Cardiovascular tina jones shadow health Transcript

Cardiovascular tina jones shadow health Transcript

Transcript

Started: Jun 27, 2020 | Total Time:109 min
Your avatar
Hello my name is Danielle I will be your provider today

Greet
06/27/20 3:27 PM CDT
Tina Jones
Hey.
Your avatar
Can you verify your name

Question
06/27/20 3:27 PM CDT
Tina Jones
Tina Jones.
Your avatar
Your date of birth

Question
06/27/20 3:27 PM CDT
Tina Jones
February 17th.
Your avatar
Thank you

Question
06/27/20 3:27 PM CDT
Tina Jones
You’re welcome.
Your avatar
What brings you in today

Question
06/27/20 3:27 PM CDT
Tina Jones
I’ve been noticing my heart seems to be beating too fast every once in a while lately, and it started to worry me. My mom said I should make an appointment. You don’t want to ignore heart stuff, I guess.
Your avatar
I’m sorry to hear you’re experiencing those symptoms, they can be very uncomfortable. I’ll ask you some questions to learn more about your symptoms, and we will try to determine what’s causing you to feel this way

Empathize
06/27/20 3:29 PM CDT
Tina Jones
Thanks for saying that.
Your avatar
When did you first notice these symptoms

Question
06/27/20 3:30 PM CDT
Tina Jones
I think the first time was about a month ago.
Your avatar
What were you doing when you noticed these symptoms (Clarified to What were you doing when you got the palpitations?.)

Question
06/27/20 3:30 PM CDT
Tina Jones
I usually notice them on my way to class in the mornings. My schoolwork has really been picking up and I’ve been drinking energy drinks to help keep me focused during the day, so maybe the caffeine or whatever else is in those things has something to do with it. (Clarified to what I was doing when the palpitations occured.)
Your avatar
How many energy drinks do you drink per day

Question
06/27/20 3:31 PM CDT
Tina Jones
Usually just one in the morning, kind of like some people have a cup of coffee. Some mornings lately I’ve had two, though.
Your avatar
Drinking high levels of caffeine can make you feel stressed or anxious, and can dehydrate you. over time, lots of caffeine can make you experience “crashes” during the day, too. let’s talk about healthy alternatives

Educate
06/27/20 3:33 PM CDT
Tina Jones
Sure, I think I understand what you mean.
Your avatar
How often were you experiencing these symptoms

Question
06/27/20 3:33 PM CDT
Tina Jones
No.
Your avatar
How often do you notice your heart racing fast (Clarified to How often does your heart beat fast?.)

Question
06/27/20 3:33 PM CDT
Tina Jones
It’s been about once a week for the past month. (Clarified to how often my heart beats fast.)
Your avatar
Can you describe it for me (Clarified to What is your heartbeat like?.)

Question
06/27/20 3:34 PM CDT
Tina Jones
It’s usually normal, but it’s way faster during these episodes I’ve been having. (Clarified to what my heartbeat is like.)
Your avatar
How do you feel when your heart is racing fast

Question
06/27/20 3:34 PM CDT
Tina Jones
Well, when my heart starts beating really fast, it just feels like a thumping in my chest. It makes me anxious and uncomfortable.
Your avatar
Is there anything that relieves the fast heartbeat (Clarified to Does anything relieve your symptoms?.)

Question
06/27/20 3:35 PM CDT
Tina Jones
I haven’t tried anything specific, other than just trying to relax and breathe deep. (Clarified to if anything relieves my symptoms.)
Your avatar
Do you take any medications to help you with your symptoms

Question
06/27/20 3:35 PM CDT
Tina Jones
Nope.
Your avatar
What medications are you taking

Question
06/27/20 3:35 PM CDT
Tina Jones
I have a daily inhaler and a rescue inhaler for my asthma.
Your avatar
Are you taking any new medications

Question
06/27/20 3:36 PM CDT
Tina Jones
Yeah, I have a daily inhaler now that I’ve been using.
Your avatar
What’s the name of the medication

Question
06/27/20 3:36 PM CDT
Tina Jones
The daily inhaler is Flovent, and the rescue inhaler is Proventil.
Your avatar
Do you have any new allergies

Question
06/27/20 3:36 PM CDT
Tina Jones
No, not that I know of.
Your avatar
Do you have a history of hypertension

Question
06/27/20 3:37 PM CDT
Tina Jones
…I’ve never been diagnosed with blood pressure problems. But I think it can be on the high side sometimes.
Your avatar
Do you check your blood pressure

Question
06/27/20 3:37 PM CDT
Tina Jones
Only when I’m here at the clinic.
Your avatar
Do you have any health history that would contribute to hypertension (No matching questions found.)

Question
06/27/20 3:38 PM CDT
Your avatar
Do you have diabetes

Question
06/27/20 3:38 PM CDT
Tina Jones
Yeah, I was diagnosed a few years ago.
Your avatar
Do you have high cholesterol

Question
06/27/20 3:38 PM CDT
Tina Jones
I’ve never had it tested. My family has problems with high cholesterol, but I don’t think I do.
Your avatar
Any history of a heart murmur

Question
06/27/20 3:38 PM CDT
Tina Jones
No.
Your avatar
Do you have health insurance

Question
06/27/20 3:39 PM CDT
Tina Jones
I have health insurance through work. To be honest, though, I’m not exactly sure what it covers.
Your avatar
Are you able to afford your Medications

Question
06/27/20 3:41 PM CDT
Tina Jones
It wasn’t the cost that was a problem. I just didn’t like taking it.
Your avatar
What is your access to healthcare

Question
06/27/20 3:42 PM CDT
Tina Jones
I have health insurance through my job, so I can go to the doctor if I need to. It’s always a hassle though, so I try to avoid it unless I really have to like right now.
Your avatar
Do you have anything that stresses you out (Clarified to Are you stressed out?.)

Question
06/27/20 3:44 PM CDT
Tina Jones
Yeah, I’ve been pretty stressed lately. (Clarified to if I am stressed out.)
Your avatar
What are you stressed about

Question
06/27/20 3:44 PM CDT
Tina Jones
School is really busy right now, like I have a lot of projects due all around the same time. And on top of that, I’ve had to cover more at work lately, and I’m in charge of a big project at work, too.
Your avatar
Sounds like you’re working really hard. I’m sorry you’re dealing with so much stress.

Empathize
06/27/20 3:45 PM CDT
Tina Jones
Thanks for understanding.
Your avatar
Tell me about your diet (Clarified to What is your diet like?.)

Question
06/27/20 3:46 PM CDT
Tina Jones
It’s pretty good, I think. I’m not a huge health nut or anything. (Clarified to what my diet is like.)
Your avatar
What are usually eat in a typical day

Question
06/27/20 3:46 PM CDT
Tina Jones
Let’s see . . . a muffin or pumpkin bread for breakfast, a sandwich for lunch, and some kind of meat with a veggie for dinner.
Your avatar
Do you have snacks

Question
06/27/20 3:46 PM CDT
Tina Jones
Yeah, I usually have some snacks during the day.
Your avatar
What type of snacks

Question
06/27/20 3:46 PM CDT
Tina Jones
I try to eat snacks that are kind of healthy like pretzels–sometimes if I’ll treat myself and get french fries, but I try not to do that too often.
Your avatar
Do you exercise

Question
06/27/20 3:47 PM CDT
Tina Jones
I’m pretty exhausted by the end of the day, so I don’t have the energy to do any extra exercise. But I’m on my feet all the time at work so I feel like that’s a little bit of exercise most days at least.
Your avatar
I understand being busy and having very little free time. however, exercise is healthy for you, and can even relieve stress. even small amounts of exercise, such as taking a short walk, can improve your health

Educate
06/27/20 3:49 PM CDT
Tina Jones
Thanks for telling me.
Your avatar
Do you use any recreational drugs

Question
06/27/20 3:49 PM CDT
Tina Jones
No.
Your avatar
Do you use tobacco products

Question
06/27/20 3:49 PM CDT
Tina Jones
No. I think it’s gross.
Your avatar
Do you drink alcohol

Question
06/27/20 3:50 PM CDT
Tina Jones
I do sometimes, yeah, when I go out with my friends.
Your avatar
How often do you drink alcohol

Question
06/27/20 3:50 PM CDT
Tina Jones
No more than once or twice a week, sometimes less.
Your avatar
How much do you drink when you go out

Question
06/27/20 3:50 PM CDT
Tina Jones
Just a few. I’m not a big drinker.
Your avatar
How do you feel overall

Question
06/27/20 3:51 PM CDT
Tina Jones
I’m feeling fine right now, but I wanted to make sure there’s nothing serious going on with my heart.
Your avatar
Do you have any other symptoms

Question
06/27/20 3:51 PM CDT
Tina Jones
I guess when it happens I feel a bit worried, like anxious, but that’s all.
Your avatar
Do you experience any fatigue

Question
06/27/20 3:51 PM CDT
Tina Jones
Yeah, most days I feel pretty exhausted by the end of the day.
Your avatar
Do you have any nausea vomiting

Question
06/27/20 3:51 PM CDT
Tina Jones
I haven’t had thrown up, or even had an upset stomach, in a long time.
Your avatar
Have you noticed any swelling in your legs

Question
06/27/20 3:52 PM CDT
Tina Jones
No, not that I have noticed.
Your avatar
Do you have a family history of heart problems

Question
06/27/20 3:52 PM CDT
Tina Jones
Um, none that I know of. Wait, my Poppa–that’s Mom’s dad–died of a heart attack.
Your avatar
Do you have a family history of heart disease

Question
06/27/20 3:52 PM CDT
Tina Jones
Um, none that I know of. Wait, my Poppa–that’s Mom’s dad–died of a heart attack.
Your avatar
Any family history of high cholesterol

Question
06/27/20 3:53 PM CDT
Tina Jones
Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.
Your avatar
Family history of obesity

Question
06/27/20 3:53 PM CDT
Tina Jones
No, I don’t think so. My brother and my dad are kind of big, but I wouldn’t say they were obese or anything.
Your avatar
Family history of a stroke

Question
06/27/20 3:53 PM CDT
Tina Jones
Yeah, that’s how my Nana died.
Your avatar
Any family history of hypertension

Question
06/27/20 3:53 PM CDT
Tina Jones
We’ve got high blood pressure in our family for sure. Granny, Mom, and Dad had it…and honestly I think my other three grandparents might’ve had issues with that, too.
Your avatar
A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs

Educate
06/27/20 3:55 PM CDT
Tina Jones
Alright, thanks for letting me know.
Your avatar
I am going to examine you now

Question
06/27/20 3:56 PM CDT
Tina Jones
Alright.
Your avatar
Inspected anterior chest wall

Exam Action
06/27/20 3:56 PM CDT
Your avatar
Inspected right side chest wall

Exam Action
06/27/20 3:56 PM CDT
Your avatar
Inspected anterior chest wall

Exam Action
06/27/20 3:56 PM CDT
Your avatar
Inspected left side chest wall

Exam Action
06/27/20 3:56 PM CDT
Your avatar
Inspected anterior chest wall

Exam Action
06/27/20 3:56 PM CDT
Your avatar
Inspected for jugular venous distention: JVP 1 cm above sternal angle

Exam Action
06/27/20 3:56 PM CDT
Your avatar
Inspected fingernails of right hand

Exam Action
06/27/20 3:57 PM CDT
Your avatar
Checked capillary refill in fingernails

Exam Action
06/27/20 3:57 PM CDT
Your avatar
Checked capillary refill in fingernails

Exam Action
06/27/20 3:57 PM CDT
Your avatar
Checked capillary refill in fingernails

Exam Action
06/27/20 3:57 PM CDT
Your avatar
Checked capillary refill in fingernails

Exam Action
06/27/20 3:57 PM CDT
Your avatar
Inspected fingernails of left hand

Exam Action
06/27/20 3:57 PM CDT
Your avatar
Checked capillary refill in fingernails

Exam Action
06/27/20 3:58 PM CDT
Your avatar
Checked capillary refill in fingernails

Exam Action
06/27/20 3:58 PM CDT
Your avatar
Checked capillary refill in fingernails

Exam Action
06/27/20 3:58 PM CDT
Your avatar
Checked capillary refill in fingernails

Exam Action
06/27/20 3:58 PM CDT
Your avatar
Inspected fingernails of right hand

Exam Action
06/27/20 3:58 PM CDT
Your avatar
Inspected legs

Exam Action
06/27/20 3:59 PM CDT
Your avatar
Inspected right leg

Exam Action
06/27/20 3:59 PM CDT
Your avatar
Inspected legs

Exam Action
06/27/20 3:59 PM CDT
Your avatar
Inspected left leg

Exam Action
06/27/20 3:59 PM CDT
Your avatar
Inspected legs

Exam Action
06/27/20 3:59 PM CDT
Your avatar
Inspected right leg for edema: No edema

Exam Action
06/27/20 3:59 PM CDT
Your avatar
Inspected toenails

Exam Action
06/27/20 3:59 PM CDT
Your avatar
Checked capillary refill in toenails

Exam Action
06/27/20 3:59 PM CDT
Your avatar
Checked capillary refill in toenails

Exam Action
06/27/20 3:59 PM CDT
Your avatar
Checked capillary refill in toenails

Exam Action
06/27/20 4:00 PM CDT
Your avatar
Checked capillary refill in toenails

Exam Action
06/27/20 4:00 PM CDT
Your avatar
Checked capillary refill in toenails

Exam Action
06/27/20 4:00 PM CDT
Your avatar
Checked capillary refill in toenails

Exam Action
06/27/20 4:00 PM CDT
Your avatar
Checked capillary refill in toenails

Exam Action
06/27/20 4:00 PM CDT
Your avatar
Checked capillary refill in toenails

Exam Action
06/27/20 4:00 PM CDT
Your avatar
Checked capillary refill in toenails

Exam Action
06/27/20 4:00 PM CDT
Your avatar
Checked capillary refill in toenails

Exam Action
06/27/20 4:00 PM CDT
Your avatar
Inspected legs

Exam Action
06/27/20 4:00 PM CDT
Your avatar
Inspected left leg for edema: No edema

Exam Action
06/27/20 4:00 PM CDT
Your avatar
Palpated temporal arteries: No thrill on either side, 2+ on both sides

Exam Action
06/27/20 4:02 PM CDT
Your avatar
Palpated temporal arteries: No thrill on either side, 2+ on both sides

Exam Action
06/27/20 4:03 PM CDT
Your avatar
Palpated right carotid pulse: No thrill, 2+

Exam Action
06/27/20 4:03 PM CDT
Your avatar
Palpated left carotid pulse: No thrill, 2+

Exam Action
06/27/20 4:03 PM CDT
Your avatar
Palpated chest at PMI: Present at midclavicular line and 5th intercostal space, brisk and tapping, diameter 2 cm

Exam Action
06/27/20 4:04 PM CDT
Your avatar
Palpated right radial pulse: No thrill, 2+

Exam Action
06/27/20 4:05 PM CDT
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Palpated left radial pulse: No thrill, 2+

Exam Action
06/27/20 4:05 PM CDT
Your avatar
Palpated right brachial pulse: No thrill, 2+

Exam Action
06/27/20 4:05 PM CDT
Your avatar
Palpated left brachial pulse: No thrill, 2+

Exam Action
06/27/20 4:05 PM CDT
Your avatar
Palpated right femoral pulse: No thrill, 2+

Exam Action
06/27/20 4:06 PM CDT
Your avatar
Palpated left femoral pulse: No thrill, 2+

Exam Action
06/27/20 4:06 PM CDT
Your avatar
Palpated right popliteal pulse: No thrill, 2+

Exam Action
06/27/20 4:06 PM CDT
Your avatar
Palpated left popliteal pulse: No thrill, 2+

Exam Action
06/27/20 4:06 PM CDT
Your avatar
Palpated right tibial pulse: No thrill, 2+

Exam Action
06/27/20 4:07 PM CDT
Your avatar
Palpated left tibial pulse: No thrill, 2+

Exam Action
06/27/20 4:07 PM CDT
Your avatar
Palpated right dorsalis pedis pulse: No thrill, 2+

Exam Action
06/27/20 4:07 PM CDT
Your avatar
Palpated left dorsalis pedis pulse: No thrill, 2+

Exam Action
06/27/20 4:07 PM CDT
Your avatar
Auscultated right temporal pulse

Exam Action
06/27/20 4:08 PM CDT
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Auscultated left temporal pulse

Exam Action
06/27/20 4:08 PM CDT
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Auscultated right temporal pulse

Exam Action
06/27/20 4:08 PM CDT
Your avatar
Auscultated right carotid pulse

Exam Action
06/27/20 4:12 PM CDT
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Auscultated left carotid pulse

Exam Action
06/27/20 4:12 PM CDT
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Auscultated right carotid pulse

Exam Action
06/27/20 4:12 PM CDT
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Auscultated breath sounds in posterior left upper lobe

Exam Action
06/27/20 4:13 PM CDT
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Auscultated right temporal pulse

Exam Action
06/27/20 4:13 PM CDT
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Auscultated breath sounds in anterior left upper lobe

Exam Action
06/27/20 4:13 PM CDT
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Auscultated breath sounds in anterior right upper lobe

Exam Action
06/27/20 4:13 PM CDT
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Auscultated breath sounds in anterior right middle lobe

Exam Action
06/27/20 4:13 PM CDT
Your avatar
Auscultated breath sounds in anterior left mid-chest (upper lobe)

Exam Action
06/27/20 4:13 PM CDT
Your avatar
Auscultated breath sounds in anterior right lower lobe

Exam Action
06/27/20 4:13 PM CDT
Your avatar
Auscultated breath sounds in anterior left lower lobe

Exam Action
06/27/20 4:14 PM CDT
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Auscultated breath sounds in posterior left lower lobe on side

Exam Action
06/27/20 4:14 PM CDT
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Auscultated breath sounds in posterior left lower lobe near spine

Exam Action
06/27/20 4:14 PM CDT
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Auscultated breath sounds in posterior right lower lobe near spine

Exam Action
06/27/20 4:14 PM CDT
Your avatar
Auscultated breath sounds in posterior right lower lobe on side

Exam Action
06/27/20 4:14 PM CDT
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Auscultated breath sounds in posterior right lower lobe

Exam Action
06/27/20 4:14 PM CDT
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Auscultated aortic area with the bell

Exam Action
06/27/20 4:14 PM CDT
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Auscultated aortic area with the diaphragm

Exam Action
06/27/20 4:14 PM CDT
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Auscultated pulmonic area with the diaphragm

Exam Action
06/27/20 4:15 PM CDT
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Auscultated Erb’s point with the diaphragm

Exam Action
06/27/20 4:15 PM CDT
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Auscultated tricuspid area with the diaphragm

Exam Action
06/27/20 4:15 PM CDT
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Auscultated mitral area with the diaphragm

Exam Action
06/27/20 4:15 PM CDT
Your avatar
Auscultated aorta in abdomen

Exam Action
06/27/20 4:15 PM CDT
Your avatar
Auscultated right renal pulse

Exam Action
06/27/20 4:15 PM CDT
Your avatar
Auscultated left renal pulse

Exam Action
06/27/20 4:15 PM CDT
Your avatar
Auscultated right iliac pulse

Exam Action
06/27/20 4:16 PM CDT
Your avatar
Auscultated left iliac pulse

Exam Action
06/27/20 4:16 PM CDT
Your avatar
Auscultated right femoral pulse

Exam Action
06/27/20 4:16 PM CDT
Your avatar
Auscultated left femoral pulse

Exam Action
06/27/20 4:16 PM CDT
Your avatar
Tested ABI: 141/145 = 0.972

Exam Action
06/27/20 4:16 PM CDT
Your avatar
Performed EKG: Regular sinus rhythm, no ST changes

Exam Action
06/27/20 4:17 PM CDT
Your avatar
Tested ABI: 141/145 = 0.972

Exam Action
06/27/20 4:17 PM CDT
Your avatar
Any family history of high cholesterol

Question
06/27/20 5:40 PM CDT
Tina Jones
Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.
Your avatar
A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs

Educate
06/27/20 5:40 PM CDT
Tina Jones
That makes sense.
Your avatar
Any family history of high cholesterol

Question
06/27/20 5:41 PM CDT
Tina Jones
Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.
Your avatar
A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs

Empathize
06/27/20 5:42 PM CDT
Tina Jones
Thanks for understanding.
Your avatar
Do you know your family history of high blood pressure is a risk for heart disease

Question
06/27/20 5:45 PM CDT
Tina Jones
Yeah, I know.
Your avatar
A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs

Educate
06/27/20 5:45 PM CDT
Tina Jones
Alright, thanks for letting me know.
Your avatar
A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs

Empathize
06/27/20 5:45 PM CDT
Tina Jones
Thanks for saying that.

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