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Debbie O Connor COPD Shadow Health- Experience Overview and Digital Clinical Experience (Rated 93.8%)

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Download Debbie O Connor COPD Shadow Health- Experience Overview and Digital Clinical Experience (R and more Exams Nursing in PDF only on Docsity! Experience Overview Patient: Debbie O'Connor Digital Clinical Experience Score C h a p te r: S ta te m e n t 1 Proficiency Level: Beginning • Students rated as “beginning” are starting to develop their advanced practice competencies and clinical reasoning skills. In comparable programs, 50% of students perform at the level of a beginning practitioner. Review your results in the tabs on the left side of the page to identify areas for improvement. Subjective Data Collection 30 out of 32 Medication Selection 22 out of 27 Education and Empathy 4 out of 6 Patient Teaching 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 93 out of 111 C h a p te r: S ta te m e n t 2 • Finding: Asked about additional symptoms • Finding: Reports fatigue and weakness (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: Do you feel fatigued? • History of Present Illness Example Question: What are your symptoms? • Finding: Reports desire for smoking cessation aids (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 concerns or symptoms the patient may have. Example Question: What can I do for you? C h a p te r: S ta te m e n t 5 Finding: Reports purulent sputum (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: Do you have purulent sputum? • Finding: Reports cough (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: 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: C h a p te r: S ta te m e n t 6 How do you feel about your symptoms? C h a p te r: S ta te m e n t 7 • 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 • Finding: Reports exertion worsens symptoms (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: Does exertion make your symptoms worse? • Finding: Reports coughing fits after smoking (Found) C h a p te r: S ta te m e n t 1 0 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 do you have coughing fits? • Finding: Asked about treatment and relieving factors of respiratory symptoms • Finding: Reports trying to hold off on smoking cigarettes as long as possible (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 do you wait between cigarettes? • Finding: Asked about severity of respiratory distress • Finding: Reports breathing difficulty and associated discomfort is a 6/10 (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 C h a p te r: S ta te m e n t 1 1 • Finding: Asked about existing health conditions • Finding: Reports chronic bronchitis related to COPD (Found) Past Medical History 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: Can you rate your symptoms on a scale of 1 to 10? • Finding: Asked about effects of health on social activity • Finding: Reports low social activity - doesn't feel up to getting out and about (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 your symptoms prevent you from social activities? C h a p te r: S ta te m e n t 1 2 • 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? • Finding: Followed up on LABA • Finding: Reports the LABA is formoterol inhaler (Found) Home Medications 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: C h a p te r: S ta te m e n t 1 5 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 a LABA inhaler? • Finding: Reports formoterol dose of 12 micrograms (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 the dosage of your inhaler? • Finding: Reports only using once every 12 hours, once in the morning and once at night (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: How often do you take your inhaler? • Finding: Reports using LABA this morning C h a p te r: S ta te m e n t 1 6 (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: When is the last time you used your inhaler? • Finding: Reports the LABA is not very effective (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: Is the inhaler effective? • Finding: Denies medication side effects (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: C h a p te r: S ta te m e n t 1 7 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 vaccines • Finding: Denies recent influenza vaccine (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 C h a p te r: S ta te m e n t 2 0 • Finding: Asked about living environment • Finding: Reports she lives with her daughter (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: Social History frequency will help you understand the patient's background and how it may affect their current situation. Example Question: Have you had a flu shot? • Finding: Denies recent pneumococcal vaccines (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: Have you had a pneumonia vaccine? C h a p te r: S ta te m e n t 2 1 Who do you live with? • Finding: Reports recently moving in with her daughter because of her declining health (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: When did you move in with your daughter? • Finding: Reports stress from arguments with daughter over 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: Is your home stressful? • Finding: Asked about substance use • Finding: C h a p te r: S ta te m e n t 2 2 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 started smoking at age 15 (Found) C h a p te r: S ta te m e n t 2 5 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: When did you start smoking? • Finding: Reports quit smoking when her daughter was young but started smoking again in her 30s (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: Have you ever quit smoking? • Finding: Reports 37 pack years according to an online calculator her daughter used (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: How many pack years do you have? • C h a p te r: S ta te m e n t 2 6 Finding: Followed up on smoking cessation • Finding: Reports trying to quit several times unsuccessfully with nicotine replacement therapy (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: Have you ever quit smoking using nicotine replacement therapy? • Finding: Reports having tried nicotine gum, lozenges, and patches (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 kind of nicotine replacement therapy have you tried? • Finding: Reports nicotine replacement therapy failed because she did not want to deal with the required compliance C h a p te r: S ta te m e n t 2 7 Family Medical History • 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 husband smoked and died of lung cancer C h a p te r: S ta te m e n t 3 0 • Finding: Asked about weight changes • Finding: Reports weight gain of 30 pounds in the last two years (Found) 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. Review of Systems (Available) 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 husband smoke? • Finding: Reports daughter is a "health nut" non-smoker (Available) 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: Does your daughter smoke? C h a p te r: S ta te m e n t 3 1 Example Question: How much weight have you gained? • Finding: Asked about review of systems for HEENT • Finding: Reports vision is nearsighted (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 nearsighted? • Finding: Reports wearing glasses (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: Do you wear glasses? • Finding: Asked about review of systems for integumentary C h a p te r: S ta te m e n t 3 2 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 1 Anxiety Over Worsening Symptoms Followed Up Do you have trouble moving around your home? • Finding: Reports difficulty with activities like dressing or cooking due to exhaustion (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: Do you have difficulty getting dressed? Comments If your instructor provides individual feedback on this assignment, it will appear here. Education & Empathy : 4 of 6 (66.7%) © Shadow Health® 2012 - 2020 (800) 860-3241 | Help Desk | Terms of Service | Privacy Policy | Description: Ms. O'Connor reports anxiety and distress over her worsening health. C h a p te r: S ta te m e n t 3 5 what brings you here today I'm having so much trouble just trying to breathe. And I've had these terrible coughing fits. A few days ago, a bronchospasm. My health is going downhill fast . . . I know it has to do with my smoking habit. It's so hard to kick. I was hoping I could get something to help me. when did the symptoms started? I've had breathing problems for years now -- I was hospitalized for COPD distress two years ago -- but it's been worse for about four months. For about two weeks now I've been coughing up some nasty mucus, and ever since that awful coughing fit three days ago, I've had even more fatigue and difficulty breathing. I am so sorry to hear that. Thank you. how often do you visit the doctor? I'm having so much trouble just trying to breathe. And I've had these terrible coughing fits. A few days ago, a bronchospasm. My health is going downhill fast . . . I know it has to do with my smoking habit. It's so hard to kick. I was hoping I could get something to help me. Question 11:20 AM CDT Question 11:20 AM CDT Empathize 11:22 AM CDT Question 11:43 AM CDT C h a p te r: S ta te m e n t 3 6 do you drink water? Water's mostly what I drink. are you depresses? 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 C h a p te r: S ta te m e n t 3 7 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 5 Diet and Exercise Followed Up Description: Ms. O'Connor reports she mainly eats frozen food, and that she is not capable of exercise. C h a p te r: S ta te m e n t 4 0 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 Empathize 11:39 AM CDT 6 Oxygen Therapy Followed Up Description: Ms. O'Connor expresses that she would like oxygen therapy but is unable to use it while smoking. have you ever had bronchitis? I've been diagnosed with COPD. It's chronic bronchitis. Hard as heck to breathe. I know my smoking habit makes it worse, too. I've thought about oxygen, but since I smoke, I'd blow myself up. Question 11:40 AM CDT C h a p te r: S ta te m e n t 4 1 Comments If your instructor provides individual feedback on this assignment, it will appear here. i am sorry to hear that Thanks. Model Statement: "Oxygen therapy could help alleviate some of your symptoms of breathlessness and fatigue. Unfortunately, you cannot use oxygen therapy if you smoke. It's too dangerous. Once you quit smoking, you can seek this treatment." Empathize 11:40 AM CDT © Shadow Health® 2012 - 2020 (800) 860-3241 | Help Desk | • • 2. Recommendation and Monitoring 1. Assessment The patient presents with COPD exacerbation Model Note Debbie O’Connor is a 55-year-old White woman who has been previously diagnosed 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. Assessment 2. 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 C h a p te r: S ta te m e n t 4 2 Total points per column + 20 points + 2 points COPD Medication(s) Selected glycopyrrolate / formoterol indacaterol / glycopyrrolate salmeterol Points Earned + 2 points + 2 points 0 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 dry powder inhaler is the best treatment for Ms. O'Connor’s COPD symptoms. It effectively treats Class C COPD symptoms and adheres to C h a p te r: S ta te m e n t 4 5 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 C h a p te r: S ta te m e n t 4 6 Greet the patient Patient Teaching Score: 14 out of 16 Medication(s) Selected varenicline Points Earned ✓ + 9 points ✓ ✓ Rationale Congratulations! You have correctly prescribed Ms. O'Connor varenicline for smoking cessation. Ms. O'Connor has failed to stop smoking using nicotine replacement in the past, and varenicline is easier to manage than bupropion in combination with nicotine replacement. Topics priorized for patient teaching Education Items • Greet the patient and explain why you need to educate them. Greet the patient and explain why you need to educate them. Comments C h a p te r: S ta te m e n t 4 7 Model Statement: Inhale the contents of each capsule twice to make sure you receive a full dose. Model Statement: Problems with your eyes, such as changes in vision, pain in your eyes, or irritated eyes, could mean you're experiencing a serious side effect. If any of these things happen to you, contact your healthcare provider right away. 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. Contact your healthcare professional if you experience changes in vision or irritation or pain in your eyes contact a professional for any questions Statement 6/5/2020 4:56:21 PM Oh, dear. I sure hope that doesn't happen to me. Contact your healthcare professional if you experience difficult, painful, or unusually frequent urination C h a p te r: S ta te m e n t 5 0 Model Statement: Problems with urination, such as difficulty urinating, painful urination, or needing to urinate often, could mean you're experiencing a serious side effect. If any of these things happen to you, contact your healthcare provider right away. albuterol / ipratropium 4 out of 4 Model Plan any problems with urination, contact a doctor 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 C h a p te r: S ta te m e n t 5 1 Model Statement: Do not use this medication more times than your healthcare provider has recommended. 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. Okay. 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. C h a p te r: S ta te m e n t 5 2 Model Statement: If you experience shortness of breath after taking this medication, contact your healthcare provider immediately. Say Goodbye Comments If your instructor provides individual feedback on this assignment, it will appear here. Model Statement: Prescription Writing Score: 23 out of 30 Topics priorized for patient teaching Education Items • Educate the patient on anything else and say goodbye Educate the patient on anything else and say goodbye do you have any more questions for me? Ok. See you later. Statement 6/5/2020 4:58:49 PM © Shadow Health® 2012 - 2020 (800) 860-3241 | Help Desk | tiotropium dry powder inhaler 10 out of 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? C h a p te r: S ta te m e n t 5 5 Feedback C h a p te r: S ta te m e n t 5 6 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? C h a p te r: S ta te m e n t 5 7 ipratropium bromide / albuterol mdi 3 out of 10 lose the point for this section. Field Student's Answer Is Correct? Feedback Signature Olga L Viego ✓ Date 05/06/2020 ✓ 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? C h a p te r: S ta te m e n t 6 0 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. Safe and Effective Dosage: 0 out of 7 point Feedback Patient Name Debbie O'Connor ✓ Date of Birth 10/05/1964 ✓ C h a p te r: S ta te m e n t 6 1 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 C h a p te r: S ta te m e n t 6 2 Additional Information 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 C h a p te r: S ta te m e n t 6 5 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 use your rescue inhaler for exacerbations 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? C h a p te r: S ta te m e n t 6 6 varenicline starting convenience pack 10 out of 10 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 Patient Information: 1 out of 1 point Feedback Signature Olga L Viego ✓ Date 05/06/2020 ✓ C h a p te r: S ta te m e n t 6 7 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 C h a p te r: S ta te m e n t 7 0 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? C h a p te r: S ta te m e n t 7 1 Click to return to main page content. Comments If your instructor provides individual feedback on this assignment, it will appear here. Feedback Signature Olga L Viego ✓ Date 05/06/2020 ✓ © Shadow Health® 2012 - 2020 (800) 860-3241 | Help Desk | C h a p te r: S ta te m e n t 7 2

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