Shadow Health Assessment is a course in nursing that helps students to improve their
communication, documentation, and physical assessment skills (Shadow Health, 2021).
Researchers believe that Shadow Health Assessment also plays a critical role in enhancing
nursing students’ reflection and necessary thinking skills (Shadow Health, 2021). Reflection
means the art of analyzing one’s experiences to improve how one work. It is essential for nurses
to have reflection skills as it helps them gain vast experience, gain confidence, and develop self-
awareness (Koshy et al., 2017). Nurses who intend to improve their reflective skills should have
an excellent skillset; description, critical analysis, evaluation, and synthesis skills (Koshy et al.,
2017). Nurses should also demonstrate the ability to take a patient’s comprehensive health
history as it enlightens patients on what is going on in their bodies. Additionally, it predicts what
health issues may affect a patient in the future and keep a track record of medications. This
reflection essay will discuss my experience with the shadow health virtual assignment.

Things that went well and those that did not
In the course of conducting a Gastroesophageal reflux disease assessment without
evidence of esophagitis for Ms. Jones, some things went on well as planned while others went
wrong. For instance, the objective data collection exercise went on well. The assessment
registered an exemplary performance since all sections on the physical examination were gotten
right apart from the shape of the abdomen. The shape of the abdomen was protuberant and not
symmetrical, as the patient noted. However, the issue of education concerning the amount of
soda intake did not go well. In my submission, the patient was not satisfactorily educated about
the impacts of excessive consumption of soda. Shadow Health Assessment;

It was established that there is a need to engage in more subjective data collection as it
yielded the most information. For instance, the question asked in this assessment is, “Have you
been vomiting or feeling nauseated? I think it was effective because it provided more
information concerning the patient’s health. The patient complained of pains after consuming
bigger meals. Ms. Jones also claimed that spicy meals precipitate her symptoms. This
information was very helpful in diagnosing and treating Ms. Jones. Additionally, subjective data
collection techniques enhance accuracy in diagnosis. Read more
The assessment found that Ms. Jones consumes a coke diet daily not knowing that soda is
acidic and can worsen the symptoms of Gastroesophageal reflux disease without evidence of
esophagitis. This would be solved by educating Ms. Jones on the adverse effects of excessive
soda intake and encouraging her to consume a lot of water instead. Moreover, it was found that
more advanced diagnostic techniques that are founded on the present symptoms should be
required. The physical assessment was also found to be necessary as it helps establish precise
planning and education for illness.
Diagnostic tests
Based on the above findings, I would order the following tests. The first test to order is
the PPI trial, which would help me discover GERD signs with no unease signs (Bickley, 2021).
In the event that GERD diagnosis is not deliberated together with a pre-operative assessment for
the non-erosive illness, I would then move to examine the Esophageal PH (Bickley, 2021). The
last test to order is the upper endoscopy, which would play a pivotal role in investigating the
danger associated with Barrett’s esophagus (Bickley, 2021).
Differential diagnosis

The differential diagnosis currently considered is gastritis. Gastritis defines a group of
health conditions characterized by the inflammation of the stomach’s lining (Yang et al., 2019).
The inflammation of gastritis is more often caused by infection, which is similar to the bacterium
that causes stomach ulcers (Yang et al., 2019). The main gastritis symptoms comprise upper
stomach pain, nausea, and vomiting. The diagnosis is not likely as the patient denies nausea and
vomiting. Shadow Health Assessment;

Patient education
The present assessment managed to teach patients on matters of diet and lifestyle
successfully. For instance, the assessment asked Ms. Jones to reduce the amounts of meals she
takes on any typical day, avoid high-fat content, avoid acidic foods that worsen symptoms, and
avoid drinking any fluid other than water during meals (MacFarlane, 2018). There is a need for
the patient to be educated on how to evading lying down, stooping/bending two or three hours
after having a meal. This means that if Ms. Jones had some physical activities to do, she should
be encouraged to do them before meals. If it has to be after meals, then she should do them about
three hours after meals. Shadow Health Assessment;
Prescription
At this point, I would sure prescribe some medications. This is because medications
would have quick action and help neutralize the acids in the body. Alginate acid, Histamine H2
receptor antagonists (H2RAs), and Proton Pump inhibitors (PPI) are examples of medications
that would help neutralize postprandial acid pocket and prevent reflux from getting into the
esophagus (Richter & Rubenstein, 2018). Famoditine would also be an effective drug as it helps
to block the production of stomach acid. Famoditine is administered by mouth twice daily and is taken for two weeks (Richter & Rubenstein, 2018). Omeprazole is yet another medication that is
used to treat heartburn and acid reflux (Richter & Rubenstein, 2018). It is administered in
capsules or delayed-release capsules, preferable in the morning before a meal.
The present assessment demonstrated both sound critical thinking and clinical decision-
making skills. For instance, through critical thinking, I understood that the symptoms exhibited
by Ms. Jones were linked to GERD. Additionally, critical thinking was evident when identifying
the relevant diagnostic tests, including esophageal PH monitoring, PPI trial, and upper
endoscopy. In this assessment, decision-making skills were seen when selecting the most
effective prescription. The choices made include alginate and antacids, H2RAS, and PPI.
Decision-making was also employed when educating the patient on the diet, lifestyle, and the
importance of following prescriptions. Shadow Health Assessment;
In conclusion, nursing students must have excellent reflection and critical thinking skills.
This is because the skills help them gain vast experience, gain confidence, and develop self-
awareness. Objective data collection in the assessment went on well since all sections on the
physical examination were gotten right apart from the shape of the abdomen. However, the issue
of education, particularly on the amount of soda intake, did not go well. The tests conducted in
the assessment include the PPI trial, Esophageal PH examination, and the upper endoscopy. The
assessment taught the patient on matters diet and lifestyle but found it necessary to learn how to
evade lying down, stooping/bending two or three hours after having a meal. Some of the
prescriptions necessary for managing symptoms include Alginate acid, Histamine H2 receptor
antagonists (H2RAs), Famoditine, and Omeprazole. The present assessment indeed demonstrated
both sound critical thinking and clinical decision-making skills.