Chamberlain College of Nursing NR 305 RN HEALTH ASSESSMENT

Week 5 Discussion Video Transcript Video Audio Anne at her desk reviewing a patient chart as she expresses her inner thoughts

Anne: Let’s see… my next patient is Mary. She’s 53, Caucasian, and had a heart attack a year ago. She is being seen today for an exacerbation of COPD. She also has controlled Type II diabetes. She’s had depression that started when she lost her job a year ago. She’s still is unemployed but receiving government checks. But that isn’t enough income for her to live independently. She had to move in with her daughter and son- in-law.

Today her chief complaint is a harsh productive cough and increased shortness of breath. And she’s still smoking, which is upsetting her daughter who has a young child who is bothered by the second-hand smoke.

Anne and Mary in an exam room

Anne: Hi, Mary. How are you feeling today?

Mary: Overall, I feel pretty healthy. I walk for about half an hour every single day. And I’ve been following the diet that the dietician suggested, watching what I eat. I’m proud of the fact that my diabetes has never been better controlled!

Anne: So far, so good. Is there anything that concerns you?

Mary: Yes. Lately I’ve been coughing so hard and having difficulty catching my breath which is causing me to feel like I might be having some twinges in my chest, and I’m scared to death I’m going to have another heart attack. I want to know what more I can do to prevent that from happening again.

Anne: I’d be happy to explore healthy options. To start, I’d like to ask you a few follow- up questions related to the history form you filled out in the waiting room. You’re still smoking?

Mary: (Sigh…) Yes, cigarettes are my one remaining vice. I’ve been smoking over 40 years. My parents smoked and they taught me how to light their cigarettes when I was 12!

Anne: How much are you smoking?

Mary: About a pack a day. That’s 20 cigarettes. I light up first thing in the morning. If I don’t, it’s all I think about. My body craves it. It is just so frustrating, especially since it is upsetting my daughter and son in law so much. I don’t know where I will go if they kick me out of their home.

Anne: I’m sure that is very upsetting to think about, Mary. Let me take a quick listen to you and then we can discuss some options that may be available to you.

Mary: Sure, that would be fine.