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Week 4 Shaddowhealth HTN DM Attempt 1 - Feedback
Advanced Pharmacology (NU 636)
Herzing University
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ATTEMPT 1
Experience Overview
Patient: Arun Patel
Digital Clinical Experience Score
76%
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%. 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
50.
out of
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: 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: 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: 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: 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: 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: PM CDT
I don't exercise. I just don't have the time.
Tell me about your diet
Question 08/02/21 9: 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: PM CDT
I never drink.
What kind of work do you do
Question 08/02/21 9: 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: 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: PM CDT
Thank you.
Sorry to hear about your financial difficulties
Empathize 08/02/21 9: 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: 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: PM CDT
I need to educate you on your medication
Question 08/02/21 9: 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: PM CDT
Its important that you know about your medications
Question 08/02/21 9: 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: PM CDT
Ok, got it.
Please stop taking your previous medications (No matching questions found.)
Question 08/02/21 9: PM CDT
You may stop taking your previous medications (No matching questions found.)
Question 08/02/21 9: 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: 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: PM CDT
I'm still on metformin.
Signs for low blood sugar (No matching questions found.)
Question 08/02/21 9: PM CDT
You need to monitor signs for blow blood sugar
Educate 08/02/21 9: PM CDT
Yeah, youre probably right.
avoid Salt substitutes or any salty foods
Educate 08/02/21 9: 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: PM CDT
Good to know.
Anything else I can help you with
Question 08/02/21 9: 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: 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
Question 08/02/21 9: PM CDT
Yeah, my dad has hypertension, and my mom has diabetes. And her high cholesterol.
Do you have any signs of high blood pressure and high blood sugar
Question 08/02/21 9: 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: 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: PM CDT
get any flare ups (No matching questions found.)
Question 08/02/21 9: PM CDT
Do you get any flare-ups (No matching questions found.)
Question 08/02/21 9: PM CDT
You get flare-ups (No matching questions found.)
Question 08/02/21 9: PM CDT
any symptoms of high blood pressure and high blood sugar
Question 08/02/21 9: PM CDT
I indeed have hypertension. I guess my numbers aren't looking so hot, so that's why I'm here.
Take it with meals to avoid gastrointestinal upset
Question 08/02/21 10: PM CDT
OK. That sounds good.
Take it at the same time daily
Question 08/02/21 10: PM CDT
Yeah. Got it.
Need to discontinue your previous medication
Question 08/02/21 10: PM CDT
Alright. I'll stop taking my other medication.
Checks for signs of low blood sugar
Question 08/02/21 10: PM CDT
I'll start keeping snacks in my school bag.
Important to check for self-monitoring
Question 08/02/21 10: PM CDT
Alright - I can do that.
Writing your lisinopril take the next dose immediately if you miss a dose
Question 08/02/21 10: PM CDT
OK. Yeah, that's pretty important. Will do.
To discontinue the previous medication
Question 08/02/21 10: PM CDT
Alright. I will.
One of the side effects are fatigue headache and cough
Question 08/02/21 10: PM CDT
Thanks for the heads up.
Seek emergency Health if you show signs of severe allergic reaction
Question 08/02/21 10: PM CDT
You're scaring me.
Avoid salt substitutes
Question 08/02/21 10: PM CDT
Gotcha.
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."
3 Financial Pressure
Followed Up
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
Empathize 09:05 PM CDT
Ha, thanks.
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."
4 Generalized Anxiety Disorder
Not Encountered
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."
5 Chronic Illness Management
Followed Up
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
Educate 09:13 PM CDT
Ok, got it.
I don't exercise. I just don't have the time.
Tell me about your diet
Question 09:02 PM CDT
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."
7 Diet
Not Followed Up
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
Question 09:03 PM CDT
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."
8 Weight Control
Followed Up
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
Educate 09:07 PM CDT
I hadn't thought of that.
Model Statement: "Maintaining a healthy weight is important to managing your type 2 diabetes and hypertension. Being overweight puts additional stress on your body to control your blood sugar levels through insulin; it can also complicate your hypertension. In order to help get your high blood pressure and diabetes under control you will need to manage your weight."
Week 4 Shaddowhealth HTN DM Attempt 1 - Feedback
Course: Advanced Pharmacology (NU 636)
University: Herzing University
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