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# Shadow Health Focused Exam: Chest Pain – Mastering the Subjective Assessment
Are you a nursing student struggling to master the subjective assessment of chest pain in Shadow Health? Feeling overwhelmed by the sheer amount of information you need to gather? This comprehensive guide dives deep into the crucial elements of a focused exam on chest pain within the Shadow Health platform, providing you with the skills and knowledge to confidently navigate this challenging clinical scenario. We'll cover vital questioning techniques, key symptom identification, and how to effectively document your findings—all tailored to maximize your learning within the Shadow Health environment.
Understanding the Shadow Health Focused Exam
Shadow Health simulations provide invaluable practice for real-world clinical encounters. A focused exam is different from a comprehensive assessment. It concentrates on a specific presenting complaint – in this case, chest pain. This targeted approach requires efficient questioning to isolate the critical information needed for accurate diagnosis and management. This guide provides a structured approach to ensure you cover all the bases in your Shadow Health chest pain assessment.
The Importance of a Detailed Subjective Assessment
The subjective data you collect is the foundation of your patient's story. It's where you build the crucial narrative that guides your objective assessment and subsequent diagnostic reasoning. In Shadow Health, failing to adequately explore the subjective details will likely lead to a less-than-optimal outcome and valuable learning opportunities missed. Let's break down the key areas to focus on:
H2: Gathering Essential Information: The 7 Key Areas
To effectively assess chest pain in Shadow Health (or in a real-life patient encounter), consider these seven key areas:
#### H3: 1. Location and Radiation: Pinpointing the Pain
Ask the patient to describe the precise location of their chest pain. Is it centralized, localized to a specific area (e.g., retrosternal, left-sided), or does it radiate to other parts of the body (e.g., jaw, arm, back)? The location often provides crucial clues about the underlying cause.
#### H3: 2. Character of the Pain: Quality and Descriptors
Use precise language when documenting the quality of pain. Is it sharp, stabbing, crushing, burning, aching, or squeezing? Does it feel like pressure or tightness? These descriptors paint a vivid picture and help differentiate between conditions.
#### H3: 3. Onset and Duration: Timing is Crucial
When did the chest pain begin? Was it sudden or gradual? How long has it lasted? The timing of onset provides valuable clues. For example, sudden onset might suggest a cardiac event, while gradual onset could point towards musculoskeletal issues.
#### H3: 4. Severity: Using a Pain Scale
Quantify the pain using a standardized scale (e.g., 0-10 numeric rating scale). This allows you to objectively measure pain intensity and track changes over time. Remember to ask about the worst pain experienced.
#### H3: 5. Associated Symptoms: The Whole Picture
Don't just focus on the chest pain itself. Explore associated symptoms: shortness of breath (dyspnea), nausea, vomiting, diaphoresis (excessive sweating), dizziness, palpitations, fatigue, cough, or fever. These co-occurring symptoms can significantly impact your differential diagnosis.
#### H3: 6. Aggravating and Relieving Factors: Clues to the Cause
Ask what makes the chest pain better or worse. Does it worsen with activity or improve with rest? Does it respond to medication or specific positions? Identifying these factors can narrow down the possibilities.
#### H3: 7. Past Medical History: Context is Key
A comprehensive past medical history is crucial. Explore the patient's cardiac history (e.g., hypertension, hyperlipidemia, coronary artery disease), pulmonary history (e.g., asthma, COPD), and any prior episodes of chest pain. This provides vital contextual information.
Optimizing Your Shadow Health Performance
Remember, Shadow Health is a learning tool. Don't be afraid to experiment with your questioning techniques. If you miss crucial information, the simulation will often guide you back to the relevant area, enhancing your learning. Pay close attention to the feedback provided after each interaction.
Conclusion
Mastering the subjective assessment of chest pain in Shadow Health requires a structured and methodical approach. By focusing on the seven key areas outlined above, you'll gather comprehensive information, improve your diagnostic reasoning, and significantly enhance your performance within the simulation. Consistent practice and careful attention to detail are key to success.
FAQs
Q1: How can I improve my communication skills within the Shadow Health simulation?
A1: Practice active listening and use open-ended questions to encourage the patient to elaborate. Reflect back what the patient says to ensure understanding.
Q2: What if I miss a crucial piece of information during the subjective assessment?
A2: Shadow Health will often guide you back to gather the missing information. Don't be discouraged; it's part of the learning process.
Q3: Are there specific keywords I should use when documenting my findings?
A3: Use precise medical terminology and avoid jargon. Focus on clarity and accuracy in your documentation.
Q4: How does the subjective assessment influence the objective assessment in Shadow Health?
A4: The subjective findings guide your choices during the objective exam, ensuring you focus on relevant physical examination maneuvers.
Q5: What resources can I use to further enhance my understanding of chest pain assessment?
A5: Consult reputable medical textbooks, online resources, and your course materials for additional information and clarification.
| shadow health focused exam chest pain subjective: Communities in Action National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on Community-Based Solutions to Promote Health Equity in the United States, 2017-04-27 In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome. |
| shadow health focused exam chest pain subjective: Strengthening Forensic Science in the United States National Research Council, Division on Engineering and Physical Sciences, Committee on Applied and Theoretical Statistics, Policy and Global Affairs, Committee on Science, Technology, and Law, Committee on Identifying the Needs of the Forensic Sciences Community, 2009-07-29 Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators. |
| shadow health focused exam chest pain subjective: Oxford Handbook of Clinical Diagnosis Huw Llewelyn, Hock Aun Ang, Keir E. Lewis, Anees Al-Abdullah, 2014 This handbook describes the diagnostic process clearly and logically, aiding medical students and others who wish to improve their diagnostic performance and to learn more about the diagnostic process. |
| shadow health focused exam chest pain subjective: Mental Health for Emergency Departments , 2009 |
| shadow health focused exam chest pain subjective: Fundamental Skills for Patient Care in Pharmacy Practice Colleen Doherty Lauster, Sneha Baxi Srivastava, 2013-03-25 Fundamental Skills for Patient Care in Pharmacy Practice enables students and new pharmacists to master the skills associated with clinical care in either the inpatient or outpatient setting. In accessible steps, this valuable resource provides the tools for gaining medication histories from patients and counseling them on the most effective and safe manner to take medications. Each chapter explores the background and practice of a critical skill, tools that aid in its development and mastery, and tips for success. Students and pharmacists will come away with the knowledge to identify drug-related problems and formulate plans for solutions to these problems. Fundamental Skills for Patient Care in Pharmacy Practice prepares future pharmacists to communicate effectively in verbal and written formats with health professionals and special patient populations as they prepare and present SOAP notes, patient cases, and discharge counseling. |
| shadow health focused exam chest pain subjective: Pain Imaging Maria Assunta Cova, Fulvio Stacul, 2019-03-06 This book addresses all pain imaging aspects related to both the central nervous system and the body (thorax, abdomen and pelvis), thus updating the international literature on the topic. By adopting a clinical-radiological approach and offering a comprehensive differential diagnosis for a number of painful syndromes (many of which can mimic one other), the work aims to support and enhance the diagnostic management of these patients, suggesting the most appropriate diagnostic algorithm. The book is divided into separate sections for each anatomical macro-area, and the chapters cover the respective topics from both clinical and radiological perspectives. Further, the book includes extensive electronic supplementary material. As such, it offers an invaluable tool for radiologists, neuroradiologists and clinicians working in internal medicine, surgery and neurology, and could also be used in residency programs for these groups. |
| shadow health focused exam chest pain subjective: Treatment of Chronic Pain by Interventional Approaches Timothy R. Deer, Michael S. Leong, Asokumar Buvanendran, Philip S. Kim, Sunil J. Panchal, 2014-12-08 From reviews of Deer, eds., Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches: Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches is a major textbook... [I]t should be a part of all departmental libraries and in the reference collection of pain fellows and pain practitioners. In fact, this text could be to pain as Miller is to general anesthesia. Journal of Neurosurgical Anesthesiology Edited by master clinician-experts appointed by the American Academy of Pain Medicine, this is a soft cover version of the Interventional sections of the acclaimed Deer, eds., Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches. It is intended as a primary reference for busy clinicians who seek up-to-date and authoritative information about interventional approaches to treating chronic pain. State-of-the-art coverage of full range of techniques: neural blockades, neurolysis blocks, and neurostimulation Review of clinically relevant anatomy and physiology Key Points preview contents of each chapter |
| shadow health focused exam chest pain subjective: Living Mindfully Across the Lifespan J. Kim Penberthy, J. Morgan Penberthy, 2020-11-22 Living Mindfully Across the Lifespan: An Intergenerational Guide provides user-friendly, empirically supported information about and answers to some of the most frequently encountered questions and dilemmas of human living, interactions, and emotions. With a mix of empirical data, humor, and personal insight, each chapter introduces the reader to a significant topic or question, including self-worth, anxiety, depression, relationships, personal development, loss, and death. Along with exercises that clients and therapists can use in daily practice, chapters feature personal stories and case studies, interwoven throughout with the authors’ unique intergenerational perspectives. Compassionate, engaging writing is balanced with a straightforward presentation of research data and practical strategies to help address issues via psychological, behavioral, contemplative, and movement-oriented exercises. Readers will learn how to look deeply at themselves and society, and to apply what has been learned over decades of research and clinical experience to enrich their lives and the lives of others. |
| shadow health focused exam chest pain subjective: Subjective Lives and Economic Transformations in Mongolia Rebecca M. Empson, 2020-06-01 Almost 10 years ago the mineral-rich country of Mongolia experienced very rapid economic growth, fuelled by China’s need for coal and copper. New subjects, buildings, and businesses flourished, and future dreams were imagined and hoped for. This period of growth is, however, now over. Mongolia is instead facing high levels of public and private debt, conflicts over land and sovereignty, and a changed political climate that threatens its fragile democratic institutions. Subjective Lives and Economic Transformations in Mongolia details this complex story through the intimate lives of five women. Building on long-term friendships, which span over 20 years, Rebecca documents their personal journeys in an ever-shifting landscape. She reveals how these women use experiences of living a ‘life in the gap’ to survive the hard reality between desired outcomes and their actual daily lives. In doing so, she offers a completely different picture from that presented by economists and statisticians of what it is like to live in this fluctuating extractive economy. |
| shadow health focused exam chest pain subjective: Essentials of Interventional Techniques in Managing Chronic Pain Laxmaiah Manchikanti, Alan D. Kaye, Frank J.E. Falco, Joshua A. Hirsch, 2018-01-04 This comprehensive review covers the full and latest array of interventional techniques for managing chronic pain. Chapters are grouped by specific treatment modalities that include spinal interventional techniques, nonspinal and peripheral nerve blocks, sympathetic interventional techniques, soft tissue and joint injections, and implantables. Practical step-by-step and evidence-based guidance is given to each approach in order to improve the clinician's understanding. Innovative and timely, Essentials of Interventional Techniques in Managing Chronic Pain is a critical resource for anesthesiologists, neurologists, and rehabilitation and pain physicians. |
| shadow health focused exam chest pain subjective: Diagnostic Imaging for the Emergency Physician E-Book Joshua S. Broder, 2011-03-15 Diagnostic Imaging for the Emergency Physician, written and edited by a practicing emergency physician for emergency physicians, takes a step-by-step approach to the selection and interpretation of commonly ordered diagnostic imaging tests. Dr. Joshua Broder presents validated clinical decision rules, describes time-efficient approaches for the emergency physician to identify critical radiographic findings that impact clinical management and discusses hot topics such as radiation risks, oral and IV contrast in abdominal CT, MRI versus CT for occult hip injury, and more. Diagnostic Imaging for the Emergency Physician has been awarded a 2011 PROSE Award for Excellence for the best new publication in Clinical Medicine. - Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability. - Choose the best test for each indication through clear explanations of the how and why behind emergency imaging. - Interpret head, spine, chest, and abdominal CT images using a detailed and efficient approach to time-sensitive emergency findings. - Stay on top of current developments in the field, including evidence-based analysis of tough controversies - such as indications for oral and IV contrast in abdominal CT and MRI versus CT for occult hip injury; high-risk pathology that can be missed by routine diagnostic imaging - including subarachnoid hemorrhage, bowel injury, mesenteric ischemia, and scaphoid fractures; radiation risks of diagnostic imaging - with practical summaries balancing the need for emergency diagnosis against long-terms risks; and more. - Optimize diagnosis through evidence-based guidelines that assist you in discussions with radiologists, coverage of the limits of negative or normal imaging studies for safe discharge, indications for contrast, and validated clinical decision rules that allow reduced use of diagnostic imaging. - Clearly recognize findings and anatomy on radiographs for all major diagnostic modalities used in emergency medicine from more than 1000 images. - Find information quickly and easily with streamlined content specific to emergency medicine written and edited by an emergency physician and organized by body system. |
| shadow health focused exam chest pain subjective: Health Literacy in Nursing Terri Ann Parnell, 2014-08-18 Print+CourseSmart |
| shadow health focused exam chest pain subjective: Families Caring for an Aging America National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Care Services, Committee on Family Caregiving for Older Adults, 2016-12-08 Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults. |
| shadow health focused exam chest pain subjective: Differential Diagnosis of Chest Pain Umashankar Lakshmanadoss, 2020-07-01 This book aims to provide an excellent overview of the differential diagnosis and approach to chest pain in various clinical settings. This book is divided into two sections including the introduction and the approach to chest pain. Our introductory chapter starts with the basic principles of statistics and its application in various diagnostic modalities of heart disease. Our authors present a nice approach to patients presenting with chest pain in various scenarios. We have also included a chapter describing GERD, which could present as chest pain and another chapter describing aortic dissection, which is a life-threatening disease presenting with chest pain. We hope that this book will serve as an accessible handbook on the differential diagnosis of chest pain. |
| shadow health focused exam chest pain subjective: Wound Care Carrie Sussman, Barbara M. Bates-Jensen, 2007 Designed for health care professionals in multiple disciplines and clinical settings, this comprehensive, evidence-based wound care text provides basic and advanced information on wound healing and therapies and emphasizes clinical decision-making. The text integrates the latest scientific findings with principles of good wound care and provides a complete set of current, evidence-based practices. This edition features a new chapter on wound pain management and a chapter showing how to use negative pressure therapy on many types of hard-to-heal wounds. Technological advances covered include ultrasound for wound debridement, laser treatments, and a single-patient-use disposable device for delivering pulsed radio frequency. |
| shadow health focused exam chest pain subjective: Geriatric Emergency Medicine Joseph H. Kahn, Brendan G. Magauran (Jr.), Jonathan S. Olshaker, 2014-01-16 This comprehensive volume provides a practical framework for evaluation, management and disposition of this growing vulnerable patient population. |
| shadow health focused exam chest pain subjective: OSCEs for Medical Finals Hamed Khan, Iqbal Khan, Akhil Gupta, Nazmul Hussain, Sathiji Nageshwaran, 2013-01-22 OSCEs for Medical Finals has been written by doctors from a variety of specialties with extensive experience of medical education and of organising and examining OSCEs. The book and website package consists of the most common OSCE scenarios encountered in medical finals, together with checklists, similar to OSCE mark schemes, that cover all of the key learning points students need to succeed. Each topic checklist contains comprehensive exam-focussed advice on how to maximise performance together with a range of ‘insider's tips' on OSCE strategy and common OSCE pitfalls. Designed to provide enough coverage for those students who want to gain as many marks as possible in their OSCEs, and not just a book which will ensure students ‘scrape a pass', the book is fully supported by a companion website at www.wiley.com/go/khan/osces, containing: OSCE checklists from the book A survey of doctors and students of which OSCEs have a high chance of appearing in finals in each UK medical school |
| shadow health focused exam chest pain subjective: The Meaning of Success Jo Bostock, 2014-03-06 The Meaning of Success: Insights from Women at Cambridge makes a compelling case for a more inclusive definition of success. It argues that in order to recognise, reward and realise the talents of both women and men, a more meaningful definition of success is needed. Practical ways of achieving this are explored through interviews with female role models at the University of Cambridge. First-person stories bring alive the achievements and challenges women experience in their working lives, and the effect gender has on careers. The book stimulates a debate about how to bring about a more inclusive working environment. |
| shadow health focused exam chest pain subjective: Point-of-care testing Peter Luppa, Ralf Junker, 2018-07-18 The underlying technology and the range of test parameters available are evolving rapidly. The primary advantage of POCT is the convenience of performing the test close to the patient and the speed at which test results can be obtained, compared to sending a sample to a laboratory and waiting for results to be returned. Thus, a series of clinical applications are possible that can shorten the time for clinical decision-making about additional testing or therapy, as delays are no longer caused by preparation of clinical samples, transport, and central laboratory analysis. Tests in a POC format can now be found for many medical disciplines including endocrinology/diabetes, cardiology, nephrology, critical care, fertility, hematology/coagulation, infectious disease and microbiology, and general health screening. Point-of-care testing (POCT) enables health care personnel to perform clinical laboratory testing near the patient. The idea of conventional and POCT laboratory services presiding within a hospital seems contradictory; yet, they are, in fact, complementary: together POCT and central laboratory are important for the optimal functioning of diagnostic processes. They complement each other, provided that a dedicated POCT coordination integrates the quality assurance of POCT into the overall quality management system of the central laboratory. The motivation of the third edition of the POCT book from Luppa/Junker, which is now also available in English, is to explore and describe clinically relevant analytical techniques, organizational concepts for application and future perspectives of POCT. From descriptions of the opportunities that POCT can provide to the limitations that clinician’s must be cautioned about, this book provides an overview of the many aspects that challenge those who choose to implement POCT. Technologies, clinical applications, networking issues and quality regulations are described as well as a survey of future technologies that are on the future horizon. The editors have spent considerable efforts to update the book in general and to highlight the latest developments, e.g., novel POCT applications of nucleic acid testing for the rapid identification of infectious agents. Of particular note is also that a cross-country comparison of POCT quality rules is being described by a team of international experts in this field. |
| shadow health focused exam chest pain subjective: Crossing the Quality Chasm Institute of Medicine, Committee on Quality of Health Care in America, 2001-07-19 Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change. |
| shadow health focused exam chest pain subjective: Seidel's Guide to Physical Examination - E-Book Jane W. Ball, Joyce E. Dains, John A. Flynn, Barry S. Solomon, Rosalyn W. Stewart, 2017-12-21 - NEW! Emphasis on clinical reasoning provides insights and clinical expertise to help you develop clinical judgment skills. - NEW! Enhanced emphasis on patient safety and healthcare quality, particularly as it relates to sports participation. - NEW! Content on documentation has been updated with a stronger focus on electronic charting (EHR/EMR). - NEW! Enhanced social inclusiveness and patient-centeredness incorporates LGBTQ patients and providers, with special a emphasis on cultural competency, history-taking, and special considerations for examination of the breasts, female and male genitalia, reproductive health, thyroid, and anus/rectum/prostate. - NEW! Telemedicine, virtual consults, and video interpreters content added to the Growth, Measurement, and Nutrition chapter. - NEW! Improved readability with a clear, straightforward, and easy-to-understand writing style. - NEW! Updated drawing, and photographs enhance visual appeal and clarify anatomical content and exam techniques. |
| shadow health focused exam chest pain subjective: Historical Painting Techniques, Materials, and Studio Practice Arie Wallert, Erma Hermens, Marja Peek, 1995-08-24 Bridging the fields of conservation, art history, and museum curating, this volume contains the principal papers from an international symposium titled Historical Painting Techniques, Materials, and Studio Practice at the University of Leiden in Amsterdam, Netherlands, from June 26 to 29, 1995. The symposium—designed for art historians, conservators, conservation scientists, and museum curators worldwide—was organized by the Department of Art History at the University of Leiden and the Art History Department of the Central Research Laboratory for Objects of Art and Science in Amsterdam. Twenty-five contributors representing museums and conservation institutions throughout the world provide recent research on historical painting techniques, including wall painting and polychrome sculpture. Topics cover the latest art historical research and scientific analyses of original techniques and materials, as well as historical sources, such as medieval treatises and descriptions of painting techniques in historical literature. Chapters include the painting methods of Rembrandt and Vermeer, Dutch 17th-century landscape painting, wall paintings in English churches, Chinese paintings on paper and canvas, and Tibetan thangkas. Color plates and black-and-white photographs illustrate works from the Middle Ages to the 20th century. |
| shadow health focused exam chest pain subjective: Genre in a Changing World Charles Bazerman, Adair Bonini, 2009-09-16 Genre studies and genre approaches to literacy instruction continue to develop in many regions and from a widening variety of approaches. Genre has provided a key to understanding the varying literacy cultures of regions, disciplines, professions, and educational settings. GENRE IN A CHANGING WORLD provides a wide-ranging sampler of the remarkable variety of current work. The twenty-four chapters in this volume, reflecting the work of scholars in Europe, Australasia, and North and South America, were selected from the over 400 presentations at SIGET IV (the Fourth International Symposium on Genre Studies) held on the campus of UNISUL in Tubarão, Santa Catarina, Brazil in August 2007—the largest gathering on genre to that date. The chapters also represent a wide variety of approaches, including rhetoric, Systemic Functional Linguistics, media and critical cultural studies, sociology, phenomenology, enunciation theory, the Geneva school of educational sequences, cognitive psychology, relevance theory, sociocultural psychology, activity theory, Gestalt psychology, and schema theory. Sections are devoted to theoretical issues, studies of genres in the professions, studies of genre and media, teaching and learning genre, and writing across the curriculum. The broad selection of material in this volume displays the full range of contemporary genre studies and sets the ground for a next generation of work. |
| shadow health focused exam chest pain subjective: Middle Range Theory for Nursing Mary Jane Smith, PhD, RN, FAAN, Patricia R. Liehr, PhD, RN, 2018-03-10 Three-time recipient of the AJN Book of the Year Award! Praise for the third edition: “This is an outstanding edition of this book. It has great relevance for learning about, developing, and using middle range theories. It is very user friendly, yet scholarly. Score: 90, 4 Stars -Doody's Medical Reviews The fourth edition of this invaluable publication on middle range theory in nursing reflects the most current theoretical advances in the field. With two additional chapters, new content incorporates exemplars that bridge middle range theory to advanced nursing practice and research. Additional content for DNP and PhD programs includes two new theories: Bureaucratic Caring and Self-Care of Chronic Illness. This user-friendly text stresses how theory informs practice and research in the everyday world of nursing. Divided into four sections, content sets the stage for understanding middle range theory by elaborating on disciplinary perspectives, an organizing framework, and evaluation of the theory. Middle Range Theory for Nursing, Fourth Edition presents a broad spectrum of 13 middle range theories. Each theory is broken down into its purpose, development, and conceptual underpinnings, and includes a model demonstrating the relationships among the concepts, and the use of the theory in research and practice. In addition, concept building for research through the lens of middle range theory is presented as a rigorous 10-phase process that moves from a practice story to a conceptual foundation. Exemplars are presented clarifying both the concept building process and the use of conceptual structures in research design. This new edition remains an essential text for advanced practice, theory, and research courses. New to the Fourth Edition: Reflects new theoretical advances Two completely new chapters New content for DNP and PhD programs Two new theories: Bureaucratic Caring and Self-Care of Chronic Illness Two articles from Advances in Nursing Science documenting a historical meta-perspective on middle range theory development Key Features: Provides a strong contextual foundation for understanding middle range theory Introduces the Ladder of Abstraction to clarify the range of nursing’s theoretical foundation Presents 13 middle range theories with philosophical, conceptual, and empirical dimensions of each theory Includes Appendix summarizing middle range theories from 1988 to 2016 |
| shadow health focused exam chest pain subjective: Sophie's World Jostein Gaarder, 2010-07-15 The international bestseller about life, the universe and everything. 'A simply wonderful, irresistible book' DAILY TELEGRAPH 'A terrifically entertaining and imaginative story wrapped round its tough, thought-provoking philosophical heart' DAILY MAIL 'Remarkable ... an extraordinary achievement' SUNDAY TIMES When 14-year-old Sophie encounters a mysterious mentor who introduces her to philosophy, mysteries deepen in her own life. Why does she keep getting postcards addressed to another girl? Who is the other girl? And who, for that matter, is Sophie herself? To solve the riddle, she uses her new knowledge of philosophy, but the truth is far stranger than she could have imagined. A phenomenal worldwide bestseller, SOPHIE'S WORLD sets out to draw teenagers into the world of Socrates, Descartes, Spinoza, Hegel and all the great philosophers. A brilliantly original and fascinating story with many twists and turns, it raises profound questions about the meaning of life and the origin of the universe. |
| shadow health focused exam chest pain subjective: Alternative Medicine for the Elderly P. Cherniack, 2003-04-23 This book on complementary alternative medicine (CAM) for the Elderly provides a critical and objective evaluation of alternative medical therapy for the elderly. The focus on practical aspects such as adverse effects and general risks of various therapeutic methods makes it a valuable reference book for the general practitioner, for geriatricians and professionals within the area of alternative medicine, but also for interested laypeople. In the three sections, Epidemiology, Types of CAM, and Common Medical Problems and CAM, a broad range of issues are covered. They range from drug compliance in elderly people to CAM in the treatment of specific conditions such as pulmonary diseases, arthritis or cancer. The above features and in particular the unbiased approach to discuss the pros and cons of CAM make this publication a must-have for everybody searching for detailed information on alternative medicine for the elderly. |
| shadow health focused exam chest pain subjective: NP Notes ruth McCaffrey, 2017-10-23 Put this handy guide to work in class, in clinical, and in practice. From screening and assessment tools and differential diagnosis through the most commonly ordered drugs and billing and coding, this volume in the Davis Notes Series presents the information you need every day in a pocket-sized resource. |
| shadow health focused exam chest pain subjective: Reflective Practice in Nursing Lioba Howatson-Jones, 2016-02-27 Would you like to develop some strategies to manage knowledge deficits, near misses and mistakes in practice? Are you looking to improve your reflective writing for your portfolio, essays or assignments? Reflective practice enables us to make sense of, and learn from, the experiences we have each day and if nurtured properly can provide skills that will you come to rely on throughout your nursing career. Using clear language and insightful examples, scenarios and case studies the third edition of this popular and bestselling book shows you what reflection is, why it is so important and how you can use it to improve your nursing practice. Key features: · Clear and straightforward introduction to reflection directly written for nursing students and new nurses · Full of activities designed to build confidence when using reflective practice · Each chapter is linked to relevant NMC Standards and Essential Skills Clusters |
| shadow health focused exam chest pain subjective: All Down Darkness Wide Seán Hewitt, 2022-07-14 A luminous memoir from the prize-winning poet - a story of love, heartbreak and coming of age, and a tender exploration of queer identity. 'Beautiful' Colm Tóibín 'Rapturous' New York Times 'Extraordinary' Observer 'Stunning' Sunday Times When Seán meets Elias, the two fall headlong into a love story. But as Elias struggles with severe depression, the couple comes face to face with crisis. Wrestling with this, Seán Hewitt delves deep into his own history, enlisting the ghosts of queer figures and poets before him. From a nineteenth-century cemetery in Liverpool to the pine forests of Gothenburg, Hewitt plumbs the darkness in search of solace and hope. All Down Darkness Wide is a mesmerising story of heartache and renewal, and a fearless exploration of a world that too often sets happiness and queer life at odds. WINNER OF THE ROONEY PRIZE FOR IRISH LITERATURE 2022 'Extraordinarily beautiful... the best new work of non-fiction I've read in years' Sarah Perry 'Rigorous and sensual... Hewitt has forged a life-enhancing memoir' Spectator |
| shadow health focused exam chest pain subjective: The Condition of the Working-Class in England in 1844 Frederick Engels, 2014-02-12 The Condition of the Working Class in England is one of the best-known works of Friedrich Engels. Originally written in German as Die Lage der arbeitenden Klasse in England, it is a study of the working class in Victorian England. It was also Engels' first book, written during his stay in Manchester from 1842 to 1844. Manchester was then at the very heart of the Industrial Revolution, and Engels compiled his study from his own observations and detailed contemporary reports. Engels argues that the Industrial Revolution made workers worse off. He shows, for example, that in large industrial cities mortality from disease, as well as death-rates for workers were higher than in the countryside. In cities like Manchester and Liverpool mortality from smallpox, measles, scarlet fever and whooping cough was four times as high as in the surrounding countryside, and mortality from convulsions was ten times as high as in the countryside. The overall death-rate in Manchester and Liverpool was significantly higher than the national average (one in 32.72 and one in 31.90 and even one in 29.90, compared with one in 45 or one in 46). An interesting example shows the increase in the overall death-rates in the industrial town of Carlisle where before the introduction of mills (1779–1787), 4,408 out of 10,000 children died before reaching the age of five, and after their introduction the figure rose to 4,738. Before the introduction of mills, 1,006 out of 10,000 adults died before reaching 39 years old, and after their introduction the death rate rose to 1,261 out of 10,000. |
| shadow health focused exam chest pain subjective: Handbook of Clinical Diagnostics Xue-Hong Wan, Rui Zeng, 2019-08-26 The book covers basic theories, basic knowledge and basic skills on clinical diagnosis, basic requirements for doctors’ ethical conduct, clinical reasoning and documentation of medical records during the process of making a diagnosis. It consists of six parts, including ‘Symptoms’, ‘History Taking’, ‘Physical Examination’, ‘Supplementary Examination’, ‘Common Clinical Diagnosis Techniques’, and ‘Diagnostic Process and Clinical Reasoning’. A vocabulary index is included for easy reference at the end of the book. This book is compiled by authors of 14 Chinese medical schools and universities, whose years of experience in clinical diagnostics, rich overseas learning and working experiences. This book is included in the first round of English textbooks series for clinical medicine major of China's higher medical colleges; and is among 13th Five-Year planning textbooks of National Health Commission of the People’s Republic of China. It is also an ideal textbook for MBBS (Bachelor of Medicine and Bachelor of Surgery) student It is a co-publication book with People's Medical Publishing House (PMPH). The ISBN of PMPH version in China is 978-7-117-23852-6. |
| shadow health focused exam chest pain subjective: The Relevance of Social Science for Medicine L. Eisenberg, A. Kleinman, 2012-12-06 The central purpose of this book is to demonstrate the relevance of social science concepts, and the data derived from empirical research in those sciences, to problems in the clinical practice of medicine. As physicians, we believe that the biomedical sciences have made - and will continue to make - important con tributions to better health. At the same time, we are no less fIrmly persuaded that a comprehensive understanding of health and illness, an understanding which is necessary for effective preventive and therapeutic measures, requires equal attention to the social and cultural determinants of the health status of human populations. The authors who agreed to collaborate with us in the writ ing of this book were chosen on the basis of their experience in designing and executing research on health and health services and in teaching social science concepts and methods which are applicable to medical practice. We have not attempted to solicit contributions to cover the entire range of the social sciences as they apply to medicine. Rather, we have selected key ap proaches to illustrate the more salient areas. These include: social epidemiology, health services research, social network analysis, cultural studies of illness behavior, along with chapters on the social labeling of deviance, patterns of therapeutic communication, and economic and political analyses of macro-social factors which influence health outcomes as well as services. |
| shadow health focused exam chest pain subjective: Emergency Nursing Made Incredibly Easy! Lippincott Williams & Wilkins, 2014-11-11 Completely revised and updated to reflect the latest guidelines and innovation, Emergency Nursing Made Incredibly Easy!, Second Edition, offers essential information on emergency, trauma, and critical care. Presented in the easy-to-learn and enjoyable Incredibly Easy! format, it covers emergency care basics, including patient assessment and triage, trauma, disease crises, and patient and family communication. It also addresses legal issues such as handling evidence and documentation, and holistic issues such as pain and end-of-life care. Chapters detail emergency nursing by body system and cover shock, multi-system traumas, environmental emergencies, disaster preparedness, communicable diseases, and obstetric and pediatric emergencies. The presentation features light-hearted cartoons and humor, Memory Joggers and other icons, and end-of-chapter review questions. |
| shadow health focused exam chest pain subjective: American Politics Today William T. Bianco, David T. Canon, 2017 The Fifth Edition of American Politics Today is designed to show students the reality of politics today and how it connects to their own lives. New features--from chapter opening cases that address the kinds of questions students ask, to full-page graphics that illustrate key political processes--show students how politics works and why it matters. All components of the learning package--textbook, InQuizitive adaptive learning tool, and coursepack--are organized around specific chapter learning goals to ensure that students learn the nuts and bolts of American government. |
| shadow health focused exam chest pain subjective: Clinical Emergency Medicine Scott C. Sherman, Joseph W. Weber, Michael Schindlbeck, Rahul Patwari, 2014-01-10 Ninety-eight of the chief complaints and disorders you're most likely to encounter in the ED! A clear, concise guide for clinicians new to the Emergency Department A Doody's Core Title for 2015! Written by authors who are practicing emergency physicians and emergency medicine educators, Clinical Emergency Medicine distills the entire content of the emergency medicine curriculum into less than one hundred succinct, clinically relevant chapters. This unique book is intended to guide you through what you must know and be able to do during an actual shift and give you a better understanding of the issues and problems you will face while working in the Emergency Department. Featuring a consistent, find-it-now design, Clinical Emergency Medicine delivers concise, must-know information on ninety-eight chief complaints and disorders, ranging from asthma and chest pain to fever and poisoning. Each chapter begins with Key Points, followed by an Introduction, Clinical Presentation (History and Physical Examination), Diagnostic Studies, Medical Decision Making, Treatment and Disposition, and Suggested Reading. Whenever possible, the authors provide practical advice on drug dosing, the medical decision-making thought process, treatment plans, and dispositions that will be of value in a clinical environment. Numerous diagnostic algorithms simplify the problem and point you towards a solution. Valuable to medical students, physician assistants, nurse practitioners, and junior level residents, Clinical Emergency Medicine teaches you things that may not have been covered in medical or physician assistant school, but have an important bearing on patient outcomes. |
| shadow health focused exam chest pain subjective: Communicating with the Patient Philip Ley, Michael Stanway Spelman, 1967 |
| shadow health focused exam chest pain subjective: The Symbolic Species: The Co-evolution of Language and the Brain Terrence W. Deacon, 1998-04-17 A work of enormous breadth, likely to pleasantly surprise both general readers and experts.—New York Times Book Review This revolutionary book provides fresh answers to long-standing questions of human origins and consciousness. Drawing on his breakthrough research in comparative neuroscience, Terrence Deacon offers a wealth of insights into the significance of symbolic thinking: from the co-evolutionary exchange between language and brains over two million years of hominid evolution to the ethical repercussions that followed man's newfound access to other people's thoughts and emotions. Informing these insights is a new understanding of how Darwinian processes underlie the brain's development and function as well as its evolution. In contrast to much contemporary neuroscience that treats the brain as no more or less than a computer, Deacon provides a new clarity of vision into the mechanism of mind. It injects a renewed sense of adventure into the experience of being human. |
| shadow health focused exam chest pain subjective: Prolo Your Pain Away! Ross A. Hauser, Marion A. Hauser, Kurt Pottinger, 1998 Prolotherapy is a simple, natural and safe technique that stimulates the body's healing mechanisms into growing new ligament and tendon tissue. It provides a permanent cure for many chronic, painful conditions without the complications of surgery or drugs. Prolotheraphy can help or cure the following conditions: low back pain, headaches, migraines, arthritis, fibromyalgia, herniated discs, sciatica, reflex sympathetic dystrophy, sports injuries, post-surgery pain, heel spurs, tennis elbow, and a host of other chronically painful conditions. |
| shadow health focused exam chest pain subjective: Evidence-based Physical Diagnosis Steven R. McGee, 2007 Clinical reference that takes an evidence-based approach to the physical examination. Updated to reflect the latest advances in the science of physical examination, and expanded to include many new topics. |
| shadow health focused exam chest pain subjective: Guidelines on Food Fortification with Micronutrients Richard Hurrell, World Health Organization, 2006 This publication contains practical guidance on the design, implementation and evaluation of appropriate food fortification programmes. They are designed primarily for use by nutrition-related public health programme managers, but should also be useful to all those working to control micronutrient malnutrition, including the food industry.The guidelines are written from a nutrition and public health perspective, and topics discussed include: the concept of food fortification as a potential strategy for the control of micronutrient malnutrition; the prevalence, causes, and consequences of micronutrient deficiencies, and the public health benefits of micronutrient malnutrition control; technical information on the various chemical forms of micronutrients that can be used to fortify foods; regulation and international harmonisation, communication, advocacy, consumer marketing and public education. |
Shadow Health Focused Exam Chest Pain Subjective
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Shadow Health Focused Exam Chest Pain Subjective [PDF]
The final chapter. will summarize the key points that have been discussed throughout the book. The book is crafted in an easy-to-understand language and is complemented by engaging …
Shadow Health Focused Exam Chest Pain Subjective
Pain Imaging Maria Assunta Cova,Fulvio Stacul,2019-03-06 This book addresses all pain imaging aspects related to both the central nervous system and the body (thorax, abdomen and …
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American Academy of Pain Medicine, this is a soft cover version of the Interventional sections of the acclaimed Deer, eds., Comprehensive Treatment of Chronic Pain by Medical, …
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Shadow Health Focused Exam Chest Pain Subjective ... Shadow Health Focused Exam Chest Pain Subjective Strengthening Forensic Science in the United States National Research …
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the fundamentals and more intricate discussions. Shadow Health Focused Exam Chest Pain Subjective [PDF] Decoding Shadow Health Focused Exam Chest Pain Subjective: Revealing …
Focused Exam Chest Pain Shadow Health - archive.ncarb.org
explains the large number of possible causes for chest pain and what type of pain that could signal danger It is an offspring of a previous book by Dr Miller describing chest pain that was …
Shadow Health Focused Exam Chest Pain Subjective
Pain Imaging Maria Assunta Cova,Fulvio Stacul,2019-03-06 This book addresses all pain imaging aspects related to both the central nervous system and the body (thorax, abdomen and …
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Focused Exam Chest Pain Shadow Health: When You Have Chest Pains Gershon M. Lesser,Larry Strauss,1989 Chest Pain of Recent Onset National Institute for Health and …
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Learning Objectives. Learning Activities. Health History. Single Systems. Comprehensive Assessment. Focused Exam: Cough. Focused Exam: Chest Pain. Focused Exam: Abdominal …
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Shadow Health Focused Exam Chest Pain Subjective
shadow health focused exam chest pain subjective copy american academy of pain medicine this is a soft cover version of the interventional sections of the acclaimed deer eds comprehensive …
Shadow Health Focused Exam Chest Pain Subjective [PDF]
The final chapter. will summarize the key points that have been discussed throughout the book. The book is crafted in an easy-to-understand language and is complemented by engaging …
Shadow Health Focused Exam Chest Pain Subjective
Pain Imaging Maria Assunta Cova,Fulvio Stacul,2019-03-06 This book addresses all pain imaging aspects related to both the central nervous system and the body (thorax, abdomen and …
Shadow Health Focused Exam Chest Pain Subjective [PDF]
Shadow Health Focused Exam Chest Pain Subjective [PDF] Understanding the Shadow Health Focused Exam Shadow Health simulations provide invaluable practice for real-world clinical …
Shadow Health Focused Exam Chest Pain Subjective [PDF]
This comprehensive guide dives deep into the crucial elements of a focused exam on chest pain within the Shadow Health platform, providing you with the skills and knowledge to confidently …
Shadow Health Focused Exam Chest Pain Subjective Copy
American Academy of Pain Medicine, this is a soft cover version of the Interventional sections of the acclaimed Deer, eds., Comprehensive Treatment of Chronic Pain by Medical, …
Shadow Health Focused Exam Chest Pain Subjective
Shadow Health Focused Exam Chest Pain Subjective ... Shadow Health Focused Exam Chest Pain Subjective Strengthening Forensic Science in the United States National Research …
Shadow Health Focused Exam Chest Pain Subjective
the fundamentals and more intricate discussions. Shadow Health Focused Exam Chest Pain Subjective [PDF] Decoding Shadow Health Focused Exam Chest Pain Subjective: Revealing …
Focused Exam Chest Pain Shadow Health - archive.ncarb.org
explains the large number of possible causes for chest pain and what type of pain that could signal danger It is an offspring of a previous book by Dr Miller describing chest pain that was …
Shadow Health Focused Exam Chest Pain Subjective
Pain Imaging Maria Assunta Cova,Fulvio Stacul,2019-03-06 This book addresses all pain imaging aspects related to both the central nervous system and the body (thorax, abdomen and …
Shadow Health Focused Exam Chest Pain Subjective (book)
Shadow Health Focused Exam Chest Pain Subjective: Communities in Action National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on …
Shadow Health Focused Exam Chest Pain Subjective …
Shadow Health Focused Exam Chest Pain Subjective is an essential topic that needs to be grasped by everyone, from students and scholars to the general public. This book will furnish …
Shadow Health Focused Exam Chest Pain Subjective Copy
Shadow Health Focused Exam Chest Pain Subjective Strengthening Forensic Science in the United States National Research Council,Division on Engineering and Physical …
Focused Exam Chest Pain Shadow Health - archive.ncarb.org
Focused Exam Chest Pain Shadow Health: When You Have Chest Pains Gershon M. Lesser,Larry Strauss,1989 Chest Pain of Recent Onset National Institute for Health and …
Health Assessment DCETM Learning Objectives - Cloudinary
Learning Objectives. Learning Activities. Health History. Single Systems. Comprehensive Assessment. Focused Exam: Cough. Focused Exam: Chest Pain. Focused Exam: Abdominal …
Shadow Health Focused Exam Chest Pain Objective Data …
a complete set of current evidence based practices This edition features a new chapter on wound pain management and a chapter showing how to use negative pressure therapy on many …
Shadow Health Focused Exam Chest Pain Subjective Full PDF
Are you looking for Shadow Health Focused Exam Chest Pain Subjective PDF? This is definitely going to save you time and cash in something you should think about.
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Shadow Health Focused Exam Chest Pain Subjective Strengthening Forensic Science in the United States National Research Council,Division on Engineering and Physical …
