Shadow Health
Professional Development
Ace my homework – Write a 500-word Ace homework tutors – APA reflection essay of your experience with the Shadow Health virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:
What went well in your assessment?
What did not go so well? What will you change for your next assessment?
What findings did you uncover?
What questions yielded the most information? Why do you think these were effective?
What diagnostic tests would you order based on your findings?
What differential diagnoses are you currently considering?
What patient teaching were you able to complete? What additional patient teaching is needed?
Would you prescribe any medications at this point? Why or why not? If so, what?
How did your assessment demonstrate sound critical thinking and clinical decision making?
Gastrointestinal Results | Completed
Advanced Physical Assessment – March 2020, advanced_physical_assessment__td8__031720__sect1
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Documentation / Electronic Health Record
Document: Provider Notes
Student Documentation Model Documentation
Subjective
this 28 you African pleasant female, presents with complaints of
stomach pains that started a month ago. “feels like heartburn”
Relieved with antacids, but is getting worse. Pain 1-2 right now, but
a 5/10 after eating. Eating makes it worse. Sitting up helps.
PMH: diabetes: no meds: Asthma: on proventil and albuterol:
controlled
Social hx: hx of THC use, none now. drinks 3-4 cans of soda in a
day.
ROS: heart burn normal form of stools, no diarrhea or constipation :
Denies mental health issues:
FMK PGF with colon cancer
Diet: lots of fried and fast food:
Exercise: limited
HPI: Ms. Jones is a pleasant 28-year-old African American woma
who presented to the clinic with complaints of upper stomach pa
after eating. She noticed the pain about a month ago. She states
that she experiences pain daily, but notes it to be worse 3-4 time
per week. Pain is a 5/10 and is located in her upper stomach. Sh
describes it “kind of like heartburn” but states that it can be shar
She notes it to increase with consumption of food and specifical
fast food and spicy food make pain worse. She does notice that
has increased burping after meals. She states that time generally
makes the pain better, but notes that she does treat the pain “ev
few days” with an over the counter antacid with some relief.
Social History: She denies any specific changes in her diet recen
but notes that she has increased her water intake. Breakfast is
usually a muffin or pumpkin bread, lunch is a sandwich with chip
dinner is a homemade meal of a meat and vegetable, snacks are
French fries or pretzels. She denies coffee intake, but does drink
cola on a regular basis. She denies use of tobacco and illicit drug
She drinks alcohol occasionally, last was 2 weeks ago, and was
drink. She does not exercise.
Review of Systems: General: Denies changes in weight and gene
fatigue. She denies fevers, chills, and night sweats. • Cardiac: De
a diagnosis of hypertension, but states that she has been told he
blood pressure was high in the past. She denies known history o
murmurs, dyspnea on exertion, orthopnea, paroxysmal nocturna
dyspnea, or edema.
• Respiratory: She denies shortness of breath, wheezing, cough,
sputum, hemoptysis, pneumonia, bronchitis, emphysema,
tuberculosis. She has a history of asthma, last hospitalization wa
age 16, last chest XR was age 16. • Gastrointestinal: States that
general her appetite is unchanged, although she does note that s
will occasionally experience loss of appetite in anticipation of the
pain associated with eating. Denies nausea, vomiting, diarrhea, a
constipation. Bowel movements are daily and generally brown in
color. Denies any change in stool color, consistency, or frequenc
Denies blood in stool, dark stools, or maroon stools. No blood in
emesis. No known jaundice, problems with liver or spleen.
Your Results Lab Pass (/assignment_attempts/6541639/lab_pass.pd
Overview
Transcript
Subjective Data Collection
Objective Data Collection
Education & Empathy
Documentation
Document: Provider Notes
Student Documentation Model Documentation
Objective
Skin Turgor : no tenting
Lungs; CTA:
Heart: Normal S1, S2 sounds. no murmur
Abdominal : round, distended, discoloration, striae, no scars noted,
symetrical. normal bowel sounds, no organomegly or rebound
tenderness
Liver palpable 1cm below right costal margin:
Liver percussion with 7cm span in the mid-clavicular line.
Spleen: not palpable: no tenderness
Kidney: No CVA tenderness, not palpable
General: Ms. Jones is a pleasant, obese 28-year-old African
American woman in no acute distress. She is alert and oriented.
maintains eye contact throughout interview and examination.
• Abdominal: Abdomen is soft and protuberant without scars or s
lesions; skin is warm and dry, without tenting. Bowel sounds pre
and normoactive in all quadrants. No tenderness to light or deep
palpation. Tympanic throughout. Liver is 7 cm at the MCL and 1
below the right costal margin. Spleen and bilateral kidneys are no
palpable. No CVA tenderness.
• Cardiovascular: Regular rate and rhythm, S1 and S2 present, n
murmurs, rubs, gallops, clicks, precordial movements. No bruits
auscultation over abdominal aorta. No femoral, iliac, or renal bru
• Respiratory: Chest is symmetrical with respirations. Lung sound
clear to auscultation anteriorly and posteriorly without wheezes,
crackles, or cough.
Assessment
Heartburn
Possible GERD
Gastroesophageal reflux disease without evidence of esophagitis
Plan
Ace my homework – Write my paper – Online assignment help tutors – Discuss diet and avoiding fried, spicy, and soda foods.
Exercise regimen encouraged
Daily activy encouraged
Take small frequent meals
Consider Zantac if needed
F/u in one week with above regimen.
consider h-phyloric IGG/IGM if persistent sx
Return to clinic if symptoms worsen, bloody stools
RT hospital if chest pain
Educate on lifestyle changes including weight loss, engagement
daily physical activity, and limitation of foods that may aggravate
symptoms including chocolate, citrus, fruits, mints, coffee, alcoh
and spicy foods. • Ms. Jones may elevate the head of her bed or
sleep on a wedge-shaped bolster for comfort or symptom reduc
• Encourage to eat smaller meals and to avoid eating 2-3 hours
before bedtime. • Educate on dietary reduction in fat to decrease
symptoms. • Trial of ranitidine 150 mg by mouth daily for two we
If reduction in symptoms, Ms. Jones may continue therapy. If
symptoms persist, consider testing for helicobacter pylori, trial o
proton pump inhibitor, or upper endoscopy. • Educate on when t
seek emergent care including signs and symptoms of upper and
lower gastrointestinal bleed, weight loss, and chest pain. • Retur
clinic in two weeks for evaluation and follow up.
Comments
If your instructor provides individual feedback on this assignment, it will appear here.
Gastrointestinal Results | Completed
Advanced Physical Assessment
Professional Development
The Shadow Health virtual patient simulation provided a valuable learning experience that allowed me to develop my clinical assessment and decision-making skills. Through the case of Ms. Jones, who presented with upper abdominal pain, I was able to practice gathering a thorough history, performing a focused physical exam, formulating a differential diagnosis, and developing an evidence-based treatment plan (Shadow Health, 2023).
What went well in my assessment was obtaining a detailed subjective history from Ms. Jones regarding her symptoms, diet, lifestyle factors, medical history, medications, and family history (O’Brien et al., 2020). This helped me identify potential etiologies and risk factors for her condition. I was also able to perform a focused physical exam and document my objective findings systematically using an SOAP note format (Institute of Medicine, 2015 – Research Paper Writing Help Service).
An area for improvement is strengthening my clinical reasoning. While I considered gastroesophageal reflux disease (GERD) and peptic ulcer disease as leading differential diagnoses based on Ms. Jones’ symptoms (Sontrop & Murphy, 2016: 2024 – Do my homework – Help write my assignment online), I did not fully explore other potential causes such as gastric ulcer or non-ulcer dyspepsia in my assessment (Tack & Talley, 2017). In the future, I will work on developing a more comprehensive differential diagnosis list early on.
Some key findings from Ms. Jones’ history that helped guide my assessment included her reports of epigastric pain worsening after eating fried and spicy foods, which are known triggers for GERD (El-Serag & Sweet, 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Her physical exam was also notable for mild epigastric tenderness on palpation. Moving forward, I aim to integrate subjective and objective findings more cohesively in my clinical reasoning.
My treatment plan focused on lifestyle modifications such as a heart-healthy diet, weight loss, limiting reflux triggers, and exercise (Tack & Talley, 2017). I also recommended a trial of ranitidine to help control acid production in cases of GERD (Sontrop & Murphy, 2016: 2024 – Do my homework – Help write my assignment online). While this demonstrated sound initial management, I did not thoroughly consider alternative diagnoses or additional testing in my differential and plan (El-Serag & Sweet, 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay).
In summary, this virtual patient experience highlighted areas of clinical competency I have gained as well as aspects of my clinical reasoning that would benefit from further development. I aim to apply the lessons learned to strengthen my assessment and decision-making abilities in future patient encounters.
El-Serag, H. B., & Sweet, S. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Epidemiology and risk factors for gastroesophageal reflux disease (GERD): what have we learned in the past decade? Digestive diseases, 32(3), 305–310. https://doi.org/10.1159/000360729
Institute of Medicine (US) Committee on Planning a Continuing Health Care Professional Education Institute. (2015 – Research Paper Writing Help Service). Redesigning continuing education in the health professions. National Academies Press (US).
O’Brien, B. C., Harris, I. B., Beckman, T. J., Reed, D. A., & Cook, D. A. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Standards for reporting qualitative research: a synthesis of recommendations. Academic medicine : journal of the Association of American Medical Colleges, 89(9), 1245–1251. https://doi.org/10.1097/ACM.0000000000000388
Shadow Health. (2023). Shadow Health. https://www.shadowhealth.com
Sontrop, J. M., & Murphy, N. J. (2016: 2024 – Do my homework – Help write my assignment online). Gastroesophageal Reflux Disease Overview: Prevalence, Pathogenesis, Evaluation, and Effects on Esophageal Mucosa. Surgical Clinics of North America, 96(2), 183–194. https://doi.org/10.1016/j.suc.2015 – Research Paper Writing Help Service.11.001
Tack, J., & Talley, N. J. (2017). Functional dyspepsia—symptoms, definitions and validity of the Rome IV criteria. Nature reviews. Gastroenterology & hepatology, 14(3), 134–141. https://doi.org/10.1038/nrgastro.2016: 2024 – Do my homework – Help write my assignment online.191
