1Health history will provide what kind of data for the assessment?
Subjective data
2Clues from the health history will direct the physical assessment to obtain?
Objective data
3What is the purpose of the Health history?
1. Provide subjective database
2. Identify clients strengths
3. Identify Clients health problems, Actual and potential
4. Identify support systems
5. Identify teaching needs, discharge needs, Refferal needs
4Why is family history important?
Helps identify familial or genetically linker disorder
5What should be obtained in a Complete Health History?
Clients name, age, gender, bithdate and place, MArrital status, Race, Religion, Address, Education, occupation, Source on information, who refered the clientm and if they have an advanced directive.
6What would it be called for a reason someone is seeking healthcare
Cheif complaint must use quote marks for this
7What is a genogram?
A concept map of what has happened in the family with health history
8What does psychosocial profile focus on?
Focuses on health promotion protective patterns, and roles and relationships. Such as Healthcare practices, descriptions of a typical day, nutritional assessment, activity and exercise
9What is a review of systems and what does it tell us?
A comprehensive systems head to toe verbal or survey assessment to determine the client's status. Have you had any blurred vision, headaches, ringing in ears?
10What should be included in Past Medical History?
Childhood illnesses, Surgeries, Injuries, hospitalizations, Adults medical problems, Medications, Allergies and reaction, immunizations, travel, and military service
11What is a focused Health History?
Identify why the client is seeking care, Followed by a complete symptom analysis.
12what should be done when setting the scene?
Quiet environment, Provide privacy, Client is confortable and warm and well lit, Explain what your doing, inform them youre taking notes
13Culture and age influences
Make sure there are no cultural considerations that could influence the interaction
14What should you do when documenting findings?
Be accurate and objective, Dont write in complete sentences, Can start with verb, Standard medical abbreviations, Stay away from "Normal" "good", Include pertinent negatives.