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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. | ||
 | Welcome Mr Foster. What brings you to the clinic today? | Question 10:29 AM PDT |
 | 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 | |
| I am sorry that you have been having the chest pain. | Empathize 10:30 AM PDT |
| Thanks. I appreciate that. | |
| how long does the chest pain last ? | Question 10:37 AM PDT |
| When I feel it, it seems to get better over the course of a couple of minutes or so. | |
| what is the frequency of the chest pain? | Question 10:37 AM PDT |
| Well, it has happened three times the past month. It usually goes away after about a couple of minutes. | |
| 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 |
| 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) | |
| how do you feel when in pain? | Question 10:41 AM PDT |
| How would you rate the chest pain? | Question 10:43 AM PDT |
| 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. | |
| is the pain crushing ? Chest pain shadow health assessment Education & Empathy | Question 10:43 AM PDT |
| No, it’s more tight and uncomfortable. | |
| Am sorry about that. | Empathize 10:44 AM PDT |
| Thanks. I appreciate that. | |
| is the pain gnawing? | Question 10:44 AM PDT |
| No, it’s not like that. [AUDIO COMING SOON] | |
| is the pain burning ? | Question 10:45 AM PDT |
| Not really. | |
| is the pain aggravated by activity? | Question 10:45 AM PDT |
| 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 | |
| Thats understandable | Empathize 10:46 AM PDT |
| Thanks. I appreciate that. | |
| Do you have stress? | Question 11:11 AM PDT |
| Not usually, but I’m feeling pretty anxious not knowing what’s going on with my chest. | |
| Am sorry about this. | Empathize 11:11 AM PDT |
| 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. | ||
| Have you been diagnosed with hypertension? | Question 11:02 AM PDT |
| Yes, I supposedly have moderately high blood pressure. | |
| Am sorry to hear this? | Empathize 11:02 AM PDT |
| Thanks. I appreciate that. | |
| Have you been monitoring your blood pressure? | Question 11:07 AM PDT |
| Not usually. They check it when I get checkups. My doctor has never seemed overly concerned about it. | |
| do you remember your last blood pressure readings? | Question 11:08 AM PDT |
| I don’t remember. I don’t think it was too bad, though. | |
| have you done an EKG test recently? | Question 11:08 AM PDT |
| I had one about three months ago. They usually put one on me at my annual physical. | |
| well, an EKG test is all about blood pressure monitoring. | Educate 11:09 AM PDT |
| 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. | ||
| Do you exercise? | Question 11:12 AM PDT |
| 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. | |
| Am sorry that the chest pain makes you not exercise. | Empathize 11:13 AM PDT |
| 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. | ||
| what is your typical breakfast? | Question 11:13 AM PDT |
| 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 | |
| what is your typical lunch? | Question 11:14 AM PDT |
| 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. | |
| what is your typical dinner? | Question 11:14 AM PDT |
| My wife and I like to grill. We usually have some grilled meats and veggies for dinner. | |
| do you take salt? | Question 11:15 AM PDT |
| Do you drink water regularly? | Question 11:15 AM PDT |
| I usually drink water all day at work. At least four glasses, probably more. [AUDIO COMING SOON] | |
| Its good to take water, continue. | Educate 11:16 AM PDT |
| 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.” |
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6 Family History Followed Up
| Description: Mr. Foster has a family history of heart disease. | ||
| Do you have a family history of heart attack? | Question 11:30 AM PDT |
| Well, my mom’s dad died of a heart attack. He was pretty young too. Chest pain shadow health assessment Education & Empathy | |
| Do you have a family history of stroke? | Question 11:30 AM PDT |
| No, none that I know of. | |
| Do you have a family history of pulmonary embolism? | Question 11:32 AM PDT |
| No, nobody had that. | |
| Thank you Mr Foster for answering for answering my questions, I will now do the Physical examination. | Educate 11:34 AM PDT |
| 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 |
