Shadow Health Assignments
Danny Rivera Pediatric Cough Shadow Health Assessment Transcript
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Hello. My name is Pam and I will be interviewing today and later do a physical examination.
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Greet |
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Hi.
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What is your name?
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My name is Daniel Rivera, but I just go by Danny.
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What brings you to the clinic today?
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My Abuela brought me here because I’ve been feeling sick. I have been coughing a lot. . . and I feel kinda tired.
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Am sorry to hear that you are sick .
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Empathize |
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Thank you.
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Do you have a cough?
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I guess I’m kind of sick. . . I’ve been coughing a lot.
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How long have you had a cough?
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I think the cough started four. . . No, it started five days ago. Danny Rivera Pediatric Cough Shadow Health Assessment Transcript
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Is your cough a wet or a dry one?
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My cough seems kind of gurgly and watery.
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That sounds like a wet cough
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Educate |
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Oh, OK.
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Do yxxx
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Isxxx
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Am sorry to hear this.
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Empathize |
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Thank you.
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Howxxx
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I jxx
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Do thexxx
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Most timesxxx
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Am sorry to hear this.
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Empathize |
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Thank you.
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Do youxxx
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No way! I knowxxx
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True, xxx
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Educate |
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Oh, OK.
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Are you ever aroundxxxx
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Well . . . sometimes xxx
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Am sorry about that, i xxx
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Am sorry about that, i understand your concerns.
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Empathize |
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Thank you.
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What makes your coughs worse?
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My cough mostly stays the same no matter what I do. It seems to get worse at night though.
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Have you triedxxx
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I had somexxx. [AUDIO COMING SOON]
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What is the xxx
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I don’t know whatxxx
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Who xxx
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My xxx
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how muchxxx
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I just hadxxx
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How xxx
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I only xxx. [AUDIO COMING SOON]
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Apart from thexxx
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Do youxxx
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Oh yeah, I xxx
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I understand, its xxx
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Educate |
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Oh, OK.
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Are you usually active?
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I have gym class every day. I do all my exercises there. And there’s a park right next to my house where I play after school, or sometimes on the weekends, if it’s nice outside. [AUDIO COMING SOON]
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Great, keep exercising, its healthy.
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Educate |
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Oh, OK.
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Does the cough make you less active?
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No, that doesn’t help my cough.
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Are you able to focus in class?
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I can focus normally, but I couldn’t sleep very well last night because of my coughing, so it was harder than normal. Plus, it’s harder to pay attention when you keep having to cough. [AUDIO COMING SOON]
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Am sorry to hear that the cough is disturbing you sometimes. (No matching questions found.)
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Am sorry to hear that the cough is disturbing you sometimes.
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Empathize |
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Thank you.
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Do you xxx
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My xx
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Am sorry about this
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Empathize |
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Thank you.
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Have you xxx
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I don’t xxx
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what xxx
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You mean likexxxx
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Yes, that one. Ok, thanks.
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Oh, OK.
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How consistent is xxx
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It’s kind of xxx
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xx |
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My xxx . . . my left one is OK though.
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Am sorry to hear this Danny
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Empathize |
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Thank you.
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Do you havexxx
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No, xxxkind of hurts.
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Do you have xxx problems?
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A lady came to my school to xx . . . Danny Rivera Pediatric Cough Shadow Health Assessment Transcript
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Great, its good to have a test done whenever there is a chance.
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Educate |
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Oh, OK.
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Do you have soar throat?
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It feels a little bit sore, yeah.
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Does it xxx
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No, I can xxxx
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Sorry about that Danny
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Empathize |
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Thank you.
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Have you xxx
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Danny Rivera Pediatric Cough Shadow Health Assessment Transcript
Introduction and Pre-brief
In this assessment, we will go through the interview and physical examination of Danny Rivera, a pediatric patient experiencing cough and other symptoms.
Interview
Your avatar: Hello. My name is Pam, and I will be conducting the interview and later performing a physical examination.
Danny Rivera: Hi.
Your avatar: What is your name?
Danny Rivera: My name is Daniel Rivera, but you can call me Danny.
Your avatar: What brings you to the clinic today?
Danny Rivera: My grandmother brought me here because I’ve been feeling sick. I’ve been coughing a lot and feeling tired.
Your avatar: I’m sorry to hear that you’re not feeling well.
Danny Rivera: Thank you.
Your avatar: Do you have a cough?
Danny Rivera: Yeah, I’ve been coughing quite a bit.
Your avatar: How long have you had the cough?
Danny Rivera: I think it started around five days ago.
Your avatar: Is your cough wet or dry?
Danny Rivera: My cough sounds kind of gurgly and watery.
Your avatar: It seems like you have a wet cough.
Danny Rivera: Okay.
Your avatar: Have you had a fever?
Danny Rivera: I’m not sure.
Your avatar: I’m sorry to hear that.
Danny Rivera: Thank you.
Your avatar: How are you feeling overall?
Danny Rivera: I’m not feeling great.
Your avatar: I’m sorry to hear that.
Danny Rivera: Thank you.
Your avatar: Have you noticed any changes in your breathing?
Danny Rivera: Sometimes it’s a bit harder to breathe.
Your avatar: I’m sorry to hear this.
Danny Rivera: Thanks.
Your avatar: Are you able to eat and drink?
Danny Rivera: I’m eating less than usual.
Your avatar: I’m sorry about this.
Danny Rivera: Thank you.
Your avatar: Are you experiencing any chest pain?
Danny Rivera: No, not really.
Your avatar: Have you had any previous respiratory problems?
Danny Rivera: Someone came to my school to check our lungs.
Your avatar: That’s good to have a test done when there’s a chance.
Danny Rivera: Okay.
Your avatar: Is your throat sore?
Danny Rivera: It’s a little bit sore.
Your avatar: Does it hurt when you swallow?
Danny Rivera: No, I can still swallow fine.
Your avatar: I’m sorry to hear that.
Danny Rivera: Thanks.
Your avatar: Do you have difficulty sleeping?
Danny Rivera: Yeah, I had trouble sleeping last night because of the coughing.
Your avatar: It can be hard to sleep with a cough.
Danny Rivera: Yeah, it’s annoying.
Your avatar: Are you usually active?
Danny Rivera: I have gym class every day, and I play at the park after school or on weekends if it’s nice outside.
Your avatar: Staying active is good for your health.
Danny Rivera: Okay.
Your avatar: Does the cough make you less active?
Danny Rivera: No, not really.
Your avatar: Can you focus in class?
Danny Rivera: I can usually focus, but last night’s coughing made it harder.
Your avatar: I’m sorry to hear that the cough is affecting your sleep and focus.
Danny Rivera: Thanks.
Your avatar: Do you have any allergies?
Danny Rivera: I don’t think so.
Your avatar: I’m sorry to hear that.
Danny Rivera: It’s okay.
Your avatar: Have you traveled recently?
Danny Rivera: No, I haven’t gone anywhere.
Your avatar: Thank you for answering the questions. I will now perform the physical examination.
Physical Examination
The physical examination involved various actions, including checking vitals, testing lung capacity with a spirometer, inspecting the conjunctiva, otoscopic examination of the nasal passages and ears, inspecting the mouth, palpating lymph nodes, and auscultating breath sounds in different areas of the chest. The examination also included percussing different areas of the chest and auscultating voice sounds and heart sounds in different areas. The examination provided insights into Danny’s overall health and helped identify any potential issues related to his symptoms.
Please note that this is a simplified paraphrase of the provided text.
Do you have difficulty breathing?
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I can breathe OK, yeah . . . my nose is a little bit runny though.
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Thank you for answering the questions Danny. I will now do the physical examination.
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I don’t have any questions really.
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Thank you for answering the questions, i will now do the physical examination on you.
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Educate |
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Oh, OK.
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Checked vitals
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Exam Action |
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Tested lung capacity with spirometer: FEV1: 3.15 L, FVC 3.91L (FEV1/FVC: 80.5%) Danny Rivera Pediatric Cough Shadow Health Assessment Transcript
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Inspected upper conjunctiva
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Inspected upper conjunctiva
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Inspected upper conjunctiva
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Inspected lower conjunctiva
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Inspected right orbital area and sclera
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Inspected left orbital area and sclera
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Performed otoscopic examination of right naris
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Performed otoscopic examination of left naris
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Performed otoscopic examination of right ear
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Performed otoscopic examination of left ear
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Inspected mouth
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Inspected front of neck
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Inspected right side of neck
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Inspected front of neck
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Inspected left side of neck
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Inspected back of neck
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Inspected anterior chest wall
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Inspected posterior chest wall
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Inspected anterior chest wall
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Palpated frontal sinuses: No tenderness reported
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Palpated maxillary sinuses: No tenderness reported
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Palpated cervical lymph nodes: Enlarged and reported tenderness on the right side
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Palpated supraclavicular lymph nodes: Not palpable
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Palpated axillary lymph nodes: Not palpable
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Palpated axillary lymph nodes: Not palpable
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Palpated fremitus in anterior upper chest wall: Expected fremitus, equal bilaterally
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Ninety-nine.
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Palpated fremitus in anterior lower chest wall: Expected fremitus, equal bilaterally
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Ninety-nine.
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Palpated fremitus in posterior upper chest wall: Expected fremitus, equal bilaterally
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Ninety-nine.
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Palpated fremitus in posterior middle chest wall: Expected fremitus, equal bilaterally
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Ninety-nine.
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Palpated fremitus in posterior lower chest wall: Expected fremitus, equal bilaterally
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Ninety-nine.
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Auscultated breath sounds in anterior left upper lobe
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Auscultated breath sounds in anterior right upper lobe
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Auscultated breath sounds in anterior right middle lobe
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Auscultated breath sounds in anterior left mid-chest (upper lobe)
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Auscultated breath sounds in anterior left mid-chest (upper lobe)
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Auscultated breath sounds in anterior right middle lobe
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Auscultated breath sounds in anterior right lower lobe
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Auscultated breath sounds in anterior left lower lobe
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Auscultated breath sounds in posterior left upper lobe
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Auscultated breath sounds in posterior right upper lobe
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Auscultated breath sounds in posterior right mid-back (lower lobe)
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Auscultated breath sounds in posterior left mid-back (lower lobe)
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Auscultated breath sounds in posterior right lower lobe near spine
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Auscultated breath sounds in posterior left lower lobe near spine
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Auscultated breath sounds in posterior left lower lobe on side
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Auscultated breath sounds in posterior left lower lobe
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Auscultated breath sounds in posterior right lower lobe
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Auscultated breath sounds in posterior right lower lobe on side
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Auscultated voice sounds in anterior right upper lobe
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Ninety-nine.
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Ninety-nine.
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Auscultated voice sounds in anterior left upper lobe
Danny Rivera Pediatric Cough Shadow Health Assessment Transcript
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Ninety-nine.
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Ninety-nine.
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Ninety-nine.
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Ninety-nine.
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Auscultated voice sounds in anterior left mid-chest (upper lobe)
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Exam Action |
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Ninety-nine.
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Ninety-nine.
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Auscultated voice sounds in anterior right middle lobe
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Exam Action |
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Ninety-nine.
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Ninety-nine.
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Ninety-nine.
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Auscultated voice sounds in anterior right middle lobe
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Exam Action |
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Ninety-nine.
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Ninety-nine.
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Auscultated voice sounds in anterior left mid-chest (upper lobe)
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Exam Action |
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Ninety-nine.
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Auscultated voice sounds in anterior left lower lobe
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Exam Action |
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Ninety-nine.
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Auscultated voice sounds in anterior right lower lobe
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Exam Action |
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Ninety-nine.
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Ninety-nine.
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Ninety-nine.
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Auscultated voice sounds in posterior left upper lobe
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Exam Action |
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Ninety-nine.
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Ninety-nine.
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Auscultated voice sounds in posterior right upper lobe
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Ninety-nine.
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Auscultated voice sounds in posterior right mid-back (lower lobe)
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Auscultated voice sounds in posterior left mid-back (lower lobe)
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Exam Action |
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Ninety-nine.
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Ninety-nine.
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Ninety-nine.
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Auscultated voice sounds in posterior left lower lobe near spine
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Exam Action |
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Ninety-nine.
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Auscultated voice sounds in posterior right lower lobe near spine
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Exam Action |
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Ninety-nine.
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Ninety-nine.
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Ninety-nine.
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Auscultated voice sounds in posterior right lower lobe on side
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Exam Action |
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Ninety-nine.
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Auscultated voice sounds in posterior right lower lobe
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Exam Action |
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Ninety-nine.
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Auscultated voice sounds in posterior left lower lobe
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Exam Action |
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Ninety-nine.
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Ninety-nine.
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Auscultated voice sounds in posterior left lower lobe on side
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Exam Action |
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Ninety-nine.
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Ninety-nine.
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Ninety-nine.
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Auscultated aortic area with the bell
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Auscultated aortic area with the diaphragm
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Auscultated aortic area with the bell
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Auscultated aortic area with the diaphragm
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Auscultated aortic area with the bell
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Auscultated aortic area with the diaphragm
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Auscultated pulmonic area with the diaphragm
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Auscultated pulmonic area with the bell
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Auscultated Erb’s point with the bell
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Auscultated Erb’s point with the diaphragm
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Auscultated tricuspid area with the diaphragm
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Auscultated tricuspid area with the bell
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Auscultated mitral area with the bell
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Auscultated mitral area with the diaphragm
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Percussed anterior right upper lobe
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Percussed anterior right middle lobe
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Percussed anterior left upper lobe
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Percussed anterior left mid-chest (upper lobe)
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Percussed anterior left lower lobe
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Percussed anterior right lower lobe
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Percussed posterior left upper lobe
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Percussed posterior left mid-back (lower lobe)
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Percussed posterior right mid-back (lower lobe)
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Percussed posterior right upper lobe
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Percussed posterior left lower lobe
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Percussed posterior left lower lobe on side
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Percussed posterior left lower lobe near spine
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Percussed posterior right lower lobe near spine
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Percussed posterior right lower lobe
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Percussed posterior left right lobe on side
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Inspected mouth
Danny Rivera Pediatric Cough Shadow Health Assessment Transcript
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