SHADOW HEALTH
Good morning.
My name is ___ I
will be assessing
you today.
Hello
what is your name
Brian Robert Foster.
what is your date of birth
August 17 . . . [Mr. Foster reports the correct year.] [AUDIO
COMING SOON]
how old are you
I’m 58 going on 30.
how tall are you
I’m Ove foot eleven.
how much do you weigh
As of this morning, a buck ninety-seven.
Measured vitals
Tested blood pressure in left arm with cuf
Tested blood pressure in right arm with cuf
Tested blood pressure in left arm with cuf
Tested blood pressure in right arm with cuf
Tested blood pressure in right arm with cuf
Measured vitals
why are you here today
I have been having some troubling chest pain in my chest now
and then for the past month.
i am sorry you are experiencing that
Thanks. I appreciate that.
how much do you weigh in pounds
As of this morning, a buck ninety-seven.
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
can you rate your pain
I’d say maybe a . . . 5? It’s just really uncomfortable . . . like
there’s nothing I can do about it. Right now it’s like a zero
though.
when did the pain start
I Orst noticed it earlier this month. I thought it might just be
heartburn and it passed after about a couple of minutes.
what aggravates your pain
Well, I think it’s when I’m doing something physical most of
the time. The Orst 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
o[ce is on the 5th \oor.
what relieves your pain
I’m not sure. I think lying still seems to help a little.
where is your pain
When the pain happens, I feel it mostly in the middle of my
chest, over my heart.
how long does your pain last
When I feel it, it seems to get better over the course of a
couple of minutes or so.
describe your pain
Well, it mostly feels tight and uncomfortable right in the
middle of my chest.
how are you treating your pain
I haven’t taken anything for the chest pain yet.
What medications do you take
Yeah, let’s see, I take atorvastatin for cholesterol, metoprolol
for blood pressure. . . Oh yeah, and I take Osh oil too. I hear
that’s good for your cholesterol. [AUDIO COMING SOON]
do you take any over the counter medicines
Oh, just ibuprofen or Tylenol occasionally for pain.
what dose of metoprolol do you take
I think it’s 100 mg, once a day.
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
how long have you taken metoprolol
I think it’s been about one year.
what is the dose for your cholesterol medicine (
It’s 20 mg, once a day. (ClariOed to what the dosage of my
cholesterol medication is.)
how long have you taken cholesterol medicine
I think about a year. [AUDIO COMING SOON]
how much ibuprofen do you take
Just a couple when I get a headache, which is not very often.
what is the dose of ibuprofen
Just whatever the bottle recommends for an adult.
when was the last time you took ibuprofen
I don’t recall. Been a few weeks at least. [AUDIO COMING
SOON]
how much tylenol do you take
Just a couple when I get a headache, which is not very often.
what dose of tylenol do you take
Just whatever the bottle recommends for an adult.
when was the last time you took tylenol
I don’t recall. Been a few weeks at least. [AUDIO COMING
SOON]
when was the last time you took your cholesterol medicine
3 months ago.
why did you stop taking your cholesterol medicine
Yes, I get it tested every couple of years.
when was the last time you took your blood pressure pill
I usually only get it checked when I visit the doctor.
when did you last take metoprolol
I think it’s been about one year.
what is your past medical history
The doctors told me I have a little bit of high blood pressure
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
and cholesterol, but that’s it.
do you smoke
Nope, I had a lot of friends who did but I never started.
are you exposed to second hand smoking
Almost never.
do you drink alcohol
Sure, but never more than two or three beers on a weekend.
what kind of alcohol do you drink
Oh, mostly light beer, just a couple on the weekends. I’ll have
a bourbon with my son or on special occasions sometimes,
too.
do you do drugs
Nope.
do you smoke marijuana
I’ll put it this way: the last time I touched the stuf, Carter was
in o[ce.
when did you last smoke marijuana
I’ll put it this way: the last time I touched the stuf, Carter was
in o[ce.
tell me about your mom
She has type 2 diabetes and some high blood pressure, but I
think she’s doing pretty well for 80.
tell me about your dad (ClariOed to Can you tell me about your
father’s health?.)
He really wasn’t doing so great in the last few years. He died
when he was 75 of colon cancer, but even before that, his
weight and his blood pressure and cholesterol were getting
the best of him. It was rough. He didn’t last too long after the
cancer diagnosis, unfortunately. I think he was tired of
Oghting. (ClariOed to how my dad’s health was.)
do you have siblings
I have a sister, and I had a brother but he died many years
ago.
im sorry about your brother’s death (No matching questions
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
found.)
im sorry about your brother’s death
Thanks. I appreciate that.
tell me about your brothers health (No matching questions
found.)
tell me about your brother (No matching questions found.)
how did your brother die
It was a car accident. He was 24.
tell me about your sister
She has the same health problems as our mom. Diabetes and
hypertension.
how old is your sister
She’s Ofty-two.
tell me about your mom’s dad
My grandfather on my mom’s side died of a heart attack. He
was in his mid-Ofties.
tell me about your mom’s mom
She had breast cancer. She was in her 60s when she died.
tell me about your dad’s dad
He was healthy right up until he died. He went in his sleep at
85, and we just called it old age.
tell me about your dad’s mom
She died of pneumonia when she was almost 80. 78 or 79, I
think.
im sorry about your loss
Thanks. I appreciate that.
does anybody in your family have health problems (ClariOed to
Do you have a family history of psychiatric illness?.)
Thankfully, no. (ClariOed to if I have a family history of
psychiatric illness.)
tell me about any health problems in your family
Well, my dad died of colon cancer, my mom and sister have
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
diabetes . . . my daughter has asthma, we all have slightly
high blood pressure, my mom’s mom died of breast cancer,
and my mom’s dad died of a heart attack.
do you have children
Yes, I have two great kids. Well, they’re not kids. Sam is 26
and Allie is 19.
tell me about Allie (ClariOed to Who is your daughter?.)
My daughter’s name is Allie. [AUDIO COMING SOON] (ClariOed
to who my daughter is.)
does allie have health problems
Allie’s doing great. She has asthma, but she’s got a handle on
it. [AUDIO COMING SOON]
does sam have any health problems
Sam’s health is wonderful. [AUDIO COMING SOON]
is sam a boy or a girl
Yep, my son Sam. And I have a daughter Allie. [AUDIO COMING
SOON]
tell me about your social history
My social life is mostly my family now. My wife and I are
together all the time, and my son and his family lives in town.
My daughter is in college so she’s home at least once a
month. We try to have big family dinners when she’s home. I
go Oshing with my friend Smitty and his brother every once in
a while.
are you married
You bet. Happily married to my hot wife for, let’s see, 27 years
now.
do you travel
My wife and I went to Paris a couple years ago, but I haven’t
been anywhere else recently.
do you go to church
Usually only on holidays or when my mom is visiting.
do you work
I work at a civil engineering Orm here in town.
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
what do you do
I’m an engineer.
what is the name of the Orm you work for
Brian Robert Foster.
are you up to date on your immunizations
Yeah, I am.
when did you last take the \u shot
Well, I usually get the \u shot. I’ve had one in the past year.
[AUDIO COMING SOON]
it is important for you to take your \u shot early
Good to know. Thank you.
when was the last time you took a pneumonia vaccine
I can’t remember . . . I don’t think so.
have you had a tetanus shot
I’m up to date on my tetanus shot. [AUDIO COMING SOON]
when did you take your tetanus shot
I’m up to date on my tetanus shot. [AUDIO COMING SOON]
have you ever had surgery
I’ve never had any surgeries.
have you ever been hospitalized
I’ve never had to go to the hospital, no.
do you have a doctor
Dr. Melinda Smith.
when was the last time you saw dr smith (ClariOed to When
was your last doctor’s visit?.)
I had a physical about 3 months ago. (ClariOed to when my
last doctor’s visit was.)
do you have a cardiologist
No, but I guess I might need one.
you might need to have a cardiologist follow you since you
have an extensive family history of cardiac problems and you
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
are now experiencing chest pain
Good to know. Thank you.
when did you last go to the dentist
Um . . . probably about a year ago.
do you have a sexual preference
I’ve only ever been attracted to women. Well, women and Paul
Newman.
does your chest pain radiate
The pain doesn’t radiate anywhere. It’s mostly just right in the
middle of my chest.
do you have arm pain
No, when I am having the chest pain, it’s mostly just in middle
of my chest.
do you have shoulder pain
No, the pain hasn’t been in my shoulder.
do you have back pain
I haven’t had back pain, no.
do you have neck pain
My neck’s been One.
how often does your chest pain happen (ClariOed to How often
do you have chest pain?.)
Well, it has happened three times the past month. It usually
goes away after about a couple of minutes. (ClariOed to how
often have pain in your chest.)
does your pain seem to be related to anything
It seems like moving around makes it worse, or at least more
noticeable. I felt a little better when I sat down to rest for a
few minutes.
do you have crushing pain (ClariOed to Is the pain crushing?.)
No, it’s more tight and uncomfortable. (ClariOed to if the pain
is crushing.)
is the pain gnawing
No, it’s not like that. [AUDIO COMING SOON]
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
is the pain burning
Not really.
ORDER A PLAGIARISM-FREE PAPER HERE
does your pain get worse when you eat (ClariOed to Does
eating anything make your pain worse?.)
I don’t think that has anything to do with it, but I guess I don’t
know. (ClariOed to if eating makes the pain worse.)
does the pain get worse with spicy foods
I don’t think spicy foods have anything to do with it.
does the pain get worse with fatty foods (ClariOed to Do
certain foods make the pain worse?.)
I don’t think that has anything to do with it, but I guess I don’t
know. (ClariOed to if certain foods make the pain worse.)
do you eat a healthy diet
Yeah, I think so.
what do you eat daily
Um, let’s see . . . For breakfast I usually eat a granola bar and
drink an instant breakfast shake. I’ve been doing that a while
since it saves time in the morning. Most days for lunch I get a
sandwich from the sub shop near work. That’s usually a turkey
sub, but sometimes I get a spicy Italian sub. My wife and I grill
a lot, and usually have some grilled meat with veggies for
dinner.
do you take aspirin
I usually just take Tylenol or ibuprofen.
do you take Osh oil
That’s right.
what is the dose of your Osh oil
I take it daily. I think it’s 1200 milligrams.
how long have you taken Osh oil (ClariOed to Did you take Osh
oil today?.)
Took it this morning. [AUDIO COMING SOON] (ClariOed to if I
took Osh oil today.)
when were you prescribed Osh oil (No matching questions
found.)
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
why do you take Osh oil (ClariOed to How do you take Osh oil?.)
I take it daily. I think it’s 1200 milligrams. (ClariOed to how I
take Osh oil.)
do you have any allergies
No, well . . . I’ve had a bad reaction to codeine before, but that
is all I know of.
what happened when you took codeine
When I took codeine a few years ago for my back, it made me
pretty nauseous. I started throwing up and felt pretty terrible.
[AUDIO COMING SOON]
do you have any food allergies
No, well . . . I’ve had a bad reaction to codeine before, but that
is all I know of.
do you have any environmental allergies
No, well . . . I’ve had a bad reaction to codeine before, but that
is all I know of.
do you have diabetes
No, I’ve avoided it but my mother and sister both have it.
do you have heart disease
Besides moderate hypertension and slightly elevated
cholesterol, none that I know of.
do you have coronary artery disease
Not that I’m aware of.
have you had any treatment for chest pain (ClariOed to Have
you ever had treatments for heart problems?.)
Nothing other than blood pressure and cholesterol screenings.
(ClariOed to if I have been treated for heart problems.)
how often do you check your blood pressure
I usually only get it checked when I visit the doctor.
do you remember having any abnormal blood pressure
readings
Yes, I supposedly have moderately high blood pressure.
do you ever check your blood pressure at home
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
Not usually. They check it when I get checkups. My doctor has
never seemed overly concerned about it.
have you ever seen a cardiologist
I haven’t seen a cardiologist — this is the Orst time I’m telling
anyone about this chest pain. [AUDIO COMING SOON]
have you ever had an ekg
I had one about three months ago. They usually put one on
me at my annual physical.
have you ever had a stress test
Yes, I usually do one every year.
was your ekg normal
I don’t remember the actual results, but as far as I know, it
was normal.
was your stress test normal
I’m not sure, all the doctor ever tells me is, “everything looks
good.”
how often do you see a doctor
I see the doctor every 6 months unless there’s something
wrong in between.
do you exercise
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.
do you eat a lot of salt
I’m not sure, I don’t really pay attention to it.
do you drink a lot of water
I usually drink water all day at work. At least four glasses,
probably more. [AUDIO COMING SOON]
do you drink cafeine
I drink a cup or two of cofee almost every day. Not much else.
do you drink soda
Once in a blue moon maybe. I avoid it 99% of the time.
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
do you feel fatigued
I’m not more tired than normal.
do you feel stressed
Not usually, but I’m feeling pretty anxious not knowing what’s
going on with my chest.
do you have anxiety
Not usually, but I’m feeling pretty anxious not knowing what’s
going on with my chest.
do you have fever
I haven’t had a fever, no.
do you have chills
I haven’t had chills, no.
have you gained weight recently
I’ve gained maybe 20 pounds over the last couple years. I
guess I’m getting older . . . my wife doesn’t seem to mind
though!
have you lost weight recently
Not exactly . . . I’ve gained about Ofteen to twenty pounds in
the last couple years.
do you have night sweats
Nope, no night sweats.
do you live in a clean home
My wife and I own our house.
do you have palpitations
I don’t think so. I haven’t noticed any.
do you have headache
No, my head feels okay.
do you have dizziness
No, I haven’t felt dizzy.
what triggers your headaches (ClariOed to What do your
headaches feel like?.)
Uh, well, I guess they feel like a dull ache. They’re annoying,
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
but not debilitating. (ClariOed to what my headache pain feels
like.)
what relieves your headaches
I usually just take Tylenol or ibuprofen.
what makes your headaches worse
I usually just take Tylenol or ibuprofen.
what causes your headache
Uh, well, I guess they feel like a dull ache. They’re annoying,
but not debilitating.
do you have swelling
I haven’t noticed any swelling.
do you have angina
I’ve never been diagnosed with angina. [AUDIO COMING
SOON]
have you had a heart murmur
No, none that I know of.
have you had blood clots
Not that I know of.
have you had bleeding
Not that I know of.
do you have a cough
I don’t have a cough.
any di[culty breathing
My breathing’s One.
Inspected face
Inspected for jugular venous distension: No jugular venous
distention; JVP 3 cm above sternal angle
Inspected anterior chest wall
Inspected left side chest wall
Inspected anterior chest wall
Inspected right side chest wall
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
Inspected left side of abdomen
Inspected front of abdomen
Inspected right side of abdomen
Inspected right hand: no visible abnormal Ondings
Inspected left hand: no visible abnormal Ondings
Inspected Ongernails of left hand
Inspected right hand: no visible abnormal Ondings
Inspected left hand: no visible abnormal Ondings
Inspected Ongernails of right hand
Inspected left leg
Inspected right leg
Inspected toenails on left foot
Inspected toenails on right foot
Inspected left leg
Inspected right leg
Inspected right leg for edema: No edema
Inspected left leg for edema: No edema
Checked capillary reOll in Ongernails
Checked capillary reOll in Ongernails
Checked capillary reOll in Ongernails
Checked capillary reOll in Ongernails
Checked capillary reOll in Ongernails
Checked capillary reOll in Ongernails
Checked capillary reOll in Ongernails
Auscultated right carotid pulse: Bruit present
Auscultated left carotid pulse
Auscultated aortic area with the bell
Auscultated aortic area with the diaphragm
Auscultated pulmonic area with the diaphragm
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
Auscultated Erb’s point with the diaphragm
Auscultated Erb’s point with the bell
Auscultated Erb’s point with the diaphragm
Auscultated tricuspid area with the diaphragm
Auscultated mitral area with the diaphragm
Auscultated aortic area with the bell
Auscultated aortic area with the diaphragm
Auscultated pulmonic area with the diaphragm
Auscultated Erb’s point with the diaphragm
Auscultated tricuspid area with the diaphragm
Auscultated mitral area with the diaphragm
Auscultated mitral area with the bell
Auscultated tricuspid area with the bell
Auscultated Erb’s point with the bell
Auscultated pulmonic area with the bell
Auscultated aortic area with the bell
Auscultated breath sounds in anterior right upper lobe
Auscultated breath sounds in anterior left upper lobe
Auscultated breath sounds in anterior right middle lobe
Auscultated breath sounds in anterior left mid-chest (upper
lobe)
Auscultated breath sounds in anterior right lower lobe
Auscultated breath sounds in anterior left lower lobe
Auscultated breath sounds in posterior left upper lobe
Auscultated breath sounds in posterior right upper lobe
Auscultated breath sounds in posterior left mid-back (lower
lobe)
Auscultated breath sounds in posterior right mid-back (lower
lobe)
Auscultated breath sounds in posterior left lower lobe
Auscultated breath sounds in posterior right lower lobe
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
Auscultated breath sounds in posterior left lower lobe on side
Auscultated breath sounds in posterior right lower lobe on
side
Auscultated aorta in abdomen
Auscultated aorta in abdomen
Auscultated right renal pulse
Auscultated left renal pulse
Auscultated right iliac pulse
Auscultated left iliac pulse
Auscultated right femoral pulse
Auscultated left femoral pulse
Auscultated right upper quadrant
Auscultated left upper quadrant
Auscultated right lower quadrant
Auscultated left lower quadrant
Auscultated over liver
Auscultated over spleen
Palpated right carotid pulse: Thrill, 3+
Palpated left carotid pulse: No thrill, 2+
Palpated PMI: Displaced laterally; brisk and tapping; less than
3 cm
Palpated right brachial pulse: No thrill, 2+
Palpated left brachial pulse: No thrill, 2+
Palpated right radial pulse: No thrill, 2+
Palpated left radial pulse: No thrill, 2+
Palpated right femoral pulse: No thrill, 2+
Palpated left femoral pulse: No thrill, 2+
Palpated right popliteal pulse: No thrill, 1+
Palpated left popliteal pulse: No thrill, 1+
Palpated right tibial pulse: No thrill, 1+
lOMoARcPSD|5411076
Palpated left tibial pulse: No thrill, 1+
Palpated right dorsalis pedis pulse: No thrill, 1+
Palpated left dorsalis pedis pulse: No thrill, 1+
Palpated right upper quadrant with light pressure: No
tenderness reported; no masses, guarding, or distension
Palpated left upper quadrant with light pressure: No
tenderness reported; no masses, guarding, or distension
Palpated right lower quadrant with light pressure: No
tenderness reported; no masses, guarding, or distension
Palpated left lower quadrant with light pressure: No
tenderness reported; no masses, guarding, or distension
Tested skin turgor
Palpated for right kidney: Not palpable
Palpated for left kidney: Not palpable
Palpated for spleen: Not palpable
Palpated liver: Palpable 1 cm below right costal margin
Palpated right upper quadrant with deep pressure: No masses
Palpated left upper quadrant with deep pressure: No masses
Palpated right lower quadrant: with deep pressure: No masses
Palpated left lower quadrant with deep pressure: No masses
Percussed right upper quadrant
Percussed left upper quadrant
Percussed right lower quadrant
Percussed left lower quadrant
Percussed spleen
Percussed for liver span: 7 cm in the mid-clavicular line
Performed EKG
how many medications do you take daily
I’m taking cholesterol and blood pressure meds, yeah.
do you take any other medications
Just the atorvastatin and metaprolol. . . and sometimes
ORDER A PLAGIARISM-FREE PAPER HERE
lOMoARcPSD|5411076
ibuprofen when I need it. [AUDIO COMING SOON]
do you take herbal medications
I take Osh oil, that’s it.
do you feel fatigue
I’m not more tired than normal.
do you feel weak
I wouldn’t say I feel weak.
do you have trouble sleeping
I usually sleep about 6 or 7 hours a night.
do you have itching
I haven’t noticed anything weird with my skin, no.
do you have redness
I haven’t had problems with my eyes like that.
do you have nail discharge
Not that I’ve noticed.
any skin color changes
My skin hasn’t changed color on me.
double vision
I get my eyes checked every few years. So far, no glasses!
eye pain
I haven’t had problems with my eyes like that.
eye redness
I haven’t had problems with my eyes like that.
vision changes
I get my eyes checked every few years. So far, no glasses!
vision changes
I get my eyes checked every few years. So far, no glasses!
photo phobia (No matching questions found.)
do you have photo phobia (No matching questions found.)
do you have photo-phobia (No matching questions found.)
di your eyes hurt when exposed to light
I haven’t had problems with my eyes like that.
eye discharge
I haven’t had problems with my eyes like that.
earache
No, my ears are One.
Tinnitus
No, my ears are One.
Bleeding nose
No, I sure don’t think so.
Vertigo (No matching questions found.)
do you have Vertigo
Thankfully, no.
Have you had any hearing things has
My hearing’s One.
Have you had any hoarseness
Nope.
Have you had any oral ulcers (ClariOed to Have you ever had
oral lesions?.)
Um . . . no. No problems with that. (ClariOed to if I have had
oral lesions.)
Have you had a sore throat
I haven’t had a sore throat in a long time.
Have you had congestion
I haven’t felt congested. All clear. [AUDIO COMING SOON]
Have you had no discharge (No matching questions found.)
Have you had post nasal drip (No matching questions found.)
Have you had post nasal discharge (No matching questions
found.)
Have you had rhinorrhea (No matching questions found.)
Downloaded by Sam Waters (pinkgirl101@gmail.com)
lOMoARcPSD|5411076
Have you had call (No matching questions found.)
Have you had cough
I don’t have a cough.
Hemoptysis (No matching questions found.)
have you been coughing up blood
No, deOnitely not.
Can we have dyspnea (No matching questions found.)
Can we have shortness of breath (ClariOed to Do you currently
have shortness of breath?.)
My breathing’s One. (ClariOed to if I have shortness of breath
right now.)
Any pain on inspiration
No, not right now, but when I do it’s tight and uncomfortable.
I’ve experienced it three times this month.
Are you producing sputum
I don’t have a cough.
Do you have phlegm
I don’t have a cough.
Any numbness
Nope, I haven’t noticed anything.
Anything Lane (No matching questions found.)
any tingling
Nope, I haven’t noticed anything.
Have you passed out
Struggling to meet your deadline ?
Get assistance on
SHADOW HEALTH
done on time by medical experts. Don’t wait – ORDER NOW!