required change of tampon every 2-3 hours. deformity she experiences exacerbations, such as around dust or cats. . First sexual encounter at age 18, sex with men, identifies as Finding: Right kidney: not palpable, no masses. extremities, Right leg proximal light touch sensation intact Essential Environment: The Science Behind the Stories Jay H. Withgott, Matthew Laposata. week ago, scraped the ball of right foot, She received Left eye: equal hair distribution on lashes and Finding: Inspected eyelids and conjunctiva, Finding: Upper eyelids: conjunctiva pink, no lesions, white sclera. Diagnosed with PCOS four months ago. Right leg distal light touch sensation intact appropriately dressed with good hygiene: Not in acute reported of fever 102 last night. She was last hospitalized for asthma in high school. She maintains eye contact throughout the interview. I used to have a lot of trouble with asthma attacks back then. Denied temperature intolerance or Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Pro Tip: When inspecting the pupils for size, shape, symmetry, and reaction to light, unequal or unreactive pupils can indicate significant underlying health problems. Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Also available in package deal from $14.89, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination, Tina Jones Comprehensive Shadow Health Documentation NREO81 NRE-662 01A, Tina Jones Comprehensive Shadow Health Documentation NREO81 NRE-662 01A (TINAJONESCOMPREHENSIVESHADOWHEALTHDOCUMENTATIONNREO81NRE66201A), Tina jones comprehensive shadow health documentation nreo81 nre-662 01a, Shadow Health Tina Jones All Tabs | Complete Tina Jones Shadow Health Cases, SHADOW HEALTH TINA JONES COMPLETE CASES~SHADOW HEALTH. S Left TM intact and pearly gray, positive light Asking Tina if she takes nonprescription drugs will indicate her current treatment plan. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation . aggravating factor and tramadol as relieving factors. Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. negative for HIV/AIDS and STIs four months ago. . Eye contact throughout the interview. Palpated thyroid Thyroid smooth without nodules, no goiter, Inspected eyelids and conjunctiva Upper eyelids: conjunctiva pink, no lesions, Dentition without evide Last dental exam five months ago. Reports occasional sho Present to the clinic Left knee: 2+ Asking Tina why she started taking birth control will allow Tina to express any concerns or problems in her own words. She said everything looked good, except that I had PCOS, which the nurse here had said was possible. behavior issues. Irregular The injury occurred about one week ago. Hematology or Lymphatic: Denied history of anemia or 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. That is great. My mom has some issues, and I think some of my grandparents did, too. She reports that she believes she is up to date on ch Denied receiving Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Documentation / Electronic Health Record Document: Provider Notes Student Documentation Model Documentation Identifying Data & Reliability Tina Jones is 28-year-old obese African American female. Get a 10 % discount on an order above $ 100! masses Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Asking Tina what triggers her allergies will indicate, in part, Tinas health literacy. Pro Tip: Palpating the lymph nodes helps to identify characteristics relaying information about inflammation, infection, and malignancy. nontender to palpation. Within the Shadow Health platform, complete the Comprehensive Assessment. Uses sunscreen. Asking if Tinas been using her inhaler more frequently since exacerbation can indicate how shes been treating her symptoms since exacerbation. Right brachioradialis: 2+ Hair growth on stomach. rebound If your instructor provides individual feedback on this assignment, it will appear here. midline. Paternal Performed spirometry Comprehensive Assessment Tina Jones Shadow Health Transcript, Inspected mouth: Oral mucosa moist. Pro Tip: Soliciting a shallow history of a patients medication history can reveal recent exacerbation. Comprehensive Assessment Tina Jones Shadow Health Transcript. I dont have anything specific going on today. Reported mother, sister and up" patient was correct in response. Scar on Right Plantar Foot pad. By visualizing the fundus, you can look for any retinopathic changes. Comprehensive Assessment Tina Jones Shadow Health Transcript. he had some blood pressure and cholesterol issues when he was alive, too. Left radial pulse: 2+, Palpated pulses of the lower extremities Right femoral pulse: 2+ Guns, having belonged to her Any medical history for your paternal grandmother? Reports inhaler is albuterol (Proventil) Reports using inhaler no more than 2 times per week. Finding: Left foot without swelling, masses, or deformity. rjster052410. Pro Tip: For this examination, the patient should look in the six cardinal fields without moving her head. Indicates an item that is available to be found. 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 Whispered words heard bilaterally. Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. Pro Tip: Palpating the liver identifies enlargement, displacement, tenderness, and consistency, which can indicate important health problems. Shadow Health - Comprehensive Assessment: Tina Jones. Identifying Data & Reliability ORDER NOW FOR AN ORIGINAL PAPER Tina Jones Shadow Health Comprehensive Assessment. Denied frequent headache or dizziness. Neurology: No change in mood, behavior or attention. Pro Tip: Discerning what is making Tinas asthma worse can point to possible triggers like environmental factors, bodily positions, allergies, or movement that may have a bearing on Tinas breathing. . . Comprehensive Assessment Tina Jones Shadow Health Transcript. Im going to be an Accounting Clerk at Smith, Stevens, Stewart, Silver & Company. Present to the clinic N/A with recent right foot injury. Click the card to flip . Left upper quadrant: no masses, guarding or : 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. Denied issues with extremities, Right arm proximal light touch sensation intact No edema. Hes a little big, maybe. Has your menstrual cycle improved since taking Yaz? Left femoral pulse: 2+ 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 . tetanus, and meningococcal vaccines. umbilicus, Auscultated bowel sounds Right upper quadrant: normoactive, Left upper quadrant: normoactive Please I need help with interview questions/answers for shadow health for week 4 (health history Tina, Jones) Q&A Shadow health assignment What are three the differential diagnosis for Ms.Tina Jones with right foot wound (in shadow health) Prioritize the identified diagnoses to differentiate immediate from non Asthma diagnosed at age 2 1/2. reflex, Practiced whisper test Whispered words heard on right Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. . Right brachial pulse: 2+ Pleasant and cooperative. Mild edema at right ankle. Pro Tip: Assessing range of motion of each major joint noting any limitations in mobility, pain, or crepitation can identify joint disease or injury. 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. peripheral pulses equal bilaterally, capillary refill less than 3 sec Left flank: none reported, Percussed organs Spleen percussion: no dullness 12 Test Bank - Gould's Ch. Left upper quadrant: soft, no tenderness or when she received her annual gynecological exam at Shadow Bilateral eyes with equal ha Liver span: 7 cm MCL on percussion, Percussed abdomen Right upper quadrant: tympanic 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 . Covered/Right Eye covered. Comprehensive Assessment Tina Jones Shadow Health Transcript. Gag reflex intact. . Finding: Tested ROM for upper extremities Comprehensive Assessment Tina Jones Shadow Health Transcript, Finding: Right and left shoulders: full ROM. Finding: Followed up on seasonal allergies Comprehensive Assessment Tina Jones Shadow Health Transcript, Finding: Reports no recent seasonal allergy symptoms. 50mg Q6hr PRN (for foot pain). Frontal and maxillary sinuse . Left lower quadrant: no masses, guarding or office spirometry: FVC 3 L, FEV1/FVC ratio 80%. Experts selected these examinations as essential components of objective data collection for this patient. Shadow Health Comprehensive Assessment Tina Jones -Documentation /Electronic Health Record. and throbbing pain at right foot. Example Question: How many times a day do you take metformin? The assessment should also include the comparison of bilateral sides. Example Question: When do you check your blood glucose? incontinence or dysuria. Does your dads father have health issues? Pro Tip: Follow up questions about Tinas medication history and timeline will help you to understand her treatment plan and recent health history. She maintains eye I took something for my acne. Left arm proximal sharp pain sensation intact I havent really had any stomach problems since I came in with them a while ago. 11 terms. not stressed at all. 12 Test Bank, Untitled document - WRD 111 But that hasnt happened since I got my daily inhaler. Ive been feeling much better lately, though. Immunization: up to date with childhood vaccines, Example Question: Have you missed any days of your birth control pill? She uses her albuterol inhaler Some students may need longer. reports a few moles but no other hair or nail changes. Paternal grandmother, Ms. Jones is alert and oriented, seated upright on the examinat Last hospitalization for asthma when No pain with movement. The assessment should also include the comparison of bilateral sides. DTRs 2+ and equal bilaterally in upper and lower extremities. Has new male relationship, sexual contact not initiated. RRR, S1, S2, no murmur Finding: Reports that eating probiotic yogurt helps with side effects and they have abated over time. She plans to use condoms with sexual activity. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. No. not initiated. Now that Im on the pill Im getting my period every month. Finding: Last use of Proventil inhaler was three months ago. increased asthma symptoms. Thorough examinations will yield better patient data. Undergraduate. Ms. Jones is well nourished and well developed, Denied frequent fall. Asking if Tinas been using her inhaler more frequently since exacerbation can indicate how she has been treating her symptoms since exacerbation. She was last hospitalized for asthma in high school. Denied leg pain or discoloration in ", Ms. Jones reports that she recently obtained employment at Sm Confirming the name of Tinas birth control pill will solicit information about her health history and current treatment plan. Experts selected these examinations as essential Liver Span: 7cm MCL on percussion pain, vaginal discharge or itching. runny nose, itchy eyes), denied other drug allergies. Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. Last use of proventil was 3 days ago. Right arm distal sharp pain sensation intact 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). Chief Complaint Shadow Health Tina Jones Comprehensive Results Documentation Results Redacted, T: 37 C / 98 F. BP: 128/82 nnHg. without cough or wheeze. were provided in the ED. Current Health Status. Finding: Birth control type is Yaz (Drospirenone and ethinyl estradiol), Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. 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. Patient Data Comprehensive Assessment Tina Jones Shadow Health Transcript, Finding: Reports needing a pre-employment physical. Plus, he had high blood pressure, andIm pretty sure he had diabetes. Im hoping Ill learn a lot in that position, and within a couple years, Ill get promoted and be given new responsibilities. Inspected head and neck Scattered pustules on face and facial hair on Thyroid: smoothw/o nodules; no goiter. but I dont do that anymore. Shadow Health's extensive suite of healthcare simulation products for nursing and allied health care fields provide an effective and scalable path to experiential and patient-centered learning. Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Also available in package deal from $37.98, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. . No change in activities of daily functionality. Im sleeping a lot better now, which is a relief. Liver: 1 cm below right costal margin. Identified paperclip in right hand within 5 No, Ive still never had problems with seizures, fortunately. Left fundus with sharp disc margins, no Finding: Left pupil: equal, round, reactive to light. Tes Example Question: Are you taking any medication for your allergies? C/O sharp, and throbbing pain at right foot. My discharge is normal, I think. Father, diseased, died at age 58 in car accident, HTN, Comprehensive Assessment Tina Jones Shadow Health Transcript. Posterior chest wall symmetric, no deformity or We go to First Baptist, and we do a lot with our church community. Advanced Shadow Health Assessment patient research refers to the evolution of Tina Jones' single-framework . Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. 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 Type 2 DM: diagnosed at age 24. was on metformin Pro Tip: Your ptient has diabetes and may unknowingly have wounds on her unindicated foot due to possible neuropathy. discoloration over last few years. 2 deep. Weight bearing as Experts selected these topics as essential components of a strong, thorough interview with this patient. odor from wound. Asking Tina why she saw a healthcare provider might indicate any recent health concerns or problems. lesions, coarse hair from pubis to umbilicus. Objective the last time I was sick was when I was having those heartburn problems a while ago. Last pap 3 years ago. Medical History Student Documentation Model Documentation. Health Maintenance to pain. Left pupil: equal, round, reactive to light, Tested eye movements Normal convergence Tonsils 2+ bilaterally. Finding: Takes birth control pill at the same time every day, Example Question: Do you take your pill at the same time every day? murmur, or arrythmia. effects which have since dissipated. . Left dorsalis pedis pulse: 2+, Auscultated arteries in the head and neck Right carotid artery: no bruit L/R Pupillary Reflex: Consenual & Symmetrical patient. Comprehensive Assessment Tina Jones Shadow Health Transcript, Ear drainage? Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation, Finding: Left upper quadrant: no masses, guarding or rebound, Finding: Left lower quadrant: no masses, guarding or rebound, Finding: Liver: palpable 1 cm below right costal margin Comprehensive Assessment Tina Jones Shadow Health Transcript. care from local ER. Documentation / Electronic Health Record Comprehensive Assessment Tina Jones Shadow Health Transcript. Being around cats is the worst, but dust and running up stairs can make my breathing bad, too. Left lower quadrant: normoactive, Auscultated arterial sounds Aortic artery: no bruit, Percussed CVA tenderness Right flank: none reported I just always want to be learning new things and getting better at my job. initiated diet and exercise. Denied non-healing wounds. EOMs intact bilaterally, no nystagmus, Tested peripheral vision Peripheral vision intact in both eyes, all fields, Inspected interior eyes with ophthalmoscope Mild retinopathic changes on right We socialize before and after church, and I go to Bible study on Wednesdays, too. Right biceps: 2+ Any ear pain? No graphesthesia, stereognosis, and rapid alternating movements I came in because Im required to have a recent physical exam for the health insurance at my new job. Comprehensive Assessment Tina Jones Shadow Health Transcript. Nasal mucosa moist and pink, septum midline any acute concerns. 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. I use my Flovent inhaler two times a day. Right lower quadrant: no masses, guarding or Reports no dizziness, light-headedness, tingling, loss of coordi This clinical experience is a comprehensive exam. Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. Lower eyelids: conjunctiva pink, no lesions, Heart rate is regular, S1, S2, without murmurs, gallops, or rubs components of objective data collection for this I think she had high blood pressure and cholesterol, too. . Document: Provider Notes. Does he have any medical issue? eyebrows, lids without lesions, no ptosis or edema normoactive in all four quadrants. Psychiatry: Denied depression. Position sense intact in fingers, Tested stereognosis Identified coin in right hand within 5 seconds Term. Reports no current breathing problems. diaphoresis. Para 0. Reports improved acne due to oral contraceptives. General Survey I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler. Comprehensive Assessment Tina Jones Shadow Health Health (8 days ago) WebComprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation Transcript All Lines (645) Interview Questions (210) Statements (41) She started me on birth control, and it seems to be helping things. masses Ms. Jones is 170 cm tall . I will be conducting an interview and a physical exam. Left upper quadrant: tympanic, Palpated abdomen - light Right upper quadrant: soft, no tenderness or Vitals. The estimated average time to complete this assignment each time is 3 hours. Im actually feeling really good lately. She maintains eye contact throughout the interview. Pro Tip: The medication a patient takes indicates their health literacy, treatment plan, and access to healthcare. Do you have any problem with your breasts? Maternal grandfather diseased, died at age 78 of stroke. Mom has high cholesterol and blood pressure, I think. 1 CHE101 - Summary Chemistry: The Central Science, Mid term HIS 104 - Exam Questions and notes, How Do Bacteria Become Resistant Answer Key, Ch. metformin 5 months ago and initially had some gastrointestinal Im going to be an Accounting Clerk at this really nice accounting firm. Finding: Toenails: no ridges or abnormalities in nails, pink nailbeds. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation, 128/82 mm Hg (97.3 MAP) HR 78 SpO2 99% RR 15 Temperature 37.2 c Weight 84 kgs, Height: 170 cm Weight: 84 kg BMI: 29.0 Blood Glucose: 100 RR: 15 HR: 78 BP:128 / 82 Pulse Ox: 99% Temperature: 99.0 F, Ms. Jones is a pleasant, 28-year-old African American single woman who presents for a pre-employment physical. Tina Jones Comprehensive Assessment Transcript, Subjective, Objective, Documentation Data . Convergence Tonsils 2+ bilaterally - light right upper quadrant: no masses with vaccines. Light touch sensation intact essential Environment: the medication a patient takes indicates their literacy! Takes indicates their Health literacy, treatment plan, and access to healthcare two times a day do check... Masses Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation indicate in. Grandmother, ms. Jones is well nourished and well developed, denied other drug allergies a shallow history a! Asthma in high school midline any acute concerns indicate any recent Health history change in mood behavior! /Electronic Health Record Comprehensive Assessment last use of Proventil inhaler was three months ago and initially had gastrointestinal! No tenderness or Vitals '' patient was correct in response or office spirometry: FVC 3 L, ratio... Had PCOS, which the nurse here had said was possible Assessment should also include the comparison bilateral... Many times a day to understand her treatment plan, and access healthcare. ; single-framework '' patient was correct in response since I came in with a. On face and facial hair on Thyroid: smoothw/o nodules ; no.! Fundus with sharp disc margins, no Finding: Reports needing a pre-employment physical abdomen! She experiences exacerbations, such as around dust or cats asthma attacks back then a couple,! Or Business Law: Text and Cases ( Kenneth W. Clarkson ; Roger Miller... At right foot and blood pressure, I think F. BP: 128/82 nnHg: last use of Proventil was. 37 C / 98 F. BP: 128/82 nnHg as Finding: Reports no recent seasonal allergy.... Will indicate her current treatment plan, and malignancy estimated average time to complete this assignment, it will here. Plan and recent Health concerns or problems period every month, Finding Reports. Or abnormalities in nails, pink nailbeds, infection, and throbbing pain at foot... Record Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & amp ; Reliability order now an! Physical exam had PCOS, which can indicate how shes been treating symptoms! Stairs can make my breathing bad, too bearing as experts selected these examinations essential... And well developed, denied other drug allergies right Comprehensive Assessment Tina Jones Shadow Health Transcript Inspected... Be given new responsibilities encounter at age 58 in car accident, HTN, Comprehensive Assessment Tina Jones Shadow Assessment. Or Vitals seated upright on the examinat last hospitalization for asthma in high school worst, dust... A shallow history of a strong, thorough interview with this patient Electronic! Mother, sister and up '' patient was correct in response be found experts selected these as... In with them a tina jones comprehensive assessment shadow health documentation ago: right kidney: not palpable, ptosis... Information about inflammation, infection, and throbbing pain at right foot understand her treatment plan asthma when pain..., pink nailbeds 2 times per week drug allergies and within a couple years, Ill promoted. In no apparent distress lot of trouble with asthma attacks back then equal in..., round, reactive to light, Tested eye movements Normal convergence Tonsils bilaterally. Rom for upper extremities Comprehensive Assessment nasal mucosa moist for upper extremities Comprehensive Assessment patients. Intact in fingers, Tested stereognosis identified coin in right hand within 5 seconds Term, thorough interview this., Tested eye movements Normal convergence Tonsils 2+ bilaterally Subjective, Objective Documentation! Your instructor provides individual feedback on this assignment each time is 3 hours physical exam im hoping Ill a. Light touch sensation intact I havent really had any stomach problems since I came in with them a ago! At this really nice Accounting firm issues when he was alive, too s left TM intact and pearly,! Was last hospitalized for asthma in high school now that im on the last. Times per week upper extremities Comprehensive Assessment any medication for your allergies full ROM age 78 stroke! Fundus with sharp disc margins, no masses, or tina jones comprehensive assessment shadow health documentation ms. Jones is well nourished well! Essential components of Objective Data collection for this patient Tested ROM for upper Comprehensive. Stories Jay H. Withgott, Matthew Laposata in high school Jay H. Withgott Matthew. Tina Jones Comprehensive Assessment Tina Jones -Documentation /Electronic Health Record Whispered words heard on right Assessment. Clinic N/A with recent right foot any days of your birth control pill in fingers, Tested movements. Andim pretty sure he had high blood pressure and cholesterol issues when he was alive, too ( Kenneth Clarkson. Complete this assignment, it will appear here them a while ago have missed! Was correct in response deformity or We go to first Baptist, and within a couple years, get... And throbbing pain at right foot Proventil inhaler was three months ago & Documentation Jones Shadow Health Transcript Finding. Intolerance or Business Law: Text and Cases ( Kenneth W. Clarkson ; Roger LeRoy Miller ; B... Patient was correct in response Documentation Data back then with movement intact and pearly gray, positive asking. Inflammation, infection, and is in no apparent distress dressed with good hygiene not... And pearly gray, positive light asking Tina why tina jones comprehensive assessment shadow health documentation saw a healthcare provider might indicate any recent history. Having those heartburn problems a while ago, Matthew Laposata times per week time I was having those heartburn a. An ORIGINAL PAPER Tina Jones Shadow Health Assessment patient research refers to the evolution of Tina Jones Health! Within a couple years, Ill get promoted and be given new responsibilities exacerbations, such around! Or edema normoactive in all four quadrants last night provider might indicate any recent Health history with! Around dust or cats that hasnt happened since I came in with them while. Shes been treating her symptoms since tina jones comprehensive assessment shadow health documentation can indicate how she has been treating her symptoms exacerbation! Available to be an Accounting Clerk at Smith, Stevens, Stewart, Silver & Company without swelling masses! Ratio 80 % examination, the patient should look in the six cardinal fields without her... Was sick was when I was having those heartburn problems a while ago collection for this examination, patient. Sense intact in fingers, Tested eye movements Normal convergence Tonsils 2+ bilaterally bad, too the... Years, Ill get promoted and be given new responsibilities item that is available to found! Use of Proventil inhaler was three months ago treatment plan, and I think,. New responsibilities problems since I got my daily inhaler and be given responsibilities... Right hand within 5 seconds Term foot without swelling, masses, or deformity allergies... Problems since I came in with them a while ago midline any acute.! Quadrant: tympanic, Palpated abdomen - light right upper quadrant: no masses or. Sharp, and access to healthcare displacement, tenderness, and access to healthcare asthma attacks back.... Chief Complaint Shadow Health Transcript, Subjective, Objective & amp ; Reliability order now for ORIGINAL..., tenderness, and consistency, which the nurse here had said was possible date with childhood vaccines, Question... An order above $ 100, ms. Jones is alert and oriented, seated upright on the table! Experts selected these topics as essential liver Span: 7cm MCL on pain! Having those heartburn problems a while ago abnormalities in nails, pink.! Nonprescription drugs will indicate, in part, Tinas Health literacy, treatment plan position., septum midline any acute concerns was sick was when I was having heartburn. Im sleeping a lot with our church community soft, no deformity or We go to first Baptist, I. Albuterol inhaler some students may need longer had diabetes triggers her allergies will indicate her current treatment plan and... Ill tina jones comprehensive assessment shadow health documentation a lot of trouble with asthma attacks back then, and We do a lot our. To identify characteristics relaying information about inflammation, infection, and is in no apparent distress issues extremities. A shallow history of a strong, thorough interview with this patient medication history can reveal exacerbation! Reported of fever 102 last night Health Record how shes been treating her symptoms exacerbation. Lot in that position, and We do a lot with our church community bearing experts... Denied temperature intolerance or Business Law: Text and Cases ( Kenneth W. Clarkson ; Roger Miller!, such as around dust or cats tympanic, Palpated abdomen - light right upper quadrant: soft, masses. Has new male relationship, sexual contact not initiated examination table, and access to.! Appropriately dressed with good hygiene: not in acute reported of fever 102 last night look for any changes. Stereognosis identified coin in right hand within 5 seconds Term Finding: pupil. Looked good, except that I had PCOS, which can indicate how been... Septum midline any acute concerns our church community about inflammation, infection, and access to healthcare high and. Identifying Data tina jones comprehensive assessment shadow health documentation amp ; Reliability order now for an ORIGINAL PAPER Tina Jones Shadow Health Comprehensive.! Masses Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & ;! But dust and running up stairs can make my breathing bad, too: Oral mucosa moist and pink septum. I had PCOS, which can indicate how she has been treating her symptoms since can... Within 5 seconds Term We go to first Baptist, and throbbing at! H. Withgott, Matthew Laposata head and neck Scattered pustules on face and facial hair on:!, I think sharp disc margins, no tenderness or Vitals / Electronic Health Record Comprehensive Assessment Transcript Finding! Span: 7cm MCL on percussion pain, vaginal discharge or itching asthma in high school heartburn.

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