Management of Endocrine Conditions Maureen Hopkins Shadow health Sick Visit

When talking to the patient, there are many chances to teach them and show understanding. Below are some important chances identified by nursing experts for this patient. A sample response is given for each chance.

Opportunities not found during the interview:

1. Changes in Medication: Mrs. Hopkins mentions changes in her hypothyroidism medicine, but this wasn’t followed up with questions about possible side effects.
Sample Response: “It seems your pharmacy changed how they gave you Synthroid, and even the name and shape of the medicine. While changes like this might save money, it’s important to notice any differences. Some medicines should be taken exactly as prescribed for the best results. If you see changes, ask your pharmacy about them and talk to your doctor.”

2. Exercise: Mrs. Hopkins talks about walking for exercise, but there wasn’t further discussion about her exercise routine.
Sample Response: “It’s good you’re taking walks, but it’s important to exercise more often and at a moderate level. This can really help your health and with managing osteopenia.”

Opportunities followed up during the interview:

3. Hair Loss: Mrs. Hopkins is worried about her recent hair loss, and this was discussed further.
Sample Response: “I’m sorry to hear about your hair loss. It must be frustrating to see changes like this. We’ll look into it more to find out why it’s happening and how we can help.”

4. Fatigue: Mrs. Hopkins mentions feeling unusually tired, and this was addressed.
Sample Response: “It’s concerning to hear about your fatigue. It can be tough to feel tired all the time. Let’s talk more about it to figure out what’s causing it and how we can improve your energy levels.”

During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A Model Statement is provided as an example of an appropriate response to each opportunity.

Opportunities marked as Not Encountered are opportunities that were not elicited in the interview
Opportunities marked as Not Followed Up are missed opportunities that were present in the interview, but where no statements were made
Opportunities marked as Followed Up were followed up by students, and include the dialogue between student and patient

NURS 6512N Week 3 – Rachel Adler Conversation Concept Lab Shadow Health

1 Medication Changes

Not Followed Up

	Description: Mrs. Hopkins reports recent changes to her hypothyroidism medication.
	Have you had changes in your mouth and throat?	Question 05:40 PM EDT
	Hm . . . well, I did notice a while back that my Synthroid looked different when I picked it up from the pharmacy. It was a sort of oblong pill shape, whereas it’s usually circular. And the pill bottle read “levothyroxine sodium,” instead of “Synthroid” like usual.
	Have you had changes in frequency of urinating?	Question 05:41 PM EDT
	Hm . . . well, I did notice a while back that my Synthroid looked different when I picked it up from the pharmacy. It was a sort of oblong pill shape, whereas it’s usually circular. And the pill bottle read “levothyroxine sodium,” instead of “Synthroid” like usual.
	Any pain when urinating? (Clarified to: Do you have trouble urinating?)	Question 05:41 PM EDT
	I haven’t had any issues in the bathroom or the like. [AUDIO COMING SOON] (Clarified to: if I have trouble urinating)
	Do you experience pain when moving? (Clarified to: Does it hurt to walk?)	Question 05:43 PM EDT
	Model Statement: “It sounds like your pharmacy has made some changes in how they’ve dispensed your Synthroid medication and have changed the name and shape of the medication. While pharmacies sometimes make medication changes from brand name to generic to save you money, you should be on the lookout for any changes to the name, shape, and color, as some medications need to be dispensed as written to achieve the best health outcomes. If you notice changes to your medication, ask your pharmacy about them before you leave the pharmacy, and check in with your primary care provider.”

2 Exercise

Not Followed Up

	Description: Mrs. Hopkins reports walking for exercise.
	Do you experience pain when moving? (Clarified to: Does it hurt to walk?)	Question 05:43 PM EDT
	No, not at all. I like walking. (Clarified to: if it hurts to walk)
	Have you had headaches?	Question 05:46 PM EDT
	I haven’t had any headaches. [AUDIO COMING SOON]
	Have you had changes in appetite?	Question 05:46 PM EDT
	My appetite’s the same as it usually is. [AUDIO COMING SOON]
	Model Statement: “It’s great that you are taking a walk once a week for exercise, especially given the positive effects this can have on your health. However, you are not currently exercising at the recommended frequency or intensity for health maintenance. Exercising more often and at a moderate, but manageable, intensity can have positive effects on your overall health and aid the management of your osteopenia.”

3 Hair Loss

Followed Up

	Description: Mrs. Hopkins reports frustration with her recent hair loss.
	What brings you to he clinic today?	Question 11:22 PM EDT
	I came in because I’ve been really tired lately. And I’ve had some hair loss. Neither of which are really normal for me.
	am sorry to hear this	Empathize 11:22 PM EDT
	Thank you.
	Model Statement: “I’m sorry to hear that you have been experiencing hair loss. It sounds like it has been disturbing and frustrating to look in the mirror and not see your usual self. We are going to investigate more into your signs and symptoms to determine the underlying causes of your hair loss and how we might address it.”

4 Fatigue

Followed Up

	Description: Mrs. Hopkins reports feeling abnormally fatigued recently.
	What aggravates your fatigue	Question 11:33 PM EDT
	I don’t think anything makes it worse — it’s more just a steady tiredness that lasts all day.
	How has these affected your daily activities? (Clarified to: How has your fatigue made it difficult to do things?)	Question 11:35 PM EDT
	It hasn’t — I can still perform my daily activities. (Clarified to: how my fatigue has made it difficult to do activities)
	that’s great	Empathize 11:36 PM EDT
	Thank you, dear.
	Model Statement: “I’m sorry to hear you have been feeling fatigued recently. It can be very frustrating to feel like you’re moving slower and having lower energy levels to complete your daily activities. Let’s discuss your symptoms of fatigue more thoroughly so we can determine possible causes and how best to address them moving forward.”

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