Chest pain shadow health assessment Education & Empathy

Chest pain shadow health assessment Education & Empathy

Education & Empathy : 5 of 6 (83.3%)

During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A Model Statement is provided as an example of an appropriate response to each opportunity.

  • Opportunities marked as Not Encountered are opportunities that were not elicited in the interview
  • Opportunities marked as Not Followed Up are missed opportunities that were present in the interview, but where no statements were made
  • Opportunities marked as Followed Up were followed up by students, and include the dialogue between student and patient Chest pain shadow health assessment Education & Empathy
 1 Symptoms
Followed Up

 Description: Mr. Foster describes the symptoms that have been bothering him.

This is your avatar.

Welcome Mr Foster. What brings you to the clinic today?

Question
10:29 AM PDT

Brian Foster

I have been having some troubling chest pain in my chest now and then for the past month. Chest pain shadow health assessment Education & Empathy

This is your avatar.

I am sorry that you have been having the chest pain.

Empathize
10:30 AM PDT

Brian Foster

Thanks. I appreciate that.

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how long does the chest pain last ?

Question
10:37 AM PDT

Brian Foster

When I feel it, it seems to get better over the course of a couple of minutes or so.

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what is the frequency of the chest pain?

Question
10:37 AM PDT

Brian Foster

Well, it has happened three times the past month. It usually goes away after about a couple of minutes.

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Were episodes of your chest pains related? (Clarified to: What were you doing the last time you had chest pain?) Chest pain shadow health assessment Education & Empathy

Question
10:39 AM PDT

Brian Foster

Well, the pain seems to start when I’m doing something physical . . . the first time it happened while I was doing yard work, and the second time . . . I had to take the stairs at work because the elevator broke. Both times it got better if I took a break or sat down to rest. (Clarified to: what I was doing when I had chest pain last)

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how do you feel when in pain?

Question
10:41 AM PDT

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How would you rate the chest pain?

Question
10:43 AM PDT

Brian Foster

When I’m having it, it’s really tight and uncomfortable. Maybe like a 5 out of 10. Right now it’s like a zero.

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is the pain crushing ? Chest pain shadow health assessment Education & Empathy

Question
10:43 AM PDT

Brian Foster

No, it’s more tight and uncomfortable.

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Am sorry about that.

Empathize
10:44 AM PDT

Brian Foster

Thanks. I appreciate that.

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is the pain gnawing?

Question
10:44 AM PDT

Brian Foster

No, it’s not like that. [AUDIO COMING SOON]

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is the pain burning ?

Question
10:45 AM PDT

Brian Foster

Not really.

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is the pain aggravated by activity?

Question
10:45 AM PDT

Brian Foster

Well, I think it’s when I’m doing something physical most of the time. The first time it happened, my chest started hurting after I was doing some yard work. The second time happened when the elevator broke at work so I had to take the stairs. My office is on the 5th floor. Chest pain shadow health assessment Education & Empathy

This is your avatar.

Thats understandable

Empathize
10:46 AM PDT

Brian Foster

Thanks. I appreciate that.

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Do you have stress?

Question
11:11 AM PDT

Brian Foster

Not usually, but I’m feeling pretty anxious not knowing what’s going on with my chest.

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Am sorry about this.

Empathize
11:11 AM PDT

Brian Foster

Thanks. I appreciate that.

 Model Statement: “I’m sorry you’re having these symptoms; chest pain can be uncomfortable and stressful. It’s good that you came in today so we can see what is causing your discomfort.” Chest pain shadow health assessment Education & Empathy

 2 Hypertension and High Cholesterol
Followed Up

 Description: Mr. Foster describes his past medical history of hypertension and high cholesterol.

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Have you been diagnosed with hypertension?

Question
11:02 AM PDT

Brian Foster

Yes, I supposedly have moderately high blood pressure.

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Am sorry to hear this?

Empathize
11:02 AM PDT

Brian Foster

Thanks. I appreciate that.

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Have you been monitoring your blood pressure?

Question
11:07 AM PDT

Brian Foster

Not usually. They check it when I get checkups. My doctor has never seemed overly concerned about it.

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do you remember your last blood pressure readings?

Question
11:08 AM PDT

Brian Foster

I don’t remember. I don’t think it was too bad, though.

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have you done an EKG test recently?

Question
11:08 AM PDT

Brian Foster

I had one about three months ago. They usually put one on me at my annual physical.

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well, an EKG test is all about blood pressure monitoring.

Educate
11:09 AM PDT

Brian Foster

Good to know. Thank you.

 Model Statement: “It’s good that I know you have been diagnosed with hypertension and high cholesterol, because those conditions can cause additional heart problems. I would like to find out more about your diagnosis and treatment of those conditions.” Chest pain shadow health assessment Education & Empathy

 3 Exercise
Followed Up

 Description: Mr. Foster reports that he does not exercise regularly.

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Do you exercise?

Question
11:12 AM PDT

Brian Foster

Well I used to ride my bike a lot but it got stolen a couple years ago. I guess I haven’t had much regular exercise since then. I want to get a new bike if the doctor says it is OK to exercise with this chest pain I’ve been having.

This is your avatar.

Am sorry that the chest pain makes you not exercise.

Empathize
11:13 AM PDT

Brian Foster

Thanks. I appreciate that.

 Model Statement: “Exercise is important for everyone, and particularly for people with high blood pressure and cholesterol. Let’s talk about some healthy forms of exercise that you would be interested in trying.” Chest pain shadow health assessment Education & Empathy

 4 Diet
Followed Up

 Description: Mr. Foster describes his dietary habits.

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what is your typical breakfast?

Question
11:13 AM PDT

Brian Foster

I usually have something. Most days I drink an instant breakfast, or I’ll have a granola bar. Sometimes Maria will make a big breakfast on weekends with eggs, pancakes, bacon, hash browns, that kind of stuff. Chest pain shadow health assessment Education & Empathy

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what is your typical lunch?

Question
11:14 AM PDT

Brian Foster

There’s a sub shop near the office, so I usually get a turkey or Italian sub from there. Sometimes a salad if I’m feeling healthy . . . or guilty.

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what is your typical dinner?

Question
11:14 AM PDT

Brian Foster

My wife and I like to grill. We usually have some grilled meats and veggies for dinner.

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do you take salt?

Question
11:15 AM PDT

This is your avatar.

Do you drink water regularly?

Question
11:15 AM PDT

Brian Foster

I usually drink water all day at work. At least four glasses, probably more. [AUDIO COMING SOON]

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Its good to take water, continue.

Educate
11:16 AM PDT

Brian Foster

Good to know. Thank you.

 Model Statement: “Paying attention to your diet is a great start. It’s best to make sure you’re eating veggies, fruits, and whole grains, and lean proteins like fish or chicken.” Chest pain shadow health assessment Education & Empathy

 5 Weight Gain
Not Encountered

 Description: Mr. Foster reports weight gain of 15 to 20 pounds in the last few years.

 Model Statement: “Gaining some weight over the years is very common. It’s a good idea to try to keep your weight in a healthy range. Things like moderate exercise and watching caloric intake can help keep you at a healthy weight.”

 6 Family History
Followed Up

 Description: Mr. Foster has a family history of heart disease.

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Do you have a family history of heart attack?

Question
11:30 AM PDT

Brian Foster

Well, my mom’s dad died of a heart attack. He was pretty young too. Chest pain shadow health assessment Education & Empathy

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Do you have a family history of stroke?

Question
11:30 AM PDT

Brian Foster

No, none that I know of.

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Do you have a family history of pulmonary embolism?

Question
11:32 AM PDT

Brian Foster

No, nobody had that.

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Thank you Mr Foster for answering for answering my questions, I will now do the Physical examination.

Educate
11:34 AM PDT

Brian Foster

Good to know. Thank you.

 Model Statement: “Thank you for sharing your family health information. It’s important that we know about any risk factors, so that you can make healthy choices to keep those risks low.” Chest pain shadow health assessment Education & Empathy

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