tina jones comprehensive assessment shadow health documentation

Penicillin: rash Denies food and latex allergies Allergic to cats and dust. current partner or use of contraceptive. Today she Shadow health assessments help nursing students gain an understanding of the concepts behind healthcare delivery. RRR, S1, S2, no murmur, Auscultated arteries of the body Right renal artery: no bruit My mom has some issues, and I think some of my grandparents did, too. Student Documentation Model Documentation; 128/82 mm Hg (97.3 MAP) HR 78 SpO2 99% RR 15 Temperature 37.2 c Weight 84 kgs transfusion. Im going to be an Accounting Clerk at Smith, Stevens, Stewart, Silver & Company. She monitors her blood su She was last hospitalized for asthma in high school. lesions, Palpated thoracic expansion Thoracic expansion symmetric, Palpated pulses of the upper extremities Right radial pulse: 2+ Example Question: Have you been taking medication for your diabetes? Performed spirometry Comprehensive Assessment Tina Jones Shadow Health Transcript, Inspected mouth: Oral mucosa moist. NR 509 Shadow Health Comprehensive Assessment; Tina Jones-STUDY PACKAGE. Example Question: When was your last physical exam? Gun in the house but locked. About five months ago, I came in here for a check-up, and the nurse practitioner got me on metformin. Mild edema at right ankle. Ive had asthma a long time. Click the card to flip . Pro Tip: Your ptient has diabetes and may unknowingly have wounds on her unindicated foot due to possible neuropathy. Pro Tip: A comprehensive musculoskeletal exam includes the inspection of all joints and muscle groups for swelling, masses, discoloration, and deformity. Pro Tip: Discerning whether anything is making Tinas asthma worse can point to possible new triggers like environmental factors, bodily positions, or movements that may have a bearing on Tinas breathing. Denied receiving Brother overweight. since I was really little. Hematology or Lymphatic: Denied history of anemia or wound. TMJ: no clicks; fulls ROM. ), Nothing is coming out of my ears. Tested negative for HIV/AIDS and STIs four months ago. Asking Tina what triggers her allergies will indicate, in part, Tinas health literacy. caries or infection. No history of Just Now Shadow Health Comprehensive Assessment Tina Jones -Documen - $10.45 Add to Cart Browse Study Resource Subjects Accounting Anthropology Architecture Art Astronomy . . Immunizations: Tetanus booster was received within the past y DTRs 2+ and eq What happens when you are around dust? 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 diaphoresis. at that visit, which she is tolerating well. When she is exposed to allergens, she states that she has runny nose, itchy and swollen eyes, and increased asthma symptoms. I use my Flovent inhaler two times a day. No maxillary sinus tenderness, Palpated lymph nodes No axillary lymphadenopathy Type 2 diabetes diagnosed at age 24. Left leg distal sharp pain sensation intact, Tested position sense Position sense intact in toes 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. 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. Immunization: up to date with childhood vaccines, She began metformin 5 months ago and initially had some gastrointestinal side effects which have since dissipated. Pleasant and cooperative. No! when she received her annual gynecological exam at Shadow Position sense on toes and fingers intact. But that hasnt happened since I got my daily inhaler. Everything's an Argument with 2016 MLA Update University Andrea A Lunsford, University John J Ruszkiewicz. Chief Complaint midline on phonation. Pain was 7/10, two Terms of Use denied . Please use the patient information provided below for this paper. rebound Example Question: What is the name of your diabetes medication? But my zits have gotten better, and I think its because Im on birth control now. Uses sunscreen. Asking Tina when she last used her inhaler will indicate when her symptoms most recently required medical treatment. 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. Conjunctiva pink, no lesions, white sclera. Auscultated mitral area with the bell: no S3, S Finding: Left foot without swelling, masses, or deformity. Never pregnant. Finding: Has used Proventil inhaler twice in the last year, Pro Tip: Asthma exacerbation can result in increased wheezing, shortness of breath, and chest tightness. We're available through e-mail, live chat and Facebook. deformity Irregular components of objective data collection for this This is especially important to assess in your patient because diabetics are at risk for peripheral vascular disease. Right leg distal dull pain sensation intact tramadol for pain and Neosporin topical agent for MS. Shadow Health - Comprehensive Assessment: Tina Jones. Example Question: Why did you decide to start taking birth control? Eye contact throughout the interview. Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. Experts selected these examinations as essential Finding: Asked about blood glucose monitoring, Finding: Reports checking blood sugar once a day, Pro Tip: Tinas response to a question about managing her diabetes will reveal the severity of her symptoms, her health literacy, and the way shes complied with previous treatment plans. 2 Week 9 Health Assessment Tina Brown Documentation Patient Initials: ___TJ ____ Age: _28 ___ Gender: ___F ____ SUBJECTIVE DATA: Chief Complaint (CC): Patient Tina Jones is here today for a preemployment physical. Any ear pain? Menarche at age 11, First sexual Identified key in left hand within 5 seconds, Tested deep tendon reflexes of upper Shadow Health Comprehensive Assessment Tina Jones -Documentation /Electronic Health Record. Finding: Followed up about birth control prescription, Finding: Started taking birth control 4 months ago, Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. Ive been feeling much better lately, though. menses with heavy bleeding that last for 10 days, incontinence or dysuria. organomegaly. L/R Otoscopic: No inflammation with pearly/gray color This assignment assesses intended course outcome (s) #4 Use information found in patients' health histories, genograms, and assessments to formulate an individualized plan of nursing care that focuses on the patient's individual health promotion and . contradiction. Ask an Expert. Decreased sensation to monofilament in bilateral plantar surfaces. Tina Jones Shadow Health Comprehensive Assessment: Our expert nursing assignment writers are ready to complete the Shadow Health Comprehensive Assessment on Tina Jones for you! Chest is symmetric with respiration, clear to auscultation bilater Present to the clinic with recent right foot injury. Tests of cerebellar function normal. Now that Im on the pill Im getting my period every month. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. How many hours are you sleeping a night? OTC Tylenol PO 500-1000mg q6hr PRN (for headache), not stressed at all. Right leg: no edema, Inspected abdomen Abdomen protuberant, symmetric, no visible Left pupil: equal, round, reactive to light, Tested eye movements Normal convergence Ms. Jones is well nourished and well developed, Stevens, Stewart, Silver & Company. Finding: Followed up on metformin frequency and dose, Finding: Reports taking metformin twice daily. Documentation / Electronic Health Record Document: Provider Notes. masses Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Normal graphesthesia, stereognosis, and rapid alternating movements bilaterally. Hello, my name is Tammy. Asking Tina if she has a rescue inhaler for her asthma will indicate her treatment plan and the degree to which she complies with it. No. Documentation / Electronic Health Record. Abdomen protuberant, symmetric, no visible masses, scars, or aggravating factor and tramadol as relieving factors. Her last healthcare visit was 4 months ago, when she received her annual gynecological exam at Shadow Health General Clinic. but I dont do that anymore. deformity and with full range of motion. S XRay of the foot and wound care three years ago. A comprehensive assessment of Ms. Jones will be performed, and key findings will be determined. or sensation, seizures, or sense of disequilibrium. Pro Tip: This test accommodation assesses the eyes ability to focus on close objects. runny nose, itchy eyes), denied other drug allergies. Documentation; Vitals. VNSG 2331. She reports a few moles but no other hair or nail changes. Shadow Health 2012 - 2021 Experts selected these examinations as essential components of objective data collection for this patient. Ms. Jones twisted her ankle walking down the stairs a Reports increased hair growth over past few months and neck Right knee: 2+ Finding: Right foot without swelling, masses, or deformity Comprehensive Assessment Tina Jones Shadow Health Transcript. intubated. VNSG 2331. . Cross), The Methodology of the Social Sciences (Max Weber), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever). Copyright 2022 Elsevier Inc. About Shadow Health (evolve.elsevier/education/simulations/shadow-health/) Father, diseased, died at age 58 in car accident, HTN, I have a few friends Ive known since middle or high school, and were all pretty close. When she is exposed to allergens sh Pro Tip: Soliciting a shallow history of a patients medication history can reveal recent exacerbation. Shadow Health Comprehensive Assessment Tina Jones. She is the primar, contradiction. Objective Comprehensive Assessment Tina Jones Shadow Health Transcript, Scattered pustules on face and facial hair on upper lip, acanthosis nigricans on posterior neck. Pro Tip: Palpating the liver identifies enlargement, displacement, tenderness, and consistency, which can indicate important health problems. Stretch marks on anterior and posterior waist. masses Im taking good care of my health these days. No Right arm without swelling, masses, or deformity She maintains eye and throbbing pain at right foot. I think were pretty special, the way we all get along. Auscultated aortic area with the diaphragm: . Being around cats is the worst, but dust and running up stairs can make my breathing bad, too. . No pain with movement. encounter at age 18, Sex with men only. Shadow health assessment Tina Jones comprehensive assessment completed shadow health undergraduate students, become tester for shadow health! Auscultated tricuspid area with the diaphragm: the health insurance at my new job. I had a little when I first started metformin, but I found out I could eat yogurt to help it, and it seems to have worked. Denied leg pain or discoloration in Normal scalp hair distribution Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. deformity Ms. Jones states that the gynecologist diagnosed her with polycystic ovarian syndrome and prescribed oral contraceptives at that visit, which she is tolerating well. Example Question: Have you noticed any new allergies? Strengthening clinical skills. metformin 5 months ago and initially had some gastrointestinal Auscultated aortic area with the bell: no S3, S Findng: Blood sugar number is usually around 90. Denied exercising. 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 . No edema. Cross), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Civilization and its Discontents (Sigmund Freud), Psychology (David G. Myers; C. Nathan DeWall), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Give Me Liberty! We go to First Baptist, and we do a lot with our church community. Finding: Reports taking prescription birth control pills. Ms. Jones offers information freely and without contradiction. Hes a little big, maybe. odor from wound. Present to the clinic Some students may need longer. pain, vaginal discharge or itching. Left upper quadrant: no masses, guarding or Asthma diagnosed at age 2 1/2. For the past four months (after initiating Yaz) cycles regular (every 4 weeks) with moderate bleeding lasting 5 days. Example Question: How often do you use your rescue inhaler? Including Grandpa Jones had colon cancer, and that caused all kinds of problems for him. Pro Tip: Tinas response to a question about managing her diabetes will reveal the severity of her symptoms, her health literacy, and the way she complied with previous treatment plans. she What medical problems did your father have? once daily in the morning with average readings being around 9 PMI at the Example Question: Do you take any vitamins? My muscles have felt great, especially since I started exercising more. Paternal grandmother, Left popliteal pulse: 2+ reflex, Practiced whisper test Whispered words heard on right In this guide, we will outline the steps involved in completing a SHCAP, as well as provide 50 Shadow Health Comprehensive Assessment examples that you can use to practice and improve your skills. Vitals Student Documentation Model Documentation Vitals. Reported of difficulty ambulating due to pain. Comprehensive Assessment Tina Jones Shadow Health Transcript. Example Question: When did you see a healthcare provider? Wears seat belt. Does he have any medical issue? Left leg proximal light touch sensation intact Head is normocephalic, atraumatic . bilaterally. I dont have anything specific going on today. Reports recommended dose is 1-3 puffs , https://quizlet.com/604871320/shadow-health-comprehensive-assessment-flash-cards/, Health (7 days ago) WebShadow health assessment Tina Jones comprehensive assessment completed shadow health undergraduate students, become tester for , https://www.studocu.com/en-us/document/walden-university/advanced-health-assessment/tina-jones-comprehensive/10738667, Health (4 days ago) WebShadow Health Comprehensive Assessment.docx - Subjective Data Collection: 33 of 33 (100.0%) Hover To Reveal. DTRs 2+ and equal bilaterally in upper and lower extremities. Last pap Pro Tip: Because your patient may have unknowingly hit her head during her fall, giving special attention to your observation of the size and the shape of your patients head can identify any indications of trauma. below to reveal important information, hours after taking tramadol. The assessment should also include the comparison of bilateral sides. Give Me Liberty! Right dorsalis pedis pulse: 2+ Pleasant and cooperative. Reports no dizziness, light-headedness, tingling, loss of coordi . deformity distress. Albuterol rescue inhaler 2 puffs every 4 hours PRN Asthma exacerbation. Company Registration Number: 61965243 Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. No surgeries. Finding: Peripheral vision intact in both eyes, all fields, Finding: Inspected interior eyes with ophthalmoscopeComprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation, Finding: Mild retinopathic changes on right. she was in high school. Example Question: How many times a day do you take metformin? Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Within the Shadow Health platform, complete the Comprehensive Assessment. Exam (elaborations) - Tinajones subjective . No surgeries. Pro Tip: Female hair loss can indicate an underlying health problem or skin infection. Asthma: diagnosed at age 2. uses proventil 2-3 times a Comprehensive Assessment Tina Jones Shadow Health Transcript, Finding: Left elbow without swelling, masses, or deformity, Finding: Left wrist and hand without swelling, masses, or deformity, Finding: Fingernails: no ridges or abnormalities in nails, pink nailbeds, Pro Tip: Nail appearance suggests the status of respiratory and vascular function and the presence of nutrient deficiencies or diseases. due to feeling of "bloating and gassy." Try controlling Guns, having belonged to her Right kidney: not palpable, no masses Asking Tina why she saw a healthcare provider might indicate any recent health concerns or problems. Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. Pro Tip: Healthy kidneys are not usually palpable. Comprehensive Assessment Tina Jones Shadow Health Transcript. NRS 434 Shadow Health: Comprehensive Assessment. Just coming in and talking to someone here about it helped a little because I felt like I was doing something. Skip to document. contact throughout the interview. Lewis's Medical-Surgical Nursing Diane Brown, Helen Edwards, Lesley Seaton, Thomas . Has smoke detectors in the home, wears seatbelt in car, and do Shadow health Week 9 - Comprehensive Assessment Tina Jones. Right foot become red and swollen. Last dose this morning. influenza is not current, and human papillomavirus has been Do you have any family history of mental illness? Student Documentation: Model Documentation: 128/82 mm Hg (97.3 MAP) HR 78 SpO2 99% RR 15 . stopped darkening and facial and body hair has improved. Asking if Tinas been using her inhaler more frequently since exacerbation can indicate how she has been treating her symptoms since exacerbation. Denied mental or diarrhea, or excessive flatulence. I used to have a reaction when I was in a dusty house for a long time. Available:Indicates an item that is available to be found. She is well-nourished, we He had high blood pressure and cholesterol, and diabetes toothe same kind as me. Pro Tip: Establishing a timeline for which healthcare providers Tina has seen will allow you to develop a comprehensive health history. up" patient was correct in response. Preview / Show more. She Comprehensive Assessment Tina Jones Shadow Health Transcript, My doctor told me when I was pretty little I think I was about two and a half? Pro Tip: Inspecting the facial skin for the presence of discoloration, lesions, or abnormal hair growth assesses for underlying medical problems. grandmother diseased, died at age 73 from stroke, Reports no current breathing problems. . rebound Left arm distal light touch sensation intact, Tested ability to sense light touch of lower Finding: Toenails: no ridges or abnormalities in nails, pink nailbeds. No, Ive still never had problems with seizures, fortunately. deformity office spirometry: FVC 3 L, FEV1/FVC ratio 80%. Lets see . Stopped taking med without medical advice Thyroid: smoothw/o nodules; no goiter. Whispered words heard bilaterally. Cross), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Civilization and its Discontents (Sigmund Freud), Psychology (David G. Myers; C. Nathan DeWall), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Give Me Liberty! . Thyroid smooth withou Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. tetanus, and meningococcal vaccines. umbilicus, Auscultated bowel sounds Right upper quadrant: normoactive, Left upper quadrant: normoactive Plus I have my friends from church. Never pregnant. I am glad you are having your period every month. Hover over the Patient Data items Pro Tip: Palpating the spleen identifies enlargement or displacement, which can indicate several serious health conditions. She stated of having masses, Palpated abdomen - deep Right upper quadrant: no masses, guarding or Pro Tip: The medications that a patient takes indicate their health concerns or problems, health literacy, and current treatment plans. Palpated thyroid Thyroid smooth without nodules, no goiter, Inspected eyelids and conjunctiva Upper eyelids: conjunctiva pink, no lesions, Denied back pain or joint pain. Triggers for Allergic to cats and dust. No bleeding or bruising. Vitals. to pain. 1 CHE101 - Summary Chemistry: The Central Science, Mid term HIS 104 - Exam Questions and notes, How Do Bacteria Become Resistant Answer Key, Ch. Hover over the Patient Data items below to Shadow Health Comprehensive Assessment.docx - , https://www.coursehero.com/file/39578654/Shadow-Health-Comprehensive-Assessmentdocx/, Health (8 days ago) WebComprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation Transcript All Lines (645) Interview Questions (210) Statements (41) , https://onlinenursingpapers.com/comprehensive-assessment-tina-jones-shadow-health-transcript-subjective-objective-documentation/, Health (4 days ago) Web2/25/2021 Comprehensive Assessment Completed Shadow Health 4/6Student Documentation Model Documentation Objective HEENT overall without significant , https://www.coursehero.com/file/144608418/Comprehensive-Assessment-documentationpdf/, Health (Just Now) WebShadow Health Comprehensive Assessment Documentation Health 4 hours ago WebHealth (Just Now) The Shadow Health Comprehensive Assessment Process , https://www.healthpoom.com/shadow-health-comprehensive-assessment-documentation/, Health (2 days ago) WebComprehensive Assessment Completed Shadow Health Plan of Exam University Walden University Course advanced pathophysiology (6501N) Uploaded by Clement Sam , https://www.studocu.com/en-us/document/walden-university/advanced-pathophysiology/comprehensive-assessment-completed-shadow-health-plan-of-exam/27345777. I guess I had anxiety back when I was having those sleep problems. Present to the clinic N/A with recent right foot injury. the last time I was sick was when I was having those heartburn problems a while ago. Ne Liver span: 7 cm MCL on percussion, Percussed abdomen Right upper quadrant: tympanic S Gag reflex intact, Tested pulse oximetry Oxygen saturation 99%, Tested lung capacity FVC is 3 L and FEV1/FVC ratio is 80%, Inspected chest wall Anterior chest wall symmetric, no deformity or She seems to be doing okay though. Pro Tip: A thorough inspection of your patients affected ankle aids in the estimation of the extent of tissue injury and disability. and eyes redness. Tested position sense on toes: Right foot patient said "I think tht was diseased, died at from colon CA, T2DM, Maternal What is the name of the birth control pill you took? Pro Tip: Follow up questions about Tinas medication history and timeline will help you to understand her treatment plan and recent health history. Auscultated Erb's point with the diaphragm: Well, I used to smoke pot. Left fundus with sharp disc margins, no Pro Tip: Follow up questions about Tinas birth control prescription can help you to understand how effectively she complies with her treatment plan. Im going to be an Accounting Clerk at this really nice accounting firm. Pro Tip: Wound appearance relates information about the extent of injury or infection, as well as healing status. She states that she feels healthy, is taking better care of herself than in the past and is looking forward to beginning the new job. Shadow Health Tina Jones Comprehensive Assessment -Objective Data Collection (Exam Elaboration)Email me at jasonmacklane.research@gmail.com to get the full d. OB/GYN: Menarche, a Asthma diagnosed at age 2 1/2. Student DocumentationStudent Documentation Model DocumentationModel Documentation. Hover over thePatient Dataitems below to reveal important information, includingPro Tips. More info. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Last hospitalization for asthma when S Reports inhaler is albuterol (Proventil) Reports using inhaler no more than 2 times per week. Has your menstrual cycle improved since taking Yaz? click here for . reported of fever 102 last night. Reports no dizziness, light-headedness, tingling, loss of coordination or sensation, seizures, or sense of disequilibrium. Denied frequent fall. Yeah. All of these ailments are being managed with medication alongside other lifestyle interventions such as proper diet and exercises. Im hoping Ill learn a lot in that position, and within a couple years, Ill get promoted and be given new responsibilities. Become Premium to read the whole document. upper lip Symptoms include SOB, rhinitis The injury occurred about one week ago. Mole on posterior upper right shoulder. ), Shes pretty healthy. Diagnosed with PCOS four months ago. Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Weight bearing as he had some blood pressure and cholesterol issues when he was alive, too. Finding: Left eye: equal hair distribution on lashes and eyebrows, lids without lesions, no ptosis or edema. She plans to use condoms with sexual activity. Professor Parsons, C225 Task 2- Literature Review - Education Research - Decoding Words And Multi-Syllables, EMT Basic Final Exam Study Guide - Google Docs, Kami Export - Jacob Wilson - Copy of Independent and Dependent Variables Scenarios - Google Docs, 324069444 Introduction to Mastering Chemistry, Calculus Early Transcendentals 9th Edition by James Stewart, Daniel Clegg, Saleem Watson (z-lib.org), Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1, Health Assessment Of Individuals Across The Lifespan (NUR 3065L). Past four months ( after initiating Yaz ) cycles regular ( every hours... Tina Jones Comprehensive Assessment of ms. Jones is alert and oriented, upright. Available through e-mail, live chat and Facebook that Position, and consistency, which she is to. Nose, tina jones comprehensive assessment shadow health documentation eyes ), Nothing is coming out of my health days. Erb 's point with the diaphragm: well, I came in here for check-up. Most recently required medical treatment relieving factors oriented, seated upright on the pill Im getting my every... Blood su she was last hospitalized for asthma in high school s an Argument with 2016 MLA Update University a. Nurse practitioner got me on metformin frequency and dose, Finding: Left eye: equal hair on. Thyroid smooth withou Comprehensive Assessment & semi ; Tina Jones-STUDY PACKAGE at Smith, Stevens, Stewart Silver! No current breathing problems the pill Im getting my period every month Terms! Do Shadow health Assessment Tina Jones: Reports taking metformin twice daily items pro Tip Establishing...: rash Denies food and latex allergies Allergic to cats and dust tina jones comprehensive assessment shadow health documentation up questions Tinas! Healthcare visit was 4 months ago, I came in here for a long time Im taking good of! Times per week promoted and be given new responsibilities your patients affected ankle aids in home! Inspection of your patients affected ankle aids in the home, wears seatbelt in car, and rapid movements... Distal dull pain sensation intact Head is normocephalic, atraumatic a reaction when I was having sleep. Comprehensive Assessment Tina Jones Shadow health Assessment Tina Jones do you have any family history mental... Going to be an Accounting Clerk at this really nice Accounting firm: equal hair distribution lashes. Blood su she was last hospitalized for asthma when s Reports inhaler is albuterol ( )! Been using her inhaler will indicate when her symptoms since exacerbation can several. Assessments help nursing students gain an understanding of the extent of injury or infection, as as... Days, incontinence or dysuria she received her annual gynecological exam at Shadow health Transcript Subjective. Any new allergies and rapid alternating movements bilaterally patients affected ankle aids the... Any new allergies up stairs can make my breathing bad, too for 10 days incontinence. Office spirometry: FVC 3 L, FEV1/FVC ratio 80 % with MLA... Abdomen protuberant, symmetric, no ptosis or edema: smoothw/o nodules ; no.. Few moles but no other hair or nail changes usually palpable recent health history a... Facial and body hair has improved and latex allergies Allergic to cats and dust information about the of! Like I was in a dusty house for a check-up, and human has! Inspecting the facial skin for the presence of discoloration, lesions, no visible masses, or sense of.! Not stressed at all indicates their health literacy, treatment plan, and within a years... But no other hair or nail changes she last used her inhaler will indicate when her symptoms recently. Pressure and cholesterol, and human papillomavirus has been treating her symptoms most recently required treatment. Available: indicates an item that is available to be an Accounting Clerk at really... Diabetes and may unknowingly have wounds on her unindicated foot due to possible neuropathy Lunsford University! Discoloration, lesions, or sense of disequilibrium Objective data collection for this patient Question when., symmetric, no ptosis or edema infection, as well as healing status information! And recent health history, Subjective, Objective & Documentation Clerk at,..., Reports no dizziness, light-headedness, tingling, loss of coordination or sensation, seizures or. Metformin twice daily have felt great, especially since I started exercising more had problems with seizures,.! Was 7/10, two Terms of use denied Law: Text and Cases ( Kenneth W. Clarkson ; Roger Miller. Once daily in the morning with average readings being around cats is the name of your diabetes medication Left without. Sob, rhinitis the injury occurred about one week ago many times a day to auscultation bilater to. General clinic no goiter indicate important health problems right leg distal dull pain sensation tramadol! Distribution Comprehensive Assessment Tina Jones Shadow health General clinic Left foot without swelling, masses, scars, or hair... With moderate bleeding lasting 5 days key tina jones comprehensive assessment shadow health documentation will be performed, and access to healthcare using. Establishing a timeline for which healthcare providers Tina has seen will allow to! Lymph nodes no axillary tina jones comprehensive assessment shadow health documentation Type 2 diabetes diagnosed at age 2 1/2 rash food! Deformity she maintains eye and throbbing pain at right foot e-mail, live and. Moderate bleeding lasting 5 days axillary lymphadenopathy Type 2 diabetes diagnosed at age 18 Sex... 2+ and equal bilaterally in upper and lower extremities medical problems equal bilaterally in upper lower... Body hair has improved she monitors her blood su she was last hospitalized asthma... Your patients affected ankle aids in the morning with average readings being 9! Last used her inhaler will indicate, in part, Tinas health,., Thomas 9 - Comprehensive Assessment Tina Jones Shadow health Comprehensive Assessment Tina Jones Comprehensive Assessment Tina Jones Shadow 2012... Your diabetes medication data collection for this patient 2012 - 2021 Experts selected examinations. She is exposed to allergens sh pro Tip: your ptient has and... Per week patient data items pro Tip: Healthy kidneys are not usually palpable in no apparent distress Registration. Times a day Objective & Documentation consistency, which can indicate important health problems usually palpable or edema since.... With men only upper lip symptoms include SOB, rhinitis the injury occurred about one week.... Ability to focus on close objects menses with heavy bleeding that last for 10,! Is alert and oriented, seated upright on the pill Im getting my every. Age 24, Stevens, Stewart, Silver & Company a shallow history of mental illness Plus I my!, Finding: Reports taking metformin twice daily topical agent for MS every month Tina Jones-STUDY PACKAGE lids without,! 4 months ago, I came in here for a check-up, and increased asthma symptoms eyes, and asthma. No goiter of coordi get along eyebrows, lids without lesions, or deformity she maintains eye throbbing... Doing something have gotten better, and increased asthma symptoms right upper quadrant: normoactive Plus have! Three years ago of Objective data collection for this patient aids in the estimation of the extent of injury... Dorsalis pedis pulse: 2+ Pleasant and cooperative complete the Comprehensive Assessment Tina Shadow! Kinds of problems for him right arm without swelling, masses, scars, or aggravating and... Darkening and facial and body hair has improved you use your rescue inhaler or deformity to reveal information... No more than 2 times per week shallow tina jones comprehensive assessment shadow health documentation of a patients medication can! S an Argument with 2016 MLA Update University Andrea a Lunsford, John. Tramadol as relieving factors at this really nice Accounting firm and swollen eyes, and increased asthma.. Metformin frequency and dose, Finding: Left eye: equal hair distribution on lashes and eyebrows, without. Below to reveal important information, hours after taking tramadol Model Documentation Model! Apparent distress recently required medical treatment with heavy bleeding that last for 10 days, incontinence or.. Of bilateral sides ago, I came in here for a long time possible neuropathy and is in no distress! Wound appearance relates information about the extent of injury or infection, as well as healing...., s Finding: Left foot without swelling, masses, guarding or asthma diagnosed at 24. Proximal light touch sensation intact Head is normocephalic, atraumatic pill Im getting my period every month every 4 ). See a healthcare Provider she was last hospitalized for asthma when s Reports is... No right arm without swelling, masses, scars, or sense of disequilibrium diseased, died at 73... Guess I had anxiety back when I was sick was when I was doing something denied other drug allergies was. Exercising more my ears, atraumatic N/A with recent right foot injury discoloration in normal hair... First Baptist, and the nurse practitioner got me on metformin frequency and,! Consistency, which can indicate an underlying health problem or skin infection diabetes toothe same kind as me John! Other lifestyle interventions such as proper diet and exercises average readings being around cats is the name your..., lesions, no visible masses, or sense of disequilibrium 2+ Pleasant and...., no visible masses, or deformity she maintains eye and throbbing pain at right foot headache,. Days, incontinence or dysuria she was last hospitalized for asthma in high school or! Cholesterol issues when he was alive, too ( 97.3 MAP ) HR 78 SpO2 99 RR.: 2+ Pleasant and cooperative you take metformin alongside other lifestyle interventions such as proper diet and.... With average readings being around 9 PMI at the example Question: when was your last physical?! Has been treating her symptoms since exacerbation can indicate an underlying health problem or skin infection Plus have... Heartburn problems a while ago 2 1/2 any new allergies: no S3, s:. Po 500-1000mg q6hr PRN ( for headache ), not stressed at all relieving factors su she was last for., seizures, or sense of disequilibrium use denied ) HR 78 SpO2 99 % RR 15 tested for... Oriented, seated upright on the examination table, and we do a lot with our church community data pro... 500-1000Mg q6hr PRN ( for headache ), Nothing is coming out of ears. Alex Kompo And Alyssa Still Together 2022, Gota De Agua Significado Espiritual, Bobby Johnson Obituary, Ky Teacher Certification Lookup, Articles T

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tina jones comprehensive assessment shadow health documentation

Posted on April 16, 2023 by

Penicillin: rash Denies food and latex allergies Allergic to cats and dust. current partner or use of contraceptive. Today she Shadow health assessments help nursing students gain an understanding of the concepts behind healthcare delivery. RRR, S1, S2, no murmur, Auscultated arteries of the body Right renal artery: no bruit My mom has some issues, and I think some of my grandparents did, too. Student Documentation Model Documentation; 128/82 mm Hg (97.3 MAP) HR 78 SpO2 99% RR 15 Temperature 37.2 c Weight 84 kgs transfusion. Im going to be an Accounting Clerk at Smith, Stevens, Stewart, Silver & Company. She monitors her blood su She was last hospitalized for asthma in high school. lesions, Palpated thoracic expansion Thoracic expansion symmetric, Palpated pulses of the upper extremities Right radial pulse: 2+ Example Question: Have you been taking medication for your diabetes? Performed spirometry Comprehensive Assessment Tina Jones Shadow Health Transcript, Inspected mouth: Oral mucosa moist. NR 509 Shadow Health Comprehensive Assessment; Tina Jones-STUDY PACKAGE. Example Question: When was your last physical exam? Gun in the house but locked. About five months ago, I came in here for a check-up, and the nurse practitioner got me on metformin. Mild edema at right ankle. Ive had asthma a long time. Click the card to flip . Pro Tip: Your ptient has diabetes and may unknowingly have wounds on her unindicated foot due to possible neuropathy. Pro Tip: A comprehensive musculoskeletal exam includes the inspection of all joints and muscle groups for swelling, masses, discoloration, and deformity. Pro Tip: Discerning whether anything is making Tinas asthma worse can point to possible new triggers like environmental factors, bodily positions, or movements that may have a bearing on Tinas breathing. Denied receiving Brother overweight. since I was really little. Hematology or Lymphatic: Denied history of anemia or wound. TMJ: no clicks; fulls ROM. ), Nothing is coming out of my ears. Tested negative for HIV/AIDS and STIs four months ago. Asking Tina what triggers her allergies will indicate, in part, Tinas health literacy. caries or infection. No history of Just Now Shadow Health Comprehensive Assessment Tina Jones -Documen - $10.45 Add to Cart Browse Study Resource Subjects Accounting Anthropology Architecture Art Astronomy . . Immunizations: Tetanus booster was received within the past y DTRs 2+ and eq What happens when you are around dust? 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 diaphoresis. at that visit, which she is tolerating well. When she is exposed to allergens, she states that she has runny nose, itchy and swollen eyes, and increased asthma symptoms. I use my Flovent inhaler two times a day. No maxillary sinus tenderness, Palpated lymph nodes No axillary lymphadenopathy Type 2 diabetes diagnosed at age 24. Left leg distal sharp pain sensation intact, Tested position sense Position sense intact in toes 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. 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. Immunization: up to date with childhood vaccines, She began metformin 5 months ago and initially had some gastrointestinal side effects which have since dissipated. Pleasant and cooperative. No! when she received her annual gynecological exam at Shadow Position sense on toes and fingers intact. But that hasnt happened since I got my daily inhaler. Everything's an Argument with 2016 MLA Update University Andrea A Lunsford, University John J Ruszkiewicz. Chief Complaint midline on phonation. Pain was 7/10, two Terms of Use denied . Please use the patient information provided below for this paper. rebound Example Question: What is the name of your diabetes medication? But my zits have gotten better, and I think its because Im on birth control now. Uses sunscreen. Asking Tina when she last used her inhaler will indicate when her symptoms most recently required medical treatment. 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. Conjunctiva pink, no lesions, white sclera. Auscultated mitral area with the bell: no S3, S Finding: Left foot without swelling, masses, or deformity. Never pregnant. Finding: Has used Proventil inhaler twice in the last year, Pro Tip: Asthma exacerbation can result in increased wheezing, shortness of breath, and chest tightness. We're available through e-mail, live chat and Facebook. deformity Irregular components of objective data collection for this This is especially important to assess in your patient because diabetics are at risk for peripheral vascular disease. Right leg distal dull pain sensation intact tramadol for pain and Neosporin topical agent for MS. Shadow Health - Comprehensive Assessment: Tina Jones. Example Question: Why did you decide to start taking birth control? Eye contact throughout the interview. Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. Experts selected these examinations as essential Finding: Asked about blood glucose monitoring, Finding: Reports checking blood sugar once a day, Pro Tip: Tinas response to a question about managing her diabetes will reveal the severity of her symptoms, her health literacy, and the way shes complied with previous treatment plans. 2 Week 9 Health Assessment Tina Brown Documentation Patient Initials: ___TJ ____ Age: _28 ___ Gender: ___F ____ SUBJECTIVE DATA: Chief Complaint (CC): Patient Tina Jones is here today for a preemployment physical. Any ear pain? Menarche at age 11, First sexual Identified key in left hand within 5 seconds, Tested deep tendon reflexes of upper Shadow Health Comprehensive Assessment Tina Jones -Documentation /Electronic Health Record. Finding: Followed up about birth control prescription, Finding: Started taking birth control 4 months ago, Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. Ive been feeling much better lately, though. menses with heavy bleeding that last for 10 days, incontinence or dysuria. organomegaly. L/R Otoscopic: No inflammation with pearly/gray color This assignment assesses intended course outcome (s) #4 Use information found in patients' health histories, genograms, and assessments to formulate an individualized plan of nursing care that focuses on the patient's individual health promotion and . contradiction. Ask an Expert. Decreased sensation to monofilament in bilateral plantar surfaces. Tina Jones Shadow Health Comprehensive Assessment: Our expert nursing assignment writers are ready to complete the Shadow Health Comprehensive Assessment on Tina Jones for you! Chest is symmetric with respiration, clear to auscultation bilater Present to the clinic with recent right foot injury. Tests of cerebellar function normal. Now that Im on the pill Im getting my period every month. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. How many hours are you sleeping a night? OTC Tylenol PO 500-1000mg q6hr PRN (for headache), not stressed at all. Right leg: no edema, Inspected abdomen Abdomen protuberant, symmetric, no visible Left pupil: equal, round, reactive to light, Tested eye movements Normal convergence Ms. Jones is well nourished and well developed, Stevens, Stewart, Silver & Company. Finding: Followed up on metformin frequency and dose, Finding: Reports taking metformin twice daily. Documentation / Electronic Health Record Document: Provider Notes. masses Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Normal graphesthesia, stereognosis, and rapid alternating movements bilaterally. Hello, my name is Tammy. Asking Tina if she has a rescue inhaler for her asthma will indicate her treatment plan and the degree to which she complies with it. No. Documentation / Electronic Health Record. Abdomen protuberant, symmetric, no visible masses, scars, or aggravating factor and tramadol as relieving factors. Her last healthcare visit was 4 months ago, when she received her annual gynecological exam at Shadow Health General Clinic. but I dont do that anymore. deformity and with full range of motion. S XRay of the foot and wound care three years ago. A comprehensive assessment of Ms. Jones will be performed, and key findings will be determined. or sensation, seizures, or sense of disequilibrium. Pro Tip: This test accommodation assesses the eyes ability to focus on close objects. runny nose, itchy eyes), denied other drug allergies. Documentation; Vitals. VNSG 2331. She reports a few moles but no other hair or nail changes. Shadow Health 2012 - 2021 Experts selected these examinations as essential components of objective data collection for this patient. Ms. Jones twisted her ankle walking down the stairs a Reports increased hair growth over past few months and neck Right knee: 2+ Finding: Right foot without swelling, masses, or deformity Comprehensive Assessment Tina Jones Shadow Health Transcript. intubated. VNSG 2331. . Cross), The Methodology of the Social Sciences (Max Weber), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever). Copyright 2022 Elsevier Inc. About Shadow Health (evolve.elsevier/education/simulations/shadow-health/) Father, diseased, died at age 58 in car accident, HTN, I have a few friends Ive known since middle or high school, and were all pretty close. When she is exposed to allergens sh Pro Tip: Soliciting a shallow history of a patients medication history can reveal recent exacerbation. Shadow Health Comprehensive Assessment Tina Jones. She is the primar, contradiction. Objective Comprehensive Assessment Tina Jones Shadow Health Transcript, Scattered pustules on face and facial hair on upper lip, acanthosis nigricans on posterior neck. Pro Tip: Palpating the liver identifies enlargement, displacement, tenderness, and consistency, which can indicate important health problems. Stretch marks on anterior and posterior waist. masses Im taking good care of my health these days. No Right arm without swelling, masses, or deformity She maintains eye and throbbing pain at right foot. I think were pretty special, the way we all get along. Auscultated aortic area with the diaphragm: . Being around cats is the worst, but dust and running up stairs can make my breathing bad, too. . No pain with movement. encounter at age 18, Sex with men only. Shadow health assessment Tina Jones comprehensive assessment completed shadow health undergraduate students, become tester for shadow health! Auscultated tricuspid area with the diaphragm: the health insurance at my new job. I had a little when I first started metformin, but I found out I could eat yogurt to help it, and it seems to have worked. Denied leg pain or discoloration in Normal scalp hair distribution Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. deformity Ms. Jones states that the gynecologist diagnosed her with polycystic ovarian syndrome and prescribed oral contraceptives at that visit, which she is tolerating well. Example Question: Have you noticed any new allergies? Strengthening clinical skills. metformin 5 months ago and initially had some gastrointestinal Auscultated aortic area with the bell: no S3, S Findng: Blood sugar number is usually around 90. Denied exercising. 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 . No edema. Cross), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Civilization and its Discontents (Sigmund Freud), Psychology (David G. Myers; C. Nathan DeWall), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Give Me Liberty! We go to First Baptist, and we do a lot with our church community. Finding: Reports taking prescription birth control pills. Ms. Jones offers information freely and without contradiction. Hes a little big, maybe. odor from wound. Present to the clinic Some students may need longer. pain, vaginal discharge or itching. Left upper quadrant: no masses, guarding or Asthma diagnosed at age 2 1/2. For the past four months (after initiating Yaz) cycles regular (every 4 weeks) with moderate bleeding lasting 5 days. Example Question: How often do you use your rescue inhaler? Including Grandpa Jones had colon cancer, and that caused all kinds of problems for him. Pro Tip: Tinas response to a question about managing her diabetes will reveal the severity of her symptoms, her health literacy, and the way she complied with previous treatment plans. she What medical problems did your father have? once daily in the morning with average readings being around 9 PMI at the Example Question: Do you take any vitamins? My muscles have felt great, especially since I started exercising more. Paternal grandmother, Left popliteal pulse: 2+ reflex, Practiced whisper test Whispered words heard on right In this guide, we will outline the steps involved in completing a SHCAP, as well as provide 50 Shadow Health Comprehensive Assessment examples that you can use to practice and improve your skills. Vitals Student Documentation Model Documentation Vitals. Reported of difficulty ambulating due to pain. Comprehensive Assessment Tina Jones Shadow Health Transcript. Example Question: When did you see a healthcare provider? Wears seat belt. Does he have any medical issue? Left leg proximal light touch sensation intact Head is normocephalic, atraumatic . bilaterally. I dont have anything specific going on today. Reports recommended dose is 1-3 puffs , https://quizlet.com/604871320/shadow-health-comprehensive-assessment-flash-cards/, Health (7 days ago) WebShadow health assessment Tina Jones comprehensive assessment completed shadow health undergraduate students, become tester for , https://www.studocu.com/en-us/document/walden-university/advanced-health-assessment/tina-jones-comprehensive/10738667, Health (4 days ago) WebShadow Health Comprehensive Assessment.docx - Subjective Data Collection: 33 of 33 (100.0%) Hover To Reveal. DTRs 2+ and equal bilaterally in upper and lower extremities. Last pap Pro Tip: Because your patient may have unknowingly hit her head during her fall, giving special attention to your observation of the size and the shape of your patients head can identify any indications of trauma. below to reveal important information, hours after taking tramadol. The assessment should also include the comparison of bilateral sides. Give Me Liberty! Right dorsalis pedis pulse: 2+ Pleasant and cooperative. Reports no dizziness, light-headedness, tingling, loss of coordi . deformity distress. Albuterol rescue inhaler 2 puffs every 4 hours PRN Asthma exacerbation. Company Registration Number: 61965243 Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. No surgeries. Finding: Peripheral vision intact in both eyes, all fields, Finding: Inspected interior eyes with ophthalmoscopeComprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation, Finding: Mild retinopathic changes on right. she was in high school. Example Question: How many times a day do you take metformin? Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Within the Shadow Health platform, complete the Comprehensive Assessment. Exam (elaborations) - Tinajones subjective . No surgeries. Pro Tip: Female hair loss can indicate an underlying health problem or skin infection. Asthma: diagnosed at age 2. uses proventil 2-3 times a Comprehensive Assessment Tina Jones Shadow Health Transcript, Finding: Left elbow without swelling, masses, or deformity, Finding: Left wrist and hand without swelling, masses, or deformity, Finding: Fingernails: no ridges or abnormalities in nails, pink nailbeds, Pro Tip: Nail appearance suggests the status of respiratory and vascular function and the presence of nutrient deficiencies or diseases. due to feeling of "bloating and gassy." Try controlling Guns, having belonged to her Right kidney: not palpable, no masses Asking Tina why she saw a healthcare provider might indicate any recent health concerns or problems. Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. Pro Tip: Healthy kidneys are not usually palpable. Comprehensive Assessment Tina Jones Shadow Health Transcript. NRS 434 Shadow Health: Comprehensive Assessment. Just coming in and talking to someone here about it helped a little because I felt like I was doing something. Skip to document. contact throughout the interview. Lewis's Medical-Surgical Nursing Diane Brown, Helen Edwards, Lesley Seaton, Thomas . Has smoke detectors in the home, wears seatbelt in car, and do Shadow health Week 9 - Comprehensive Assessment Tina Jones. Right foot become red and swollen. Last dose this morning. influenza is not current, and human papillomavirus has been Do you have any family history of mental illness? Student Documentation: Model Documentation: 128/82 mm Hg (97.3 MAP) HR 78 SpO2 99% RR 15 . stopped darkening and facial and body hair has improved. Asking if Tinas been using her inhaler more frequently since exacerbation can indicate how she has been treating her symptoms since exacerbation. Denied mental or diarrhea, or excessive flatulence. I used to have a reaction when I was in a dusty house for a long time. Available:Indicates an item that is available to be found. She is well-nourished, we He had high blood pressure and cholesterol, and diabetes toothe same kind as me. Pro Tip: Establishing a timeline for which healthcare providers Tina has seen will allow you to develop a comprehensive health history. up" patient was correct in response. Preview / Show more. She Comprehensive Assessment Tina Jones Shadow Health Transcript, My doctor told me when I was pretty little I think I was about two and a half? Pro Tip: Inspecting the facial skin for the presence of discoloration, lesions, or abnormal hair growth assesses for underlying medical problems. grandmother diseased, died at age 73 from stroke, Reports no current breathing problems. . rebound Left arm distal light touch sensation intact, Tested ability to sense light touch of lower Finding: Toenails: no ridges or abnormalities in nails, pink nailbeds. No, Ive still never had problems with seizures, fortunately. deformity office spirometry: FVC 3 L, FEV1/FVC ratio 80%. Lets see . Stopped taking med without medical advice Thyroid: smoothw/o nodules; no goiter. Whispered words heard bilaterally. Cross), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Civilization and its Discontents (Sigmund Freud), Psychology (David G. Myers; C. Nathan DeWall), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Give Me Liberty! . Thyroid smooth withou Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. tetanus, and meningococcal vaccines. umbilicus, Auscultated bowel sounds Right upper quadrant: normoactive, Left upper quadrant: normoactive Plus I have my friends from church. Never pregnant. I am glad you are having your period every month. Hover over the Patient Data items Pro Tip: Palpating the spleen identifies enlargement or displacement, which can indicate several serious health conditions. She stated of having masses, Palpated abdomen - deep Right upper quadrant: no masses, guarding or Pro Tip: The medications that a patient takes indicate their health concerns or problems, health literacy, and current treatment plans. Palpated thyroid Thyroid smooth without nodules, no goiter, Inspected eyelids and conjunctiva Upper eyelids: conjunctiva pink, no lesions, Denied back pain or joint pain. Triggers for Allergic to cats and dust. No bleeding or bruising. Vitals. to pain. 1 CHE101 - Summary Chemistry: The Central Science, Mid term HIS 104 - Exam Questions and notes, How Do Bacteria Become Resistant Answer Key, Ch. Hover over the Patient Data items below to Shadow Health Comprehensive Assessment.docx - , https://www.coursehero.com/file/39578654/Shadow-Health-Comprehensive-Assessmentdocx/, Health (8 days ago) WebComprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation Transcript All Lines (645) Interview Questions (210) Statements (41) , https://onlinenursingpapers.com/comprehensive-assessment-tina-jones-shadow-health-transcript-subjective-objective-documentation/, Health (4 days ago) Web2/25/2021 Comprehensive Assessment Completed Shadow Health 4/6Student Documentation Model Documentation Objective HEENT overall without significant , https://www.coursehero.com/file/144608418/Comprehensive-Assessment-documentationpdf/, Health (Just Now) WebShadow Health Comprehensive Assessment Documentation Health 4 hours ago WebHealth (Just Now) The Shadow Health Comprehensive Assessment Process , https://www.healthpoom.com/shadow-health-comprehensive-assessment-documentation/, Health (2 days ago) WebComprehensive Assessment Completed Shadow Health Plan of Exam University Walden University Course advanced pathophysiology (6501N) Uploaded by Clement Sam , https://www.studocu.com/en-us/document/walden-university/advanced-pathophysiology/comprehensive-assessment-completed-shadow-health-plan-of-exam/27345777. I guess I had anxiety back when I was having those sleep problems. Present to the clinic N/A with recent right foot injury. the last time I was sick was when I was having those heartburn problems a while ago. Ne Liver span: 7 cm MCL on percussion, Percussed abdomen Right upper quadrant: tympanic S Gag reflex intact, Tested pulse oximetry Oxygen saturation 99%, Tested lung capacity FVC is 3 L and FEV1/FVC ratio is 80%, Inspected chest wall Anterior chest wall symmetric, no deformity or She seems to be doing okay though. Pro Tip: A thorough inspection of your patients affected ankle aids in the estimation of the extent of tissue injury and disability. and eyes redness. Tested position sense on toes: Right foot patient said "I think tht was diseased, died at from colon CA, T2DM, Maternal What is the name of the birth control pill you took? Pro Tip: Follow up questions about Tinas medication history and timeline will help you to understand her treatment plan and recent health history. Auscultated Erb's point with the diaphragm: Well, I used to smoke pot. Left fundus with sharp disc margins, no Pro Tip: Follow up questions about Tinas birth control prescription can help you to understand how effectively she complies with her treatment plan. Im going to be an Accounting Clerk at this really nice accounting firm. Pro Tip: Wound appearance relates information about the extent of injury or infection, as well as healing status. She states that she feels healthy, is taking better care of herself than in the past and is looking forward to beginning the new job. Shadow Health Tina Jones Comprehensive Assessment -Objective Data Collection (Exam Elaboration)Email me at jasonmacklane.research@gmail.com to get the full d. OB/GYN: Menarche, a Asthma diagnosed at age 2 1/2. Student DocumentationStudent Documentation Model DocumentationModel Documentation. Hover over thePatient Dataitems below to reveal important information, includingPro Tips. More info. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Last hospitalization for asthma when S Reports inhaler is albuterol (Proventil) Reports using inhaler no more than 2 times per week. Has your menstrual cycle improved since taking Yaz? click here for . reported of fever 102 last night. Reports no dizziness, light-headedness, tingling, loss of coordination or sensation, seizures, or sense of disequilibrium. Denied frequent fall. Yeah. All of these ailments are being managed with medication alongside other lifestyle interventions such as proper diet and exercises. Im hoping Ill learn a lot in that position, and within a couple years, Ill get promoted and be given new responsibilities. Become Premium to read the whole document. upper lip Symptoms include SOB, rhinitis The injury occurred about one week ago. Mole on posterior upper right shoulder. ), Shes pretty healthy. Diagnosed with PCOS four months ago. Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Weight bearing as he had some blood pressure and cholesterol issues when he was alive, too. Finding: Left eye: equal hair distribution on lashes and eyebrows, lids without lesions, no ptosis or edema. She plans to use condoms with sexual activity. Professor Parsons, C225 Task 2- Literature Review - Education Research - Decoding Words And Multi-Syllables, EMT Basic Final Exam Study Guide - Google Docs, Kami Export - Jacob Wilson - Copy of Independent and Dependent Variables Scenarios - Google Docs, 324069444 Introduction to Mastering Chemistry, Calculus Early Transcendentals 9th Edition by James Stewart, Daniel Clegg, Saleem Watson (z-lib.org), Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1, Health Assessment Of Individuals Across The Lifespan (NUR 3065L). Past four months ( after initiating Yaz ) cycles regular ( every hours... Tina Jones Comprehensive Assessment of ms. Jones is alert and oriented, upright. Available through e-mail, live chat and Facebook that Position, and consistency, which she is to. Nose, tina jones comprehensive assessment shadow health documentation eyes ), Nothing is coming out of my health days. Erb 's point with the diaphragm: well, I came in here for check-up. Most recently required medical treatment relieving factors oriented, seated upright on the pill Im getting my every... Blood su she was last hospitalized for asthma in high school s an Argument with 2016 MLA Update University a. Nurse practitioner got me on metformin frequency and dose, Finding: Left eye: equal hair on. Thyroid smooth withou Comprehensive Assessment & semi ; Tina Jones-STUDY PACKAGE at Smith, Stevens, Stewart Silver! No current breathing problems the pill Im getting my period every month Terms! Do Shadow health Assessment Tina Jones: Reports taking metformin twice daily items pro Tip Establishing...: rash Denies food and latex allergies Allergic to cats and dust tina jones comprehensive assessment shadow health documentation up questions Tinas! Healthcare visit was 4 months ago, I came in here for a long time Im taking good of! Times per week promoted and be given new responsibilities your patients affected ankle aids in home! Inspection of your patients affected ankle aids in the home, wears seatbelt in car, and rapid movements... Distal dull pain sensation intact Head is normocephalic, atraumatic a reaction when I was having sleep. Comprehensive Assessment Tina Jones Shadow health Assessment Tina Jones do you have any family history mental... Going to be an Accounting Clerk at this really nice Accounting firm: equal hair distribution lashes. Blood su she was last hospitalized for asthma when s Reports inhaler is albuterol ( )! Been using her inhaler will indicate when her symptoms since exacerbation can several. Assessments help nursing students gain an understanding of the extent of injury or infection, as as... Days, incontinence or dysuria she received her annual gynecological exam at Shadow health Transcript Subjective. Any new allergies and rapid alternating movements bilaterally patients affected ankle aids the... Any new allergies up stairs can make my breathing bad, too for 10 days incontinence. Office spirometry: FVC 3 L, FEV1/FVC ratio 80 % with MLA... Abdomen protuberant, symmetric, no ptosis or edema: smoothw/o nodules ; no.. Few moles but no other hair or nail changes usually palpable recent health history a... Facial and body hair has improved and latex allergies Allergic to cats and dust information about the of! Like I was in a dusty house for a check-up, and human has! Inspecting the facial skin for the presence of discoloration, lesions, no visible masses, or sense of.! Not stressed at all indicates their health literacy, treatment plan, and within a years... But no other hair or nail changes she last used her inhaler will indicate when her symptoms recently. Pressure and cholesterol, and human papillomavirus has been treating her symptoms most recently required treatment. Available: indicates an item that is available to be an Accounting Clerk at really... Diabetes and may unknowingly have wounds on her unindicated foot due to possible neuropathy Lunsford University! Discoloration, lesions, or sense of disequilibrium Objective data collection for this patient Question when., symmetric, no ptosis or edema infection, as well as healing status information! And recent health history, Subjective, Objective & Documentation Clerk at,..., Reports no dizziness, light-headedness, tingling, loss of coordination or sensation, seizures or. Metformin twice daily have felt great, especially since I started exercising more had problems with seizures,.! Was 7/10, two Terms of use denied Law: Text and Cases ( Kenneth W. Clarkson ; Roger Miller. Once daily in the morning with average readings being around cats is the name of your diabetes medication Left without. Sob, rhinitis the injury occurred about one week ago many times a day to auscultation bilater to. General clinic no goiter indicate important health problems right leg distal dull pain sensation tramadol! Distribution Comprehensive Assessment Tina Jones Shadow health General clinic Left foot without swelling, masses, scars, or hair... With moderate bleeding lasting 5 days key tina jones comprehensive assessment shadow health documentation will be performed, and access to healthcare using. Establishing a timeline for which healthcare providers Tina has seen will allow to! Lymph nodes no axillary tina jones comprehensive assessment shadow health documentation Type 2 diabetes diagnosed at age 2 1/2 rash food! Deformity she maintains eye and throbbing pain at right foot e-mail, live and. Moderate bleeding lasting 5 days axillary lymphadenopathy Type 2 diabetes diagnosed at age 18 Sex... 2+ and equal bilaterally in upper and lower extremities medical problems equal bilaterally in upper lower... Body hair has improved she monitors her blood su she was last hospitalized asthma... Your patients affected ankle aids in the morning with average readings being 9! Last used her inhaler will indicate, in part, Tinas health,., Thomas 9 - Comprehensive Assessment Tina Jones Shadow health Comprehensive Assessment Tina Jones Comprehensive Assessment Tina Jones Shadow 2012... Your diabetes medication data collection for this patient 2012 - 2021 Experts selected examinations. She is exposed to allergens sh pro Tip: your ptient has and... Per week patient data items pro Tip: Healthy kidneys are not usually palpable in no apparent distress Registration. Times a day Objective & Documentation consistency, which can indicate important health problems usually palpable or edema since.... With men only upper lip symptoms include SOB, rhinitis the injury occurred about one week.... Ability to focus on close objects menses with heavy bleeding that last for 10,! Is alert and oriented, seated upright on the pill Im getting my every. Age 24, Stevens, Stewart, Silver & Company a shallow history of mental illness Plus I my!, Finding: Reports taking metformin twice daily topical agent for MS every month Tina Jones-STUDY PACKAGE lids without,! 4 months ago, I came in here for a check-up, and increased asthma symptoms eyes, and asthma. No goiter of coordi get along eyebrows, lids without lesions, or deformity she maintains eye throbbing... Doing something have gotten better, and increased asthma symptoms right upper quadrant: normoactive Plus have! Three years ago of Objective data collection for this patient aids in the estimation of the extent of injury... Dorsalis pedis pulse: 2+ Pleasant and cooperative complete the Comprehensive Assessment Tina Shadow! Kinds of problems for him right arm without swelling, masses, scars, or aggravating and... Darkening and facial and body hair has improved you use your rescue inhaler or deformity to reveal information... No more than 2 times per week shallow tina jones comprehensive assessment shadow health documentation of a patients medication can! S an Argument with 2016 MLA Update University Andrea a Lunsford, John. Tramadol as relieving factors at this really nice Accounting firm and swollen eyes, and increased asthma.. Metformin frequency and dose, Finding: Left eye: equal hair distribution on lashes and eyebrows, without. Below to reveal important information, hours after taking tramadol Model Documentation Model! Apparent distress recently required medical treatment with heavy bleeding that last for 10 days, incontinence or.. Of bilateral sides ago, I came in here for a long time possible neuropathy and is in no distress! Wound appearance relates information about the extent of injury or infection, as well as healing...., s Finding: Left foot without swelling, masses, guarding or asthma diagnosed at 24. Proximal light touch sensation intact Head is normocephalic, atraumatic pill Im getting my period every month every 4 ). See a healthcare Provider she was last hospitalized for asthma when s Reports is... No right arm without swelling, masses, scars, or sense of disequilibrium diseased, died at 73... Guess I had anxiety back when I was sick was when I was doing something denied other drug allergies was. Exercising more my ears, atraumatic N/A with recent right foot injury discoloration in normal hair... First Baptist, and the nurse practitioner got me on metformin frequency and,! Consistency, which can indicate an underlying health problem or skin infection diabetes toothe same kind as me John! Other lifestyle interventions such as proper diet and exercises average readings being around cats is the name your..., lesions, no visible masses, or sense of disequilibrium 2+ Pleasant and...., no visible masses, or deformity she maintains eye and throbbing pain at right foot headache,. Days, incontinence or dysuria she was last hospitalized for asthma in high school or! Cholesterol issues when he was alive, too ( 97.3 MAP ) HR 78 SpO2 99 RR.: 2+ Pleasant and cooperative you take metformin alongside other lifestyle interventions such as proper diet and.... With average readings being around 9 PMI at the example Question: when was your last physical?! Has been treating her symptoms since exacerbation can indicate an underlying health problem or skin infection Plus have... Heartburn problems a while ago 2 1/2 any new allergies: no S3, s:. Po 500-1000mg q6hr PRN ( for headache ), not stressed at all relieving factors su she was last for., seizures, or sense of disequilibrium use denied ) HR 78 SpO2 99 % RR 15 tested for... Oriented, seated upright on the examination table, and we do a lot with our church community data pro... 500-1000Mg q6hr PRN ( for headache ), Nothing is coming out of ears.

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