Cardiovascular tina jones shadow health Transcript

Started: Jun 27, 2020 | Total Time:109 min

	Hello my name is Danielle I will be your provider today	Greet 06/27/20 3:27 PM CDT
	Hey.
	Can you verify your name	Question 06/27/20 3:27 PM CDT
	Tina Jones.
	Your date of birth	Question 06/27/20 3:27 PM CDT
	February 17th.
	Thank you	Question 06/27/20 3:27 PM CDT
	You’re welcome.
	What brings you in today	Question 06/27/20 3:27 PM CDT
	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.
	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
	Thanks for saying that.
	When did you first notice these symptoms	Question 06/27/20 3:30 PM CDT
	I think the first time was about a month ago.
	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
	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.)
	How many energy drinks do you drink per day	Question 06/27/20 3:31 PM CDT
	Usually just one in the morning, kind of like some people have a cup of coffee. Some mornings lately I’ve had two, though.
	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
	Sure, I think I understand what you mean.
	How often were you experiencing these symptoms	Question 06/27/20 3:33 PM CDT
	No.
	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
	It’s been about once a week for the past month. (Clarified to how often my heart beats fast.)
	Can you describe it for me (Clarified to What is your heartbeat like?.)	Question 06/27/20 3:34 PM CDT
	It’s usually normal, but it’s way faster during these episodes I’ve been having. (Clarified to what my heartbeat is like.)
	How do you feel when your heart is racing fast	Question 06/27/20 3:34 PM CDT
	Well, when my heart starts beating really fast, it just feels like a thumping in my chest. It makes me anxious and uncomfortable.
	Is there anything that relieves the fast heartbeat (Clarified to Does anything relieve your symptoms?.)	Question 06/27/20 3:35 PM CDT
	I haven’t tried anything specific, other than just trying to relax and breathe deep. (Clarified to if anything relieves my symptoms.)
	Do you take any medications to help you with your symptoms	Question 06/27/20 3:35 PM CDT
	Nope.
	What medications are you taking	Question 06/27/20 3:35 PM CDT
	I have a daily inhaler and a rescue inhaler for my asthma.
	Are you taking any new medications	Question 06/27/20 3:36 PM CDT
	Yeah, I have a daily inhaler now that I’ve been using.
	What’s the name of the medication	Question 06/27/20 3:36 PM CDT
	The daily inhaler is Flovent, and the rescue inhaler is Proventil.
	Do you have any new allergies	Question 06/27/20 3:36 PM CDT
	No, not that I know of.
	Do you have a history of hypertension	Question 06/27/20 3:37 PM CDT
	…I’ve never been diagnosed with blood pressure problems. But I think it can be on the high side sometimes.
	Do you check your blood pressure	Question 06/27/20 3:37 PM CDT
	Only when I’m here at the clinic.
	Do you have any health history that would contribute to hypertension (No matching questions found.)	Question 06/27/20 3:38 PM CDT
	Do you have diabetes	Question 06/27/20 3:38 PM CDT
	Yeah, I was diagnosed a few years ago.
	Do you have high cholesterol	Question 06/27/20 3:38 PM CDT
	I’ve never had it tested. My family has problems with high cholesterol, but I don’t think I do.
	Any history of a heart murmur	Question 06/27/20 3:38 PM CDT
	No.
	Do you have health insurance	Question 06/27/20 3:39 PM CDT
	I have health insurance through work. To be honest, though, I’m not exactly sure what it covers.
	Are you able to afford your Medications	Question 06/27/20 3:41 PM CDT
	It wasn’t the cost that was a problem. I just didn’t like taking it.
	What is your access to healthcare	Question 06/27/20 3:42 PM CDT
	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.
	Do you have anything that stresses you out (Clarified to Are you stressed out?.)	Question 06/27/20 3:44 PM CDT
	Yeah, I’ve been pretty stressed lately. (Clarified to if I am stressed out.)
	What are you stressed about	Question 06/27/20 3:44 PM CDT
	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.
	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
	Thanks for understanding.
	Tell me about your diet (Clarified to What is your diet like?.)	Question 06/27/20 3:46 PM CDT
	It’s pretty good, I think. I’m not a huge health nut or anything. (Clarified to what my diet is like.)
	What are usually eat in a typical day	Question 06/27/20 3:46 PM CDT
	Let’s see . . . a muffin or pumpkin bread for breakfast, a sandwich for lunch, and some kind of meat with a veggie for dinner.
	Do you have snacks	Question 06/27/20 3:46 PM CDT
	Yeah, I usually have some snacks during the day.
	What type of snacks	Question 06/27/20 3:46 PM CDT
	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.
	Do you exercise	Question 06/27/20 3:47 PM CDT
	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.
	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
	Thanks for telling me.
	Do you use any recreational drugs	Question 06/27/20 3:49 PM CDT
	No.
	Do you use tobacco products	Question 06/27/20 3:49 PM CDT
	No. I think it’s gross.
	Do you drink alcohol	Question 06/27/20 3:50 PM CDT
	I do sometimes, yeah, when I go out with my friends.
	How often do you drink alcohol	Question 06/27/20 3:50 PM CDT
	No more than once or twice a week, sometimes less.
	How much do you drink when you go out	Question 06/27/20 3:50 PM CDT
	Just a few. I’m not a big drinker.
	How do you feel overall	Question 06/27/20 3:51 PM CDT
	I’m feeling fine right now, but I wanted to make sure there’s nothing serious going on with my heart.
	Do you have any other symptoms	Question 06/27/20 3:51 PM CDT
	I guess when it happens I feel a bit worried, like anxious, but that’s all.
	Do you experience any fatigue	Question 06/27/20 3:51 PM CDT
	Yeah, most days I feel pretty exhausted by the end of the day.
	Do you have any nausea vomiting	Question 06/27/20 3:51 PM CDT
	I haven’t had thrown up, or even had an upset stomach, in a long time.
	Have you noticed any swelling in your legs	Question 06/27/20 3:52 PM CDT
	No, not that I have noticed.
	Do you have a family history of heart problems	Question 06/27/20 3:52 PM CDT
	Um, none that I know of. Wait, my Poppa–that’s Mom’s dad–died of a heart attack.
	Do you have a family history of heart disease	Question 06/27/20 3:52 PM CDT
	Um, none that I know of. Wait, my Poppa–that’s Mom’s dad–died of a heart attack.
	Any family history of high cholesterol	Question 06/27/20 3:53 PM CDT
	Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.
	Family history of obesity	Question 06/27/20 3:53 PM CDT
	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.
	Family history of a stroke	Question 06/27/20 3:53 PM CDT
	Yeah, that’s how my Nana died.
	Any family history of hypertension	Question 06/27/20 3:53 PM CDT
	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.
	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
	Alright, thanks for letting me know.
	I am going to examine you now	Question 06/27/20 3:56 PM CDT
	Alright.
	Inspected anterior chest wall	Exam Action 06/27/20 3:56 PM CDT
	Inspected right side chest wall	Exam Action 06/27/20 3:56 PM CDT
	Inspected anterior chest wall	Exam Action 06/27/20 3:56 PM CDT
	Inspected left side chest wall	Exam Action 06/27/20 3:56 PM CDT
	Inspected anterior chest wall	Exam Action 06/27/20 3:56 PM CDT
	Inspected for jugular venous distention: JVP 1 cm above sternal angle	Exam Action 06/27/20 3:56 PM CDT
	Inspected fingernails of right hand	Exam Action 06/27/20 3:57 PM CDT
	Checked capillary refill in fingernails	Exam Action 06/27/20 3:57 PM CDT
	Checked capillary refill in fingernails	Exam Action 06/27/20 3:57 PM CDT
	Checked capillary refill in fingernails	Exam Action 06/27/20 3:57 PM CDT
	Checked capillary refill in fingernails	Exam Action 06/27/20 3:57 PM CDT
	Inspected fingernails of left hand	Exam Action 06/27/20 3:57 PM CDT
	Checked capillary refill in fingernails	Exam Action 06/27/20 3:58 PM CDT
	Checked capillary refill in fingernails	Exam Action 06/27/20 3:58 PM CDT
	Checked capillary refill in fingernails	Exam Action 06/27/20 3:58 PM CDT
	Checked capillary refill in fingernails	Exam Action 06/27/20 3:58 PM CDT
	Inspected fingernails of right hand	Exam Action 06/27/20 3:58 PM CDT
	Inspected legs	Exam Action 06/27/20 3:59 PM CDT
	Inspected right leg	Exam Action 06/27/20 3:59 PM CDT
	Inspected legs	Exam Action 06/27/20 3:59 PM CDT
	Inspected left leg	Exam Action 06/27/20 3:59 PM CDT
	Inspected legs	Exam Action 06/27/20 3:59 PM CDT
	Inspected right leg for edema: No edema	Exam Action 06/27/20 3:59 PM CDT
	Inspected toenails	Exam Action 06/27/20 3:59 PM CDT
	Checked capillary refill in toenails	Exam Action 06/27/20 3:59 PM CDT
	Checked capillary refill in toenails	Exam Action 06/27/20 3:59 PM CDT
	Checked capillary refill in toenails	Exam Action 06/27/20 4:00 PM CDT
	Checked capillary refill in toenails	Exam Action 06/27/20 4:00 PM CDT
	Checked capillary refill in toenails	Exam Action 06/27/20 4:00 PM CDT
	Checked capillary refill in toenails	Exam Action 06/27/20 4:00 PM CDT
	Checked capillary refill in toenails	Exam Action 06/27/20 4:00 PM CDT
	Checked capillary refill in toenails	Exam Action 06/27/20 4:00 PM CDT
	Checked capillary refill in toenails	Exam Action 06/27/20 4:00 PM CDT
	Checked capillary refill in toenails	Exam Action 06/27/20 4:00 PM CDT
	Inspected legs	Exam Action 06/27/20 4:00 PM CDT
	Inspected left leg for edema: No edema	Exam Action 06/27/20 4:00 PM CDT
	Palpated temporal arteries: No thrill on either side, 2+ on both sides	Exam Action 06/27/20 4:02 PM CDT
	Palpated temporal arteries: No thrill on either side, 2+ on both sides	Exam Action 06/27/20 4:03 PM CDT
	Palpated right carotid pulse: No thrill, 2+	Exam Action 06/27/20 4:03 PM CDT
	Palpated left carotid pulse: No thrill, 2+	Exam Action 06/27/20 4:03 PM CDT
	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
	Palpated right radial pulse: No thrill, 2+	Exam Action 06/27/20 4:05 PM CDT
	Palpated left radial pulse: No thrill, 2+	Exam Action 06/27/20 4:05 PM CDT
	Palpated right brachial pulse: No thrill, 2+	Exam Action 06/27/20 4:05 PM CDT
	Palpated left brachial pulse: No thrill, 2+	Exam Action 06/27/20 4:05 PM CDT
	Palpated right femoral pulse: No thrill, 2+	Exam Action 06/27/20 4:06 PM CDT
	Palpated left femoral pulse: No thrill, 2+	Exam Action 06/27/20 4:06 PM CDT
	Palpated right popliteal pulse: No thrill, 2+	Exam Action 06/27/20 4:06 PM CDT
	Palpated left popliteal pulse: No thrill, 2+	Exam Action 06/27/20 4:06 PM CDT
	Palpated right tibial pulse: No thrill, 2+	Exam Action 06/27/20 4:07 PM CDT
	Palpated left tibial pulse: No thrill, 2+	Exam Action 06/27/20 4:07 PM CDT
	Palpated right dorsalis pedis pulse: No thrill, 2+	Exam Action 06/27/20 4:07 PM CDT
	Palpated left dorsalis pedis pulse: No thrill, 2+	Exam Action 06/27/20 4:07 PM CDT
	Auscultated right temporal pulse	Exam Action 06/27/20 4:08 PM CDT
	Auscultated left temporal pulse	Exam Action 06/27/20 4:08 PM CDT
	Auscultated right temporal pulse	Exam Action 06/27/20 4:08 PM CDT
	Auscultated right carotid pulse	Exam Action 06/27/20 4:12 PM CDT
	Auscultated left carotid pulse	Exam Action 06/27/20 4:12 PM CDT
	Auscultated right carotid pulse	Exam Action 06/27/20 4:12 PM CDT
	Auscultated breath sounds in posterior left upper lobe	Exam Action 06/27/20 4:13 PM CDT
	Auscultated right temporal pulse	Exam Action 06/27/20 4:13 PM CDT
	Auscultated breath sounds in anterior left upper lobe	Exam Action 06/27/20 4:13 PM CDT
	Auscultated breath sounds in anterior right upper lobe	Exam Action 06/27/20 4:13 PM CDT
	Auscultated breath sounds in anterior right middle lobe	Exam Action 06/27/20 4:13 PM CDT
	Auscultated breath sounds in anterior left mid-chest (upper lobe)	Exam Action 06/27/20 4:13 PM CDT
	Auscultated breath sounds in anterior right lower lobe	Exam Action 06/27/20 4:13 PM CDT
	Auscultated breath sounds in anterior left lower lobe	Exam Action 06/27/20 4:14 PM CDT
	Auscultated breath sounds in posterior left lower lobe on side	Exam Action 06/27/20 4:14 PM CDT
	Auscultated breath sounds in posterior left lower lobe near spine	Exam Action 06/27/20 4:14 PM CDT
	Auscultated breath sounds in posterior right lower lobe near spine	Exam Action 06/27/20 4:14 PM CDT
	Auscultated breath sounds in posterior right lower lobe on side	Exam Action 06/27/20 4:14 PM CDT
	Auscultated breath sounds in posterior right lower lobe	Exam Action 06/27/20 4:14 PM CDT
	Auscultated aortic area with the bell	Exam Action 06/27/20 4:14 PM CDT
	Auscultated aortic area with the diaphragm	Exam Action 06/27/20 4:14 PM CDT
	Auscultated pulmonic area with the diaphragm	Exam Action 06/27/20 4:15 PM CDT
	Auscultated Erb’s point with the diaphragm	Exam Action 06/27/20 4:15 PM CDT
	Auscultated tricuspid area with the diaphragm	Exam Action 06/27/20 4:15 PM CDT
	Auscultated mitral area with the diaphragm	Exam Action 06/27/20 4:15 PM CDT
	Auscultated aorta in abdomen	Exam Action 06/27/20 4:15 PM CDT
	Auscultated right renal pulse	Exam Action 06/27/20 4:15 PM CDT
	Auscultated left renal pulse	Exam Action 06/27/20 4:15 PM CDT
	Auscultated right iliac pulse	Exam Action 06/27/20 4:16 PM CDT
	Auscultated left iliac pulse	Exam Action 06/27/20 4:16 PM CDT
	Auscultated right femoral pulse	Exam Action 06/27/20 4:16 PM CDT
	Auscultated left femoral pulse	Exam Action 06/27/20 4:16 PM CDT
	Tested ABI: 141/145 = 0.972	Exam Action 06/27/20 4:16 PM CDT
	Performed EKG: Regular sinus rhythm, no ST changes	Exam Action 06/27/20 4:17 PM CDT
	Tested ABI: 141/145 = 0.972	Exam Action 06/27/20 4:17 PM CDT
	Any family history of high cholesterol	Question 06/27/20 5:40 PM CDT
	Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.
	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
	That makes sense.
	Any family history of high cholesterol	Question 06/27/20 5:41 PM CDT
	Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.
	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
	Thanks for understanding.
	Do you know your family history of high blood pressure is a risk for heart disease	Question 06/27/20 5:45 PM CDT
	Yeah, I know.
	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
	Alright, thanks for letting me know.
	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
	Thanks for saying that.

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Cardiovascular tina jones shadow health Transcript

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