COPD shadow health Experience Overview Patient: Debbie O'Connor | Study notes Nursing | Docsity (2024)

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Utah Valley University (UVU)Nursing

Prof. Weslie E. Sheldon

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.

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2023/2024

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Download COPD shadow healthExperience OverviewPatient: Debbie O'Connor and more Study notes Nursing in PDF only on Docsity! COPD shadow health Experience Overview Patient: Debbie O'Connor Digital Clinical Experience Score 93.8% 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. Student Performance Index 93 out of 111 63 minutes total spent in assignment © Shadow Health® 2012 - 2020 (800) 860-3241 | Help HYPERLINK "https://support.shadowhealth.com/" HYPERLINK "https://support.shadowhealth.com/"Desk HYPERLINK "https://support.shadowhealth.com/" | Terms HYPERLINK "https://chamberlain.shadowhealth.com/static/terms_of_service" HYPERLINK "https://chamberlain.shadowhealth.com/static/terms_of_service"of HYPERLINK "https://chamberlain.shadowhealth.com/static/terms_of_service" HYPERLINK "https://chamberlain.shadowhealth.com/static/terms_of_service"Service HYPERLINK "https://chamberlain.shadowhealth.com/static/terms_of_service" | Privacy Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions. • Found: Indicates an item that you found. • Available: Indicates an item that is available to be found. Category Scored Items • Finding: Established chief complaint and reason for admittance • Finding: Reports a bronchospasm three days ago (Found) Pro Tip: A patient's chief complaint establishes any illnesses or concerns they are presenting. Asking about the chief complaint will allow the patient to voice any on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: Do you have a cough? • Finding: Reports feeling anxious about symptoms and worsening health issues (Found) Pro Tip: Asking a patient about the length of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: How do you feel about your symptoms? • Finding: Asked about onset and duration of symptoms • Finding: Reports most severe fatigue and difficulty breathing began three days ago (Found) Pro Tip: Asking a patient about the length of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: When did your fatigue begin? • Finding: Reports purulent sputum production started two weeks ago (Found) Pro Tip: Asking a patient about the length of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: When did your productive cough begin? • Finding: Reports respiratory symptoms increased in the last four months (Found) Pro Tip: Asking a patient about the length of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: How long have you had your symptoms? • Finding: Followed up on characteristics of respiratory distress • Finding: Reports sputum is mostly clear with occasional yellow, gray, or dark color (Available) Pro Tip: Asking a patient about the length of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: What does your sputum look like? • Finding: Reports wheezing (Found) Pro Tip: Asking a patient about the length of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: Are you wheezing? • Finding: Reports cough sounds like crackling (Found) Pro Tip: Asking a patient about the length of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: What does your cough sound like? • Finding: Asked about aggravating factors • How do your symptoms prevent you from social activities? • Finding: Asked about existing health conditions • Finding: Reports chronic bronchitis related to COPD (Found) Pro Tip: Inquiring into the patient's relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient's existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Example Question: Do you have chronic bronchitis? • Finding: Followed up on chronic bronchitis COPD diagnosis • Finding: Reports diagnosed with "Class B" COPD (Found) Pro Tip: Inquiring into the patient's relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient's existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Example Question: What class of COPD were you diagnosed with? • Finding: Reports diagnosed after respiratory distress episode (Found) Pro Tip: Inquiring into the patient's relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient's existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Example Question: What was your respiratory episode? • Finding: Asked about ER visits or hospitalizations • Finding: Reports hospitalization after miscarriage at age 24 (Available) Pro Tip: Inquiring into the patient's relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient's existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Example Question: When were you hospitalized? • Finding: Reports most recent hospitalization was two years ago (Found) Pro Tip: Inquiring into the patient's relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient's existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Example Question: When was your most recent hospitalization? • Finding: Reports most recent hospitalization was for respiratory distress episode (Found) Pro Tip: Inquiring into the patient's relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient's existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Example Question: What was your recent hospitalization for? • Finding: Asked about home medications • Finding: Reports taking a long-acting beta-agonist (LABA) (Found) Pro Tip: A patient's home medications can provide insight into the patient's current treatment and its effacacy. Inquiring into medication history, dosage, and frequency will help you understand the patient's background and how it may affect their current situation. Example Question: Do you take a LABA? • (Available) Pro Tip: A patient's home medications can provide insight into the patient's current treatment and its effacacy. Inquiring into medication history, dosage, and frequency will help you understand the patient's background and how it may affect their current situation. Example Question: Do you have any side effects from your inhaler? • Finding: Asked about supplements and vitamins • Finding: Denies use of supplements or vitamins (Found) Pro Tip: A patient's home medications can provide insight into the patient's current treatment and its effacacy. Inquiring into medication history, dosage, and frequency will help you understand the patient's background and how it may affect their current situation. Example Question: Do you take vitamins? • Finding: Asked about medication regimen adherence • Finding: Denies missing doses (Found) Pro Tip: A patient's home medications can provide insight into the patient's current treatment and its effacacy. Inquiring into medication history, dosage, and frequency will help you understand the patient's background and how it may affect their current situation. Example Question: Do you miss doses of your medication? • Finding: Asked about spirometry • Finding: Reports sporadic spirometry readings at home (Found) Pro Tip: A patient's home medications can provide insight into the patient's current treatment and its effacacy. Inquiring into medication history, dosage, and frequency will help you understand the patient's background and how it may affect their current situation. Example Question: Do you take spirometry readings at home? • Finding: Reports most recent FEV1 reading was 1.37 L, 49% of her predicted FEV1 (Available) Pro Tip: A patient's home medications can provide insight into the patient's current treatment and its effacacy. Inquiring into medication history, dosage, and frequency will help you understand the patient's background and how it may affect their current situation. Example Question: What is your most recent spirometry reading? • Finding: Asked about oxygen use • Finding: Denies oxygen therapy due to cigarette smoking (Found) Pro Tip: A patient's home medications can provide insight into the patient's current treatment and its effacacy. Inquiring into medication history, dosage, and frequency will help you understand the patient's background and how it may affect their current situation. Example Question: Do you use oxygen even though you smoke? • Finding: Asked about allergies • Finding: Denies allergies (Found) Pro Tip: A patient's home medications can provide insight into the patient's current treatment and its effacacy. Inquiring into medication history, dosage, and frequency will help you understand the patient's background and how it may affect their current situation. Example Question: Do you have any allergies? • • Finding: Asked about substance use • Finding: Reports cigarette smoking (Found) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: Do you smoke cigarettes? • Finding: Denies drinking alcohol (Found) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: Do you drink alcohol? • Finding: Denies using illegal substances (Available) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: Do you use illegal drugs? • Finding: Followed up on current cigarette smoking • Finding: Reports three to five cigarettes a day for the past four months (Found) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: How many cigarettes do you smoke a day? • Finding: Reports stressful situations trigger her smoking (Available) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: What triggers your smoking? • Finding: Reports daughter convinced her to quit smoking because of declining health issues (Found) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: Why do you want to quit smoking? • Finding: Reports husband's death of lung cancer makes her want to quit (Available) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: What was your husband's cause of death? • Finding: Followed up on history of cigarette smoking • • Finding: Reports nicotine replacement therapy failed because she did not want to deal with the required compliance (Found) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: Why didn't nicotine replacement therapy work? • Finding: Reports her longest period without smoking was 10 years (Found) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: What is the longest amount of time you quit smoking? • Finding: Asked about exercise • Finding: Denies exercise due to fatigue, exhaustion, exacerbated symptoms upon exertion (Found) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: Why don't you exercise? • Finding: Asked about diet • Finding: Reports eating mostly frozen meals when daughter is at work (Found) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: What do you eat at home? • Finding: Reports her daughter cooks healthy meals for her (Found) Pro Tip: A patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, sexual activity, and substance use. These factors can influence their current health and wellness. Asking about a patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: Do you cook? • Finding: Asked about relevant family history • Finding: Reports father, smoker, died of a heart attack (Found) Pro Tip: A patient's family medical history can indicate if the patient is at a higher risk for certain illnesses and disorders. Gathering this information can contextualize a patient's current complaint and how their family's health history might be influencing it. Example Question: Did your father smoke? • Finding: Reports mother died of smoking-related pneumonia (Found) Pro Tip: A patient's family medical history can indicate if the patient is at a higher risk for certain illnesses and disorders. Gathering this information can contextualize a patient's current complaint and how their family's health history might be influencing it. Example Question: Did your mother smoke? • Finding: Reports yellowing of skin, nails, and teeth (Available) Pro Tip: Understanding a patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: Have you noticed changes in your skin color? • Finding: Denies cyanosis (Available) Pro Tip: Understanding a patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: Are your fingernails blue? • Finding: Asked about review of systems for genitourinary • Finding: Reports being postmenopausal (Available) Pro Tip: Understanding a patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: Are you postmenopausal? • Finding: Reports not sexually active (Available) Pro Tip: Understanding a patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: Are you sexually active? • Finding: Asked about ADLs • Finding: Reports difficulty moving around home (Found) Pro Tip: Information about a patient's activities of daily living will help you determine if their wellbeing is at risk. Questions about your patient's ability to bathe themselves, feed themselves, or walk without assistance will help you determine whether the patient can care for themselves at home. Example Question: © Shadow Health® 2012 - 2020 (800) 860-3241 | Help HYPERLINK "https://support.shadowhealth.com/" HYPERLINK "https://support.shadowhealth.com/"Desk HYPERLINK "https://support.shadowhealth.com/" | Terms HYPERLINK "https://chamberlain.shadowhealth.com/static/terms_of_service" HYPERLINK "https://chamberlain.shadowhealth.com/static/terms_of_service"of HYPERLINK "https://chamberlain.shadowhealth.com/static/terms_of_service" HYPERLINK "https://chamberlain.shadowhealth.com/static/terms_of_service"Service HYPERLINK "https://chamberlain.shadowhealth.com/static/terms_of_service" | Privacy HYPERLINK "https://chamberlain.shadowhealth.com/static/privacy_policy" HYPERLINK "https://chamberlain.shadowhealth.com/static/privacy_policy"Policy HYPERLINK "https://chamberlain.shadowhealth.com/static/privacy_policy" | 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 HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/681 8449"1 HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/681 8449"Anxiety HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/681 8449"Over HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/681 8449"Worsening HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/681 8449"Symptoms Followed HYPERLINK "https://chamberlain.shadowhea lth.com/assignment_attempts/68 18449" HYPERLINK My body is such a wreck that it makes me pretty miserable. This COPD makes me -- I'm just so anxious and really need to get better. have you ever thought about doing something to yourself? I've never thought that way. It's the opposite -- I want to start living a longer, healthier life. Quitting smoking, first of all. that is great to hear. I will help you I appreciate it, darling. Model Statement: "I'm sorry to hear that you are experiencing anxiety over your current health conditions. Not being able to Question 11:44 AM CDT Question 11:45 AM CDT Question 11:45 AM CDT Empathize 11:46 AM CDT breathe is a scary condition. With the right therapy, and if you quit smoking, you'll begin to feel better soon." HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/68 18449"2 HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/681 8449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/68 18449"Life HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/681 8449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/68 18449"Tragedy Not HYPERLINK "https://chamberlain.shadowhe alth.com/assignment_attempts/ 6818449" HYPERLINK "https://chamberlain.shadow health.com/assignment_atte mpts/6818449"Followed HYPERLINK "https://chamberlain.shadowhe alth.com/assignment_attempts /6818449" HYPERLINK "https://chamberlain.shadow health.com/assignment_atte mpts/6818449"Up Description: Ms. O'Connor reports details of her difficult life, including the loss of her husband. what is your family history? My parents died from smoking their whole lives. It was a different time . . . my father had a heart attack at 42. My mother edged him out, but she eventually got pneumonia. what do you do on daily basis? (Clarified to: What do you eat in an average day?) Model Statement: "I'm sorry that you lost your husband and your other family members. That sounds like it must have been very difficult for you." Question 11:26 AM CDT Question 11:26 AM CDT HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6 818449"3 HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818 449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6 818449"Pneumonia HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818 449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6 818449"and HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818 Question 11:20 AM CDT Empathize 11:22 AM CDT Question 11:40 AM CDT It's important to try again to quit smoking because it can reduce your risk of cardiovascular disease You certainly know your stuff. have you ever thought about doing something to yourself? I've never thought that way. It's the opposite -- I want to start living a longer, healthier life. Quitting smoking, first of all. that is great to hear. I will help you I appreciate it, darling. Model Statement: "It is vital that you quit smoking as soon as possible in order to get some relief from your COPD symptoms. Smoking is putting your life in danger and making your symptoms much worse. I can point you towards community or national smoking cessation programs that can help support you while you are quitting." Educate 11:41 AM CDT Question 11:45 AM CDT Empathize 11:46 AM CDT HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6 818449"5 HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6 818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6 818449"Diet HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/ 6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6 818449"and HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/ 6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6 818449"Exercise Followed HYPERLINK "https://chamberlain.shadowhea lth.com/assignment_attempts/68 18449" HYPERLINK "https://chamberlain.shadow health.com/assignment_atte mpts/6818449"Up Description: Ms. O'Connor reports she mainly eats frozen food, and that she is not capable of exercise. have you have any issues with your tongue? (Clarified to: Do you struggle with weight?) I've gained 30 pounds these past two years. (Clarified to: if I struggle with weight) i am sorry to hear that That's very kind. Model Statement: "When your COPD symptoms have been alleviated it is important that you try to eat well and get some light exercise. Not exercising can exacerbate your symptoms, and some exercise will help you breathe easier and build lung capacity." Question 11:39 AM CDT with Group B COPD, but whose symptoms indicate she should be upgraded to Group C COPD. She is currently a smoker and smokes 3 - 5 cigarettes a day. She experienced a bronchospasm three days ago and has had increased fatigue and difficulty breathing since then. She has expressed a desire to quit smoking, which is vitally important in order to improve her condition. • 1. HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449"Assess ment • Recommendation and Monitoring Take his medications daily Model Note I prescribed Ms. O’Connor a tiotropium dry powder inhaler, a long-acting muscarinic antagonist, for her COPD, a short-acting albuterol / ipratropium combination treatment for her COPD exacerbation symptoms, and varenicline as a smoking cessation aid. Ms. O’Connor needs to schedule a follow-up appointment in the next six weeks in order to evaluate her new COPD therapy and smoking cessation aid. I recommended that she begin checking her spirometry reading daily and keeping a log of her pulmonary function readings. First Try Second Try Third Totals Combined total points 22 out of 27 points Total points per column + 20 points + 2 points COPD Medication(s) Selected glycopyrrolate / formoterol indacaterol / glycopyrrolate Points Earned + 2 points + 2 points Rationale A medication you have selected is not the best choice for Ms. O'Connor’s COPD symptoms. You have two more attempts, so try again. You have prescribed Ms. O'Connor a You have selected a medication that is not the best therapeutic choice for Ms. O'Connor’s COPD symptoms. Choose a drug that meets current standards for a patient A tiotropium O'Connor’s COPD combination glycopyrrolate / formoterol inhaler. While this is an effective treatment for her indication, it is not a first- choice medication for her indication according to the latest GOLD prescription guidelines. You have received partial credit for this answer. with Class C COPD. You have prescribed Ms. O'Connor a combination indacaterol / glycopyrrolate inhaler. While this is an effective treatment for her indication, it is not a first- choice medication for her indication according to the latest GOLD prescription guidelines. You have received partial credit for this answer. the most current treatment standards for Class C COPD. COPD Exacerbations Medication(s) Selected albuterol / ipratropium Points Earned ✓ + 9 points ✓ Rationale Congratulations! You have correctly prescribed Ms. O'Connor a combination albuterol / ipratropium inhaler for her COPD Exacerbations. It will provide short term relief to Ms. O'Connor's symptoms and encourages medication compliance by reducing the number of inhalers she needs. Smoking Cessation Medication(s) Selected varenicline Points Earned ✓ + 9 points ✓ ✓ mpts/6818449" HYPERLINK "https://chamberla in.shadowhealth.c om/assignment_at tempts/6818449"o f HYPERLINK "https://chamberlai n.shadowhealth.co m/assignment_atte mpts/6818449" HYPERLINK "https://chamberla in.shadowhealth.c om/assignment_at tempts/6818449"7 Model Plan hello miss debbie, I will educate you on some medications Statement 6/5/2020 4:54:42 PM Sure thing, honey. • (1 point) The tiotropium capsules should be inhaled via your inhaler. Do not swallow them • (1 point) Only use the tiotropium capsules with the inhaler provided with them • (1 point) Inhale each capsule twice to get the full dose of the drug • (1 point) Contact your healthcare professional if you experience changes in vision or irritation or pain in your eyes • (1 point) Contact your healthcare professional if you experience difficult, painful, or unusually frequent urination • (1 point) Discontinue medication and contact your healthcare provider if you experience a bronchospasm shortly after administering the dose • (1 point) Keep the tiotropium capsules in their packaging until it is time to use them. Upon removing them from the packaging, use them immediately Topics priorized for patient teaching Education Items • (0.5 points) Take a missed dose as soon as possible • (0.5 points) If you suffer acute symptoms, use your rescue inhaler instead of this one • (1 point) The tiotropium capsules should be inhaled via your inhaler. Do not swallow them • (1 point) Only use the tiotropium capsules with the inhaler provided with them • (1 point) Inhale each capsule twice to get the full dose of the drug • (1 point) Contact your healthcare professional if you experience changes in vision or irritation or pain in your eyes • (1 point) Contact your healthcare professional if you experience difficult, painful, or unusually frequent urination Take a missed dose as soon as possible take the miss dose as soon as possible Statement 6/5/2020 4:54:56 PM Ok. I understand. Model Statement: If you realize you have missed a dose of this medication, take it as soon as you can. Don't wait until your next scheduled dose. If you suffer acute symptoms, use your rescue inhaler instead of this one if you have acute symptoms, you should use your rescue in haler I'll be sure to do just that. Statement 6/5/2020 4:55:17 PM Model Statement: This is a long-acting medication that does not provide immediate relief if you are suffering an exacerbation. If you do experience an exacerbation, make sure to use your rescue inhaler and not this one. The tiotropium capsules should be inhaled via your inhaler. Do not swallow them do not swallow the inhaler Statement 6/5/2020 4:55:29 PM Model Statement: This medication comes in capsules packaged with an inhaler. Only use the capsules with the inhaler. Do not eat them or try to consume them in any other way. I understand. Only use the tiotropium capsules with the inhaler provided with them only us the capsules with e correct inhaler Okay. Statement 6/5/2020 4:55:48 PM Model Statement: This medication comes in capsules packaged with an inhaler. Do not try to use the capsules with an inhaler other than the one that came with them. Inhale each capsule twice to get the full dose of the drug inhale each capsule twice Statement 6/5/2020 4:56:06 PM Alright. Model Statement: Inhale the contents of each capsule twice to make sure you I'll be sure to do that. Statement 6/5/2020 4:56:39 PM • (1 point) Do not use this drug more than recommended by your healthcare provider • (1 point) Take a missed dose as soon as possible • (1 point) Put cap back on after using inhaler • (1 point) Prep the inhaler before first use Topics priorized for patient teaching Education Items • (1 point) Do not use this drug more than recommended by your healthcare provider • (1 point) Take a missed dose as soon as possible • (1 point) Put cap back on after using inhaler • (1 point) Prep the inhaler before first use Do not use this drug more than recommended by your healthcare provider do not use more than the recommended dose Statement 6/5/2020 4:56:53 PM Okay. Model Statement: Do not use this medication more times than your healthcare provider has recommended. Take a missed dose as soon as possible take the miss dose as soon as possible We certainly don't want that. I'll make sure I take all of my medicine. Statement 6/5/2020 4:57:01 PM Model Statement: If you forget to take you medication, take your dose as soon as you remember. Put cap back on after using inhaler put the cap back on the inhaler Statement 6/5/2020 4:57:14 PM Okay. Model Statement: Remember to put the cap back on your inhaler after using it. Prep the inhaler before first use prep the inhaler before using it Statement 6/5/2020 4:57:23 PM I'll be sure to keep that in mind. Model Statement: Prep your inhaler before the first use by shaking well, and then spraying two test sprays into the air. Shake between each test spray. HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assignment_attempts/6 818449"varenicline 4 HYPERLINK "https://chamberlain.shadowhealth.co m/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.c om/assignment_attempts/6818449"o ut HYPERLINK "https://chamberlain.shadowhealth.co m/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.c om/assignment_attempts/6818449"of HYPERLINK "https://chamberlain.shadowhealth.co m/assignment_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.c om/assignment_attempts/6818449"5 Model Plan • (1 point) Take missed doses as soon as possible • (1 point) Take after meals with a full glass of water • (1 point) Begin smoking cessation counseling • (1 point) Do not take extra doses • (1 point) Common side effects include GI problems Topics priorized for patient teaching Education Items • (1 point) Common side effects include GI problems • (0.5 points) Common side effects include insomnia • (0.5 points) Common side effects include a headache • (1 point) Discontinue medication and contact your healthcare provider if you experience signs of an allergic reaction • (1 point) Discontinue medication and contact your healthcare provider if you experience shortness of breath Common side effects include GI problems common side effect might be gi upset Statement 6/5/2020 4:57:37 PM Kicking the habit will be worth some stomach trouble. Model Statement: You might experience gastrointestinal issues while taking this medication. Common side effects include insomnia gnment_attempts/6818449"tiotropium HYPERLINK "https://chamberlain.shadowhealth.com/assignme nt_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/assi gnment_attempts/6818449"dry HYPERLINK "https://chamberlain.shadowhealth.com/assignme nt_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/ass ignment_attempts/6818449"powder HYPERLINK "https://chamberlain.shadowhealth.com/assignme nt_attempts/6818449" HYPERLINK "https://chamberlain.shadowhealth.com/ass ignment_attempts/6818449"inhaler 10 HYPERLINK "https://chamberlain.shad owhealth.com/assignmen t_attempts/6818449" HYPERLINK "https://chamberlain.sha dowhealth.com/assignme nt_attempts/6818449"ou t HYPERLINK "https://chamberlain.shad owhealth.com/assignmen t_attempts/6818449" HYPERLINK "https://chamberlain.sha dowhealth.com/assignme nt_attempts/6818449"of HYPERLINK "https://chamberlain.sha dowhealth.com/assignme nt_attempts/6818449" HYPERLINK "https://chamberlain.sha dowhealth.com/assignme nt_attempts/6818449"10 Patient Information: 1 out of 1 point This section covers the information identifying the patient. Any incorrect answers here could result in the pharmacist not dispensing the medication to the patient, and therefore you will lose the point for this section. Field Student's Answer Is Correct? Feedback Patient Name Debbie O'Connor ✓ Date of Birth 10/05/1964 ✓ Safe and Effective Dosage: 7 out of 7 point This section measures how well you put together a safe and effective dose for the patient's problems. Any incorrect answers here could lead to under or overdosing the patient, and therefore you will lose all of the points in this section. Field Student's Answer Is Correct? Feedback Medication Name tiotropium dry powder inhaler ✓ Dosage 1 (one) capsule ✓ Strength 18 mcg ✓ Frequency 1 (one) daily ✓ Duration 30 (thirty) days ✓ Additional Fields: 1 out of 1 point This section covers the rest of the remaining fields for an accurate prescription. Any incorrect answers here could lead to a legally invalid prescription, and therefore you will lose the point for this sections. Field Student's Answer Is Correct? Feedback Route inhaled ✓ Quantity 30 (thirty) capsules ✓ Refills 1 (one) ✓ Indication COPD ✓ Additional Information This section covers the additional information and generic substitution fields for the prescription. These are not graded by Shadow Health, but your instructor may choose to do so when inputting your grade. in.shadowhealth.c om/assignment_at tempts/6818449"o f HYPERLINK "https://chamberlai n.shadowhealth.co m/assignment_atte mpts/6818449" HYPERLINK "https://chamberla in.shadowhealth.c om/assignment_at tempts/6818449"1 0 Patient Information: 1 out of 1 point This section covers the information identifying the patient. Any incorrect answers here could result in the pharmacist not dispensing the medication to the patient, and therefore you will lose the point for this section. Field Student's Answer Is Correct? Feedback Patient Name Debbie O'Connor ✓ Date of Birth 10/05/1964 ✓ Field Student's Answer Is Correct? Feedback Medication Name ipratropium bromide / albuterol mdi ✓ Dosage 1 (one) actuation ✓ Strength 0.5 mg / 2.5 mg per 3 mL X Correct answer: 20 mcg / 100 mcg Frequency 4 (four) times daily as needed ✓ Duration 30 (thirty) days ✓ Additional Fields: 1 out of 1 point This section covers the rest of the remaining fields for an accurate prescription. Any incorrect answers here could lead to a legally invalid prescription, and therefore you will lose the point for this sections. Field Student's Answer Is Correct? Feedback Route inhaled ✓ Quantity 1 (one) canister, 120 (one hundred and twenty) metered doses ✓ Refills 3 (three) ✓ Indication COPD Exacerbations ✓ Model Prescription The prescription you wrote is not a safe and effective dosage, but you chose the correct answers for the additional fields. Here is the preferred prescription: Field Best Answer Dosage 1 (one) actuation Strength 20 mcg / 100 mcg Frequency 4 (four) times daily as needed Duration 30 (thirty) days Route inhaled Quantity 1 (one) canister, 120 (one hundred and twenty) metered doses Refills 3 (three) Indication COPD Exacerbations Additional Information This section covers the additional information and generic substitution fields for the prescription. These are not graded by Shadow Health, but your instructor may choose to do so when inputting your grade. Field Student's Answer Dispense As Written? Required Patient Name Debbie O'Connor ✓ Date of Birth 10/05/1964 ✓ Safe and Effective Dosage: 7 out of 7 point This section measures how well you put together a safe and effective dose for the patient's problems. Any incorrect answers here could lead to under or overdosing the patient, and therefore you will lose all of the points in this section. Field Student's Answer Is Correct? Feedback Medication Name varenicline starting convenience pack ✓ Dosage 1 (one) tablet ✓ Strength 0.5 mg for first 7 (seven) days / 1 mg thereafter ✓ Frequency once daily for first 3 (three) days / 2 (two) times daily thereafter ✓ Duration 1 (one) month ✓ Additional Fields: 1 out of 1 point This section covers the rest of the remaining fields for an accurate prescription. Any incorrect answers here could lead to a legally invalid prescription, and therefore you will lose the point for this sections. Field Student's Answer Is Correct? Feedback Route mouth ✓ Quantity 1 (one) starting package (one month supply) ✓ Refills 0 (zero) ✓ Indication Smoking Cessation ✓ Additional Information This section covers the additional information and generic substitution fields for the prescription. These are not graded by Shadow Health, but your instructor may choose to do so when inputting your grade. Field Student's Answer Dispense As Written? Required Additional Information take as directed Signature and Date: 1 out of 1 point This section covers the information identifying who wrote the prescription and when. Any errors in this section could result in the pharmacist not dispensing the medication to the patient, and therefore you will lose the point for this section. Field Student's Answer Is Correct? Feedback Signature Olga L Viego ✓ Date 05/06/2020 ✓ © Shadow Health® 2012 - 2020 (800) 860-3241 | Help Desk HYPERLINK "https://support.shadowhealth.com/" |

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