.

Contact us immediately if you have rash or your tongue swells

Yeah, youre probably right.

Educate 08/02/21 9:14 PM CDT

avoid Salt substitutes or any salty foods

Educate 08/02/21 9:14 PM CDT

I hadn't thought of that.

Can you stand up you need to stand up slowly so you don't get dizzy

Educate 08/02/21 9:14 PM CDT

Good to know.

Anything else I can help you with

Question 08/02/21 9:14 PM CDT

I guess some of my numbers for my hypertension and my diabetes aren't great, so I'm really just looking to see what's up and what I can do about it. Can I help you with anything else

Question 08/02/21 9:15 PM CDT

I guess some of my numbers for my hypertension and my diabetes aren't great, so I'm really just looking to see what's up and what I can do about it. Do you have any symptoms of high blood pressure or high blood sugar

Yeah, my dad has hypertension, and my mom has diabetes. And her high cholesterol.

Question 08/02/21 9:16 PM CDT

Do you have any signs of high blood pressure and high blood sugar

Question 08/02/21 9:17 PM CDT

I indeed have hypertension. I guess my numbers aren't looking so hot, so that's why I'm here.

How long have you had hypertension and diabetes

Question 08/02/21 9:18 PM CDT

I was diagnosed with high blood pressure a year ago.

Get any flare-ups (No matching questions found.)

Question 08/02/21 9:20 PM CDT

get any flare ups (No matching questions found.)

Question 08/02/21 9:20 PM CDT

Do you get any flare-ups (No matching questions found.)

Question 08/02/21 9:20 PM CDT

You get flare-ups (No matching questions found.)

Question 08/02/21 9:23 PM CDT

any symptoms of high blood pressure and high blood sugar

Question 08/02/21 9:24 PM CDT

I indeed have hypertension. I guess my numbers aren't looking so hot, so that's why I'm here.

When did your symptoms begin

Question 08/02/21 9:25 PM CDT

I got diagnosed with diabetes five years ago, and hypertension a year ago. But for the more recent stuff . . . over the past three or so months, I've gained some weight and felt pretty fatigued. And for probably a month now, I've had to pee way more and drink way more water. Is there anything else I can do for you

Question 08/02/21 9:25 PM CDT

I guess some of my numbers for my hypertension and my diabetes aren't great, so I'm really just looking to see what's up and what I can do about it. Okay when you have problems about your blood pressure and diabetes please contact me (No matching questions found.)

Question 08/02/21 9:26 PM CDT

I'll see you again (No matching questions found.)

Question 08/02/21 9:27 PM CDT

I'll see you again (No matching questions found.)

Question 08/02/21 9:27 PM CDT

I'll see you again (No matching questions found.)

Question 08/02/21 9:47 PM CDT

Like to tell you about your medications

I appreciate it.

Question 08/02/21 10:09 PM CDT

Take it with meals to avoid gastrointestinal upset

Question 08/02/21 10:10 PM CDT

OK. That sounds good.

Take it at the same time daily

Question 08/02/21 10:10 PM CDT

Yeah. Got it.

Need to discontinue your previous medication

Question 08/02/21 10:10 PM CDT

Alright. I'll stop taking my other medication.

Checks for signs of low blood sugar

Question 08/02/21 10:11 PM CDT

I'll start keeping snacks in my school bag.

Important to check for self-monitoring

Alright - I can do that.

Question 08/02/21 10:11 PM CDT

Writing your lisinopril take the next dose immediately if you miss a dose

Question 08/02/21 10:11 PM CDT

OK. Yeah, that's pretty important. Will do.

To discontinue the previous medication

Question 08/02/21 10:12 PM CDT

Alright. I will.

One of the side effects are fatigue headache and cough

Question 08/02/21 10:12 PM CDT

Thanks for the heads up.

Seek emergency Health if you show signs of severe allergic reaction

Question 08/02/21 10:13 PM CDT

You're scaring me.

Avoid salt substitutes

Gotcha.

Question 08/02/21 10:13 PM CDT

Question 08/02/21 10:14 PM CDT

Anything else I can do for you

Ok. See you later.

Comments =============

1Di st r essOverChr oni cI l l ness Fol l owedUp

Description: Mr. Patel reports distress over having two chronic illnesses. Question 09:09 PM CDT

Its important that you know about your medications

Oh, I'm clear on how serious my diabetes is. That class I took when I was first diagnosed was very traumatic. And I know I could probably do more to stay on top of it. Educate 09:09 PM CDT

You would need to take it at the same time everyday

Ok, got it. Model Statement: "I know that a diabetes diagnosis can be frightening, and that keeping your diabetes under control is difficult and stressful. However, this is a manageable condition, and you have the chance to greatly improve your situation with diet and exercise."

2Fami l yDi fficul t i es NotEncount er ed

Description: Mr. Patel reports a strain on his family relationships due to his recent decision to go back to school to study film. Model Statement: "I'm sorry to hear that you are having a hard time with your family. I'm sure that is adding to your current stress and anxiety."

3Fi nanci alPr essur e Fol l owedUp

Description: Mr. Patel reports that he is on a tight budget and has some financial struggles. What kind of work do you do

Question 09:03 PM CDT

I'm in graduate school. I have a pretty typical stipend. Not a lot of money, but I make it work.

Can you tell me your family history

Question 09:03 PM CDT

My folks have some stuff going on, which is probably why I've got some stuff going on. My dad has hypertension like me, and my mom has diabetes like me. She has high cholesterol, too.

I'm so sorry you having a difficult time with your family which is adding stress to you

Empathize 09:04 PM CDT

Thank you.

Sorry to hear about your financial difficulties

Ha, thanks.

Empathize 09:05 PM CDT

Model Statement: "I'm sorry that you are having some financial difficulties, and that those concerns are affecting the lifestyle decisions you make. That sounds stressful."

4Gener al i z edAnxi et yDi sor der NotEncount er ed

Description: Mr. Patel reports that he has Generalized Anxiety Disorder. Model Statement: "I know that managing your Generalized Anxiety Disorder can be challenging, and I'm sorry that it has had such a big impact on your life. We can talk about ways to lessen your overall stress level. It may be time to consider incorporating non-pharmacological methods into your GAD treatment, such as counseling or community support groups."

5Chr oni cI l l nessManagement Fol l owedUp

Description: Mr. Patel reports that he does not regularly monitor his high blood pressure or type 2 diabetes. Very important to check your blood sugar regularly (Clarified to: Do you check your blood sugar at home?)

Question 09:12 PM CDT

I check my blood sugar . . . sometimes. I know with diabetes, you have to check it every day, but I don't have a lot of time, and needles are tough for me. (Clarified to: if I check my blood sugar)

Very important to check your blood sugars regularly

Educate 09:13 PM CDT

Alright. I get it.

I mention the signs and symptoms of low blood sugar are fatigue, headache, tremors

Ok, got it.

Educate 09:13 PM CDT

Contact us immediately if you have rash or your tongue swells

Educate 09:14 PM CDT

Yeah, you’re probably right. Educate 09:14 PM CDT

avoid Salt substitutes or any salty foods

I hadn't thought of that.

Can you stand up you need to stand up slowly so you don't get dizzy

Educate 09:14 PM CDT

Good to know. Model Statement: "You need to regularly check your blood pressure and blood sugar readings in order to manage your hypertension and type 2 diabetes. You should keep a log of your blood pressure and blood sugar readings. Uncontrolled high blood pressure or blood sugar is dangerous and could lead to extreme health complications down the road. I know that you don't like needles, but f you don't monitor your diabetes you could end up needing insulin, which involves injections. You should aim to use your glucometer at least four times a week, and eventually check your blood sugar daily."

6Act i vi t yLevel NotFol l owedUp

Description: Mr. Patel reports that he does not exercise and is living a more sedentary lifestyle. Do you exercise

Question 09:02 PM CDT

I don't exercise. I just don't have the time. Question 09:02 PM CDT

Tell me about your diet Model Statement: "I know that you have a sedentary lifestyle and a busy schedule. I understand how difficult it is for you to summon the energy and motivation necessary for regular physical activity, let alone make the time for it. However, regular physical activity can help you in managing your anxiety, high blood pressure, and type 2 diabetes."

7Di et NotFol l owedUp

Description: Mr. Patel reports that he primarily eats take-out food and does not feel that he has the energy to cook or pay attention to what he eats. Tell me about your diet

Question 09:02 PM CDT

My diet could be better, to be honest. I eat a lot of carbs and fried foods, and I tend to go for pizza when I've had a really bad day. I don't feel like my diet is out of control exactly, but I've been thinking about cutting down.

Do you drink

Question 09:03 PM CDT

I never drink.

What kind of work do you do Model Statement: "I know that a busy schedule and financial limitations can make it very difficult to plan nutritious meals, but a healthy diet is important for managing your diabetes and hypertension. You may want to think about getting in touch with a nutritionist who can help you figure out a dietary regimen that will work for you."

Question 09:03 PM CDT

8Wei ghtCont r ol Fol l owedUp

Description: Mr. Patel reports that he does not attempt to manage his weight. How do you deal with anxiety

Question 09:06 PM CDT

Usually when I'm anxious, I just breathe slow and take a few minutes, but I've been so much more worried lately it doesn't work very well. Honestly, the only new thing I've been doing to deal with all this stress is eat comfort food. I've probably gained 15 pounds since I last came to the doctor three months ago. Managing anxiety can be challenging I'm sorry that this is what it does to you

Empathize 09:06 PM CDT

I appreciate that.

The diet is important in managing your hypertension and diabetes

Educate 09:07 PM CDT

Alright. I get it.

In order to manage your hypertension and diabetes who need to manage your weight

I hadn't thought of that. Model Statement: "Maintaining a healthy weight is important to managing your type 2 diabetes and h...