Essay Sample with the Focused Assessment: Behavioral and Mental Health

Shadow health virtual assessment is an engaging program that allows one to gain experience in the clinical field. The program offers individuals with digital clinical experiences that mimic real-life clinical situations. Therefore, it ensures students can demonstrate their skills in clinical reasoning and improve by interacting with the digital patients. Shadow health virtual assessment offered me a chance to improve my skills in clinical reasoning and gage my abilities in the assessment of patients based on the results of the assessment. I was able to assess Rita and perform various tests on her using medical instruments and use the data gathered to come up with results of the assessment. The program was a great learning experience

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During the assessment, I was able to follow up on the medical history of the patient effectively. Rita had both asthma and diabetes, and she was taking medication for asthma which was only the inhaler which she takes twice each day. I was able to identify that the patient was neglecting medication for her diabetes. At the time of the assessment, the client's blood sugar levels were elevated. She, however, insisted that she was feeling fine. I, therefore, advised her to ensure that she checks her blood sugar at home regularly. The evaluation would ensure that the blood sugars remained at a manageable level and can be treated when the case they are elevated. I was also able to obtain information on the history of diabetes in her family. The advised showed that she was at high risk and needed to check her sugar levels and diet.

Additionally, the physical exam went well. I interacted with the patient and tested various aspects. Using my clinical knowledge and skills, I effectively evaluated the patient's cognitive abilities using follow up questions and tests and conducting an examination of some of the physical aspects of the patient (Dahlin et al., 2014). I was able to establish a good relationship with the patient. The patient trusted me and provided me with information that was as accurate as possible.

However, in the general assessment, I failed in identifying the underlying factors that could be leading to a headache and neck pain. Next time I would ensure I relied on follow up questions that are linked to the symptoms of the patient. The general assessment should have the ability to narrow down the major causes of the symptoms (Dahlin et al., 2014). In my case, however, I did not identify any factors that could have a direct connection with the symptoms of the patient despite allowing me to advise the patient on their diabetic condition.

From the assessment, it was possible that the patient may be experiencing the pain due to the accident. However, other underlying conditions could be leading to the pain, and the accident may only have aggravated the condition (Bickley, 2013). Therefore, further tests need to be carried out to determine the exact cause of the pain.

The questions that yielded the most information were those that were aimed at identifying the medical history of the patient. The medical history reviled that the patient was diabetic and asthmatic and led to follow up questions about the history of diabetes in the patient's family and the medication the patient is taking.

Based on the findings I would order a CT scan head or an MRI head to determine if the patient had incurred head injuries after the fight. Since the patient has diabetes, there is a high risk of hypertension which is a complication (Bickley, 2013). Therefore, the differential diagnosis I am currently considering is hypertension. Meningitis would also be a differential diagnosis based on the neck pains and the headache. The findings would warrant diagnostic tests that include blood culture, imaging which include both CT scans and MRI of the head which may show swelling or inflammation if meningitis is present (LeBlond, 2015). A lumbar puncture would also be a diagnostic factor that I will consider to determine if the patient could have meningitis.

During the interview, I was able to assess the patient based on her medical history. She has diabetes and does not take any medication concerning the ailment. I was able to educate her on the need to constantly monitor her blood sugars at home and the blood pressure. I also advised the patient to check her diet based on the genetic history of diabetes.

I would prescribe painkillers at this point since the cause of the pain has not been ruled out specifically. The painkillers will help ease the pain the patient is experiencing (Bickley, 2013). Since the patient is already taking Tyrol as the painkillers, I would prescribe the same to ease the pain. Additionally, the patient already confirmed that the drugs are effective in easing the pain she is experiencing.

I carefully considered all the symptoms of the patient and carried out a comprehensive assessment of the patients through physical examination. I paid attention to detail symptoms before coming up with conclusions about the condition of the patient (Bickley, 2013). Since the exact condition has not been identified a decision on the medication to be administered cannot be made. As a medic, it is important to ensure that one pays attention to detail to avoid complications that could arise from misdiagnosis (LeBlond, 2015). I, however, need to improve on the interview questions to narrow down the symptoms to a few possible causes.

References

Bickley, L. S. (2013). Bate's guide to physical examination and history taking (11th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.

Dahlin, M. D., Lipscher, R. B., & Wohl, E. (2014). U.S. Patent No. 8,712,791. Washington, DC: U.S. Patent and Trademark Office.

LeBlond, R. F. (2015). DeGowin's diagnostic examination. McGraw-Hill Medical.