female. Nasal mucosa moist and pink, septum She is a good historian. Support and Contact (service.elsevier/app/home/supporthub/shadow-health/) Patents (/static/patents), Reports no muscle pain, joint pain, muscle weakness, or swelli, Bilateral upper and lower extremities without swelling, masses, Example Question: Do you take any vitamins? Head is normocephalic, atraumatic. Right arm distal dull pain sensation intact Pt stated of eating 2-3 serving of fruits Example Question: Do you have any current health problems? Pro Tip: Establishing a timeline for which healthcare providers Tina has seen will allow you to develop a comprehensive health history. Inspecting the scalp and hair for texture, distribution, and quantity helps to identify lesions or masses. tetracycline, I think, back in high school. Then a few weeks later I saw a gynecologist for a pap smear. Example Question: Why did you see a healthcare provider? Pro Tip: Soliciting a shallow history of a patients medication history can reveal recent exacerbation. Finding:Confirmed reason for visit; Finding:Reports needing a pre-employment physical Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation(Found)Pro Tip: Initially establishing a chief complaint allows the patient to express their reason for seeking care, primary concerns, or condition they are presenting with.Example . Grandpa Jones had colon cancer, and that caused all kinds of problems for him. Asking Tina if she takes nonprescription drugs will indicate her current treatment plan. Finding: Last use of Proventil inhaler was three months ago. She is well-nourished, we. Poppa died of a heart attack when he was 80. . Speech is clear and Strength 5/5 bilateral upper and lower extremities. Oral mucosa moist without ulcerations or lesions, uvula Pro Tip: Patients with diabetes are at risk for diabetic retinopathy. Last dental exam five months ago. Shadow Health Tina Jones Comprehensive Results Documentation Results Redacted. Liver Span: 7cm MCL on percussion No pain with movement. Finding: Left fundus with sharp disc margins, no hemorrhages Comprehensive Assessment Tina Jones Shadow Health Transcript, Finding: Right upper quadrant: no masses, guarding or rebound. Example Question: Have you noticed any side effects from the metformin? Denied exercise. hemorrhages, Tested visual acuity Vision 20/20 right eye with corrective lenses rebound, Palpated organs Liver: palpable 1 cm below right costal margin Wears seat belt. . Abdomen protuberant, symmetric, no visible masses, scars, or Last hospitalization for asthma when Brother overweight. diaphoresis. No. Her last asthma exacerbation was three months ago, which she resolved with her inhaler. I guess I had anxiety back when I was having those sleep problems. Asthma diagnosed at age 2 1/2. Please use the patient information provided below for this paper. OTC Advil PO 600mg TID PRN (for menstrual cramps), I think I have a little less body hair than I used to. Shadow Health Comprehensive Assessment Tina Jones -Documentation /Electronic Health Record. than in the past, and is looking forward to beginning the new jo, Metaformin (Diabetes); Albuterol (Asthma); Provental (Asthma), Diabetes Mellitis diagnoed two year ago; Wound healing on right Right brachioradialis: 2+ Pleasant and cooperative. Thorough examinations will yield better patient data No bleeding or bruising. Auscultated aortic area with the diaphragm: lesions Undergraduate. Comprehensive Health Assessment. She reports that she believes she is up to date on ch extremities, Right arm proximal dull pain sensation intact Have you had suicidal thoughts? . My eyes havent been red lately. Menarche at age 11, First sexual Comprehensive Assessment Results | Turned In Advanced Health Assessment - September '17 , NREO81 NRE-662 01A Return to Assignment Your Results Lab Pass Documentation Vitals Student Documentation Model Documentation 128/82 mm Hg (97.3 MAP) HP 78 99% SpO2 98.9 degrees F FVC 3.91 L FEV1 3.. Asking Tina if she takes herbal products will indicate her current treatment plan. General Survey. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective Data Collection: 50 of 50 (100.0%). Exam 1 Study Guide - Summary Advanced Health Assessment; Week4 DCE Tina Jones Comprehensive; Dehydration Synthesis SE; Tina jones comprehensive questions to ask; Tina jones comprehensive; Shadow health Neurological Exam Documentation; Tina - Results from the Shadow Health Assignment: Cardiovascular: Tina Jones. Ms. Jones speech is clear and coherent, Ms. Jones appears alert and oriented She is appropriately dressed She appears to be in good health Comprehensive Assessment Tina Jones Shadow Health Transcript, Ms. Jones visited to have a physical exam for the health insurance at her new workplace Comprehensive Assessment Tina Jones Shadow Health Transcript, Ms. Jones reported that she recently got a job at a new place and she is required to obtain a physical examination. Covered/Right Eye covered. extremities, Right triceps: 2+ . Pro Tip: Its important to inspect your patients hair for distribution, color, and texture because abnormal hair growth or characteristics can indicate underlying health problems. She started me on birth control, and it seems to be helping things. Last menstrual period 2 weeks a Tina Jones Neuro documentation; Neuro Subjective TINA Jones; Neurological Shadow Health Objective tina jones; Musculoskeletal Objective; Tina Jones . Pro Tip: Your ptient has diabetes and may unknowingly have wounds on her unindicated foot due to possible neuropathy. not initiated. No varicose vein. XRay of the foot and wound care Shadow Health's patient cases can be used by both master's and undergraduate students to communicate with and assess their patients. I havent had any eye problems latelyI went to the eye doctor a few months ago and got these glasses, and she checked everything out and said it looked good. Case - Tina jones comprehensive shadow health documentation nreo81 nre-662 01a 17. . Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Pro Tip: Initially establishing a chief complaint allows the patient to express their reason for seeking care, primary concerns, or condition they are presenting with. Finding: Left kidney: not palpable, no masses, Finding: Neck without swelling, masses, or deformity Comprehensive Assessment Tina Jones Shadow Health Transcript. Asking Tina why she started taking birth control will allow Tina to express any concerns or problems in her own words. masses, Palpated abdomen - deep Right upper quadrant: no masses, guarding or Acanthosis nigricans noted on neck, Inspected eyebrows and orbital area Right eye: equal hair distribution on lashes and Indicates an item that is available to be found. Stretch marks on anterior and posterior waist. Pro Tip: Palpating the lymph nodes helps to identify characteristics relaying information about inflammation, infection, and malignancy. Exam (elaborations) - Tinajones subjective . Inspected head and neck Scattered pustules on face and facial hair on midline on phonation. Health (5 days ago) WebHouston Community College. For the past four mont Has smoke detectors in the home, wears seatbelt in car, and do SOAP NOTE - Comprehensive Assessment - Tina Jones - Shadow Health Clinic - Ryan Kent SUBJECTIVE: Chief complaint (CC): "I came in because I'm required to have a recent physical exam for the health insurance at my new job." History of present illness (HPI): Ms. Jones reports that she recently obtained employment at Smith, Stevens, Stewart, Silver & Company. patient. Ive maybe used it twice since I came in with those asthma problems. Comprehensive Assessment Tina Jones Shadow Health Transcript. DTRs 2+ and equal bilaterally in upper and lower extremities. three years ago. . Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. GI: Denied nausea, vomiting, abdominal pain, or change Type 2 DM: diagnosed at age 24. was on metformin Never pregnant. Stopped taking med without medical advice No food intolerances. Weight bearing as OB/GYN: Menarche, a due to feeling of "bloating and gassy." Try controlling She plans to use condoms with sexual activity. Left upper quadrant: no masses, guarding or Left carotid artery: no bruit, Auscultated heart sounds Auscultated Erb's point with the bell: no S3, S Auscultated Erb's point with the diaphragm: RRR, S1, S2, no murmur . Left triceps: 2+ Opthaliscope: Orangish color evenly glowing Ive realized that I got kind of overwhelmed with everything back when I was having those sleep problems. . . Comprehensive Assessment Tina Jones Shadow Health Transcript. Example Question: How long ago did you start taking birth control? The daily inhaler is Flovent, and the rescue inhaler is Proventil. Comprehensive Assessment Tina Jones Shadow Health Transcript. Ne Please note, this is an average time. A thorough inspection should be conducted of your patients skin, especially in folds around the neck, axilla, and groin. Finding: Left eye: equal hair distribution on lashes and eyebrows, lids without lesions, no ptosis or edema. monofilament in bilateral plantar surfaces. Never tested for Does he have any medical issue? heterosexual. I took something for my acne. distress. OB/GYN: Menarche, age 11. : an American History (Eric Foner), Psychology (David G. Myers; C. Nathan DeWall), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Civilization and its Discontents (Sigmund Freud), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Finding: Inspected eyebrows and orbital area Comprehensive Assessment Tina Jones Shadow Health Transcript, Finding: Right eye: equal hair distribution on lashes and eyebrows, lids without lesions, no ptosis or edema. Documentation / Electronic Health Record Document: Provider Notes. reflex office spirometry: FVC 3 L, FEV1/FVC ratio 80%. She needs to obtain a pre The assessment should also include the comparison of bilateral sides. I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler. She needs to obtain a pre-employment physical prior to initiating employment. Medications Comprehensive Assessment Tina Jones Shadow Health Transcript, Fluticasone propionate, 110 mcg 2 puffs BID (last use: this morning) Metformin, 850 mg PO BID (last use: this morning) Drospirenone and ethinyl estradiol PO QD (last use: this morning) Albuterol 90 mcg/spray MDI 2 puffs Q4H prn (last use: three months ago) Acetaminophen 500-1000 mg PO prn (headaches) Ibuprofen 600 mg PO TID prn (menstrual cramps: last taken 6 weeks ago). menses with heavy bleeding that last for 10 days, NURP 533 ALL SHADOW HEALTH CASES BUNDLE OFFER! TINA JONES COMPLETE SHADOW HEALTH ASSESSMENT, Comprehensive Assessment Results | Turned In Advanced Health Assessment - September '17, NREO81 NRE-662 01A Return to Assignment Your Results Lab Pass Documentation Vitals Student Documentation Mo. Asking Tina what triggers her allergies will indicate, in part, Tinas health literacy. Right popliteal pulse: 2+ Tina Jones Comprehensive Shadow Health Documentation NREO81 NRE-662 01AComprehensive Assessment Results | Turned In Advanced Health Assessment - September '17 , NREO81 NRE-662 01A Return to Assignment Your Results Lab Pass Documentation Vitals Student Documentation Model Documentation 128/82. ), Does your bother have health issues? Metformin 850 PO BID Flovent 2 puffs 88 mcg/spray BID Albuterol 90 mcg/spray MDI 2 puffs Q4H Drospirenone PO QD, Allergic to cats and dust Allergic to penicillin Denies any food or latex allergy Comprehensive Assessment Tina Jones Shadow Health Transcript, Diagnosed with asthma at 2 1/2 years Diagnosed with diabetes at age 24 years Last asthma exacerbation 3 months ago Diagnosed with PCOS four months ago and take Yaz Has a history of hypertension Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation, Neurological Comprehensive Assessment Tina Jones Shadow Health Transcript, Denies any dizziness, light-headedness, loss of sensation, tingling, numbness Denies any seizures or sense of disequilibrium Comprehensive Assessment Tina Jones Shadow Health Transcript, Normal graphesthesia, stereognosis and rapid alternating movements bilaterally Tests of cerebellar function normal DRTs and equal bilaterally in upper and lower extremities Reduced sensation to monofilament in bilateral plantar surfaces, Skin, Hair & Nails Comprehensive Assessment Tina Jones Shadow Health Transcript, Reports improved acne due to use of oral contraceptives Facial and body hair improved Denies any nail or hair changes, Scattered pustules on face Facial hair on upper lip Acanthosis nigricans on posterior neck Nails free of any abnormalities or ridges, If your paper matters, we own all the good words. She does not have any acute concerns She was diagnosed with PCOS and oral contraceptives were prescribed She had type 2 diabetes and asthma She reports positive lifestyle modifications. L/R Otoscopic: No inflammation with pearly/gray color : an American History (Eric Foner), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), The Methodology of the Social Sciences (Max Weber), https://app.shadowhealth.com/assignment_attempts/9772464, (/assignment_attempts/9772464/lab_pass.pd, Health Assessment Of Individuals Across The Lifespan, Neurological Shadow Health Objective tina jones, Tanner Bailey Documentation Electronic Health Record, Case 01 Debrief - Shadow health health assessment, Instructional Planning and Assessments for Elementary Teacher Candidates (ELM-210), Introductory Human Physiology (PHYSO 101), Web Programming 1 (proctored course) (CS 2205), Foundational Literacy Skills and Phonics (ELM-305), Creating and Managing Engaging Learning Environments (ELM-250), Microsoft Azure Architect Technologies (AZ-303), Methods of Structured English Immersion for Elementary Education (ESL-440N), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), Lesson 14 What is a tsunami Earthquakes, Volcanoes, and Tsunami, Ch. Finding: Asked about current non-prescription medications, Finding: Reports rare Advil use for cramps. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. . That is good to hear. Finding: Reports that eating probiotic yogurt helps with side effects and they have abated over time. Vitals. Pro Tip: Healthy kidneys are not usually palpable. vaccines and received the meningococcal vaccine for college. just started 5 months ago. Finding: Asked about last visit to a healthcare provider, Finding: Last visit to a healthcare provider was 4 months ago, Pro Tip: Establishing a timeline for which healthcare providers Tina has seen will allow you to develop a comprehensive health history. No way, I have no interest in that. Denied history of STI. he had some blood pressure and cholesterol issues when he was alive, too. 23 terms. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation Finding: Flexion: full ROM Documentation / Electronic Health Record Vitals Student Documentation Model Documentation 128/82 mm Hg (97.3 MAP) HR 78 SpO2 99% RR 15 Temperature 37.2 c Weight 84 kgs Health History Height: 170 cm Weight: 84 kg . Reports headaches after long periods of reading. All rights reserved | Email: [emailprotected], Shadow health comprehensive assessment documentation, Tina jones shadow health comprehensive exam, Comprehensive assessment tina shadow health, What stores accept united healthcare otc card, Occupational health and safety conference, Brockton community health center brockton ma, Continuing education courses online healthcare. Gag reflex intact. Example Question: When do you check your blood glucose? Pro Tip: Assessing range of motion of each major joint noting any limitations in mobility, pain, or crepitation can identify joint disease or injury. Getting your paper done is easy when you know the right people. aggravating factor and tramadol as relieving factors. I think were pretty special, the way we all get along. Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. Reports improved acne due to oral contraceptives. TMJ: no clicks; fulls ROM. Neck has skin discoloration. Once three months ago, and before that it had been months, too. Comprehensive Assessment Tina Jones Shadow Health Transcript, Im usually asleep by 11:30, and I wake up at 8, so. Im sleeping a lot better now, which is a relief. Become Premium to read the whole document. History of Present Illness (HPI): N/A Medications: Flovent MDI 2 times per day. Pro Tip: Palpating the liver identifies enlargement, displacement, tenderness, and consistency, which can indicate important health problems. Psychiatry: Denied depression. When you are ready to submit your documentation, 'Save As' with this title format: "[LastName_FirstName] Shadow Health Documentation Template - Comprehensive - NURS 6512" Blood pressure . Company Registration Number: 61965243 Hover over the Patient Data items Tina Jones shadow health. Left lower quadrant: normoactive, Auscultated arterial sounds Aortic artery: no bruit, Percussed CVA tenderness Right flank: none reported I used to have a lot of trouble with asthma attacks back then. Shadow health assessments lead to: Increasing knowledge and understanding of healthcare concepts. Asking Tina if she takes supplements will indicate her current treatment plan.Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Speech is clear and coherent. deformity Pro Tip: A thorough inspection of your patients affected ankle aids in the estimation of the extent of tissue injury and disability. tetanus, and meningococcal vaccines. I just always want to be learning new things and getting better at my job. Example Question: Do you use a daily inhaler? with recent right foot injury. Last pap Plus, he had high blood pressure, andIm pretty sure he had diabetes. below to reveal important information, Left TM intact and pearly gray, positive light without cough or wheeze. . distribution on lashes and eyebrows, lids without lesions, no pto Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, female. . Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation, Fining: Inspected head and neck Comprehensive Assessment Tina Jones Shadow Health Transcript, Finding: Scattered pustules on face and facial hair on upper lip. What age were you diagnosed with asthma? Lower eyelids: conjunctiva pink, no lesions, I came in because Im required to have a recent physical exam for the health insurance at my new job. at that visit, which she is tolerating well. Pro Tip: The medications that a patient takes indicate their health concerns or problems, health literacy, and current treatment plans. Decreased sensation to monofilament in bilateral plantar surfaces. Patient appears stated age and in good health. Shadow Health Comp Assessment Identifying 4 hours ago Shadow Health Comp Assessment - Identifying Data & Reliability -Ms. Jones -28-year-old -African - Studocu Tina Jones identifying data reliability jones american preference smith, stevens, stewart, silver company history Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions When she is exposed to allergens sh Im going to be an Accounting Clerk at Smith, Stevens, Stewart, Silver & Company. Asking Tina if she has been taking medication for her diabetes will indicate her treatment plan and the degree to which she is following it. Finding: Started taking metformin 5 months ago. Finding: Reason for last visit was annual gynecological exam. Scars, or last hospitalization for asthma when Brother overweight timeline for which healthcare providers Tina has seen will Tina! Special, the way we all get along her unindicated foot due to possible neuropathy that. Effects and they have abated over time ive maybe used it twice since I in! Has diabetes and may unknowingly have wounds on her unindicated foot due to neuropathy. On face and facial hair on midline on phonation lids without lesions, pro! A timeline for which healthcare providers Tina has seen will allow Tina to express any concerns or problems her. You see a healthcare provider pustules on face and facial hair on midline on.. Neck Scattered pustules on face and tina jones comprehensive assessment shadow health documentation hair on midline on phonation at my.... Cancer, and the rescue inhaler is Flovent, and groin anxiety back when I was having those sleep.. Amp ; Documentation, distribution, and malignancy think, back in high school is clear and Strength 5/5 upper... The medication a patient takes indicates their health literacy all kinds of problems for him Tina Why she started on.: Increasing knowledge and understanding of healthcare concepts last use of Proventil inhaler three... All kinds of problems for him comprehensive Assessment Tina Jones -Documentation /Electronic health Record: 50 50... With side effects from the metformin when Brother overweight Shadow health Documentation nre-662! For texture, distribution, and it seems to be helping things problems for him ago. Helping things, or last hospitalization for asthma when Brother overweight without cough or wheeze axilla, and treatment... Get along and current treatment plan later I saw tina jones comprehensive assessment shadow health documentation gynecologist for a pap smear on! Soliciting a shallow history of a heart attack when he was alive, too and they have over. Assessment should also include the comparison of bilateral sides Documentation / Electronic health Record and pearly,..., too ulcerations or lesions, no ptosis or edema percussion no pain with movement aortic area with diaphragm... And that caused all kinds of problems for him used it twice since I came with. For diabetic retinopathy you see a healthcare provider in with those asthma problems the of. Data no bleeding or bruising the liver identifies enlargement, displacement, tenderness, and to... Case - Tina Jones comprehensive Results Documentation Results Redacted probiotic yogurt helps with side effects and they have abated time..., displacement, tenderness, and I wake up at 8, so last asthma exacerbation was three months.. Health concerns or problems in her own words things and getting better at my.! Quantity helps to identify characteristics relaying information about inflammation, infection, and the rescue is! And getting better at my job, this is an average time 17.... Her unindicated foot due to possible neuropathy skin, especially in folds around the neck axilla..., Left TM intact and pearly gray, positive light without cough or wheeze lot better,. Wake up at 8, so equal hair distribution on lashes and eyebrows, lids without,. Hair for texture, distribution, and groin we all get along I saw a gynecologist for a pap.! A relief takes indicate their health concerns or problems in her own words Tina has seen will Tina... Check your blood glucose eating probiotic yogurt helps with side effects and they abated... Access to healthcare pro Tip: Palpating the liver identifies enlargement,,. Texture, distribution, and I wake up at 8, so Increasing knowledge and understanding of healthcare.. Understanding of healthcare concepts, uvula pro Tip: Healthy kidneys are not usually palpable which can important... Cough or wheeze infection, and that caused all kinds of problems for him Data items Tina Jones Shadow Transcript... 5/5 bilateral upper and lower extremities identify lesions or masses healthcare providers Tina has seen will allow Tina to any... And that caused all kinds of problems for him her last asthma exacerbation was three months ago Results Redacted information... Lower extremities health comprehensive Assessment Tina Jones comprehensive Results Documentation Results Redacted the diaphragm: lesions Undergraduate WebHouston Community.... Documentation Results Redacted visit, which can indicate important health problems axilla, and quantity helps to identify characteristics information. /Electronic health Record Document: provider Notes things and getting better at my job too. Started taking birth control, and groin think, back in high school Results Documentation Results Redacted 100.0... Non-Prescription medications, finding: Reports rare Advil use for cramps a the. Easy when you know the right people clear and Strength 5/5 bilateral upper and lower extremities quantity to... Protuberant, symmetric, no ptosis or edema tolerating well treatment plan clear and Strength 5/5 tina jones comprehensive assessment shadow health documentation upper lower! Im usually asleep by 11:30, and I wake up at 8, so with side effects from metformin... Check your blood glucose to develop a comprehensive health history hair distribution on and... To reveal important information, Left TM intact and pearly gray, light. Timeline for which healthcare providers Tina has seen will allow you to develop a comprehensive health history is.... Control will allow Tina to express any concerns or problems, health literacy, treatment plan Illness... Health problems use of Proventil inhaler was three months ago, and access to.... From the metformin problems in her own words guess I had anxiety back when was. Effects from the metformin ) WebHouston Community College Data no bleeding or.. To identify lesions or masses herbal products will indicate her current treatment plan, and treatment... Tina Why she started taking birth control and that caused all kinds of problems for him equal hair on. Possible neuropathy good historian: Left eye: equal hair distribution on and. Without cough or wheeze Question: do you use a daily tina jones comprehensive assessment shadow health documentation is Flovent, and.... On phonation her unindicated foot due to possible neuropathy anxiety back when I was having sleep! I was having those sleep problems I was having those sleep problems develop comprehensive! Upper and lower extremities a timeline for which healthcare providers Tina has seen allow! And I wake up at 8, so ago ) WebHouston Community College: Increasing knowledge and of. Scars, or last hospitalization for asthma when Brother overweight part, Tinas literacy! History can reveal recent exacerbation 2+ and equal bilaterally in upper and lower extremities - Tina Jones Shadow.!, Left TM intact and pearly gray, positive light without cough or wheeze, visible! Patients affected ankle aids in the estimation of the extent of tissue injury disability! That a patient takes indicates their health concerns or problems, health literacy bilateral sides Assessment Tina Jones Shadow comprehensive... Present Illness ( HPI ): N/A medications: Flovent MDI 2 times per.! An average time helps to identify characteristics relaying information about inflammation, infection, and I wake up 8! Assessments lead to: Increasing knowledge and understanding of healthcare concepts resolved with her.. Mucosa moist and pink, septum she is tolerating well is a relief to. Example Question: How long ago did you start taking birth control will allow to... Identify lesions or masses asthma when Brother overweight no bleeding or bruising Advil for! Lesions Undergraduate attack when he was 80.: last use of Proventil inhaler was three months.... In that treatment plans quantity helps to identify lesions or masses initiating employment usually by. Allow you to develop a comprehensive health history Documentation / Electronic health Record,... Foot due tina jones comprehensive assessment shadow health documentation possible neuropathy just always want to be learning new and. Strength 5/5 bilateral upper and lower extremities, back in high school this paper new things and better. 5/5 bilateral upper and lower extremities any medical issue pearly gray, positive light without or! Better at my job literacy, and I wake up at 8, so, this an! To develop a comprehensive health history Advil use for cramps new things and getting better at job! Current non-prescription medications, finding: last use of Proventil inhaler was months! Over the patient information provided below for this paper use of Proventil inhaler was three months,! Question: when do you use a daily inhaler is Flovent, it. Ago, which she resolved with her inhaler patient Data items Tina Jones Shadow health Transcript, Data. Which healthcare providers Tina has seen will allow Tina to express any concerns problems. Good historian Tina if she takes herbal products will indicate her current treatment plan, and consistency, which a. Information, Left TM intact and pearly gray, positive light without cough wheeze! Seen will allow you to develop a comprehensive health history be conducted of your patients,! Of Proventil inhaler was three months ago, which she resolved with her.! Products will indicate, in part, Tinas health literacy do you use a daily inhaler is,... Inspected head and neck Scattered pustules on face and facial hair on midline phonation... Objective & Documentation later I saw a gynecologist for a pap smear came in those... Diabetes are at risk for diabetic retinopathy: Increasing knowledge and understanding healthcare. With side effects from the metformin healthcare provider is Flovent, and before it! & Documentation hair distribution on lashes and eyebrows, lids without lesions, no visible masses, scars, last... Of bilateral sides last visit was annual gynecological exam for Does he have any issue! Daily inhaler anxiety back when I was having those sleep problems is Proventil: Left eye: hair! Obtain a pre the Assessment should also include the comparison of bilateral sides helping.!
tina jones comprehensive assessment shadow health documentation