Exam 1 heent part 1 Study guides, Class notes & Summaries

Health Assessment HESI SOAP modified format - ANS Subjective Objective Assessment Plan What color ink should be used when documenting on paper - ANS Permanent black ink What is the correct order for vital signs - ANS T, P, RR, BP, extremity, pt position, SPO2 What should be at the top of every page of documentation - ANS Patient initials and date and time of entry What should be at the end of every documentation entry - ANS Interviewers signature How do y...

N652 PNP-PC II Quiz - Questions and Answers (Complete Solutions) What is the greatest barrier to securing adequate home health care for the child with complex medical needs? A) Parent resistance to accepting such services B) Shortage of trained service providers C) Reimbursement for needed skilled nursing services D) Acquiring the necessary service related referral The parent of a child with complex health care needs tells the primary care pediatric nurse practitioner that the child has had di...

Infant assessment and development - Answer ■ Proportional changes: weight, height, head, nervous system, chest ● Weight increases 6-8lbs, up to 20lbs in the 1st year of life ■ Posterior fontanelle closes by 2 months of life ■ Eye alignment ● Some children get cross eyed at times, but usually resolve close to 4 months ■ Red reflex should be symmetrical ■ The abdominal muscles do not close until 3 years of life ■ For boys: ● Both testicles are descended by 6 months ● N...

1. Define diagnostic reasoning Reflective thinking because thhe process involves questioning one's thinking to determine if all possible avenues have been explored & if thhe conclusions that are bein g drawn are based on evidence. Seen as a kind of critical thinking. 2. What is subjective data? Anything thhe patient tells you or complains of regarding thheir symptoms Chief complaint HPI ROS 3. What is objective data? Anything YOU can see, touch, feel, hear, or smell as part of your exam Include...

NR 603 Week 1 Advanced Clinical Diagnosis and Practice Across the Lifespan Week 1 Crystal Quince Chamberlain College of Nursing NR 603: Advanced Clinical Diagnosis and Practice Across the Lifespan October 2017 NR 603 Week 1: PBL Case Discussion: Neurologic Disorders Part Two S (Subjective) Name: Christopher D. Age: 15 years old Sex: Male Race: White Insurance: NA CC: Presents with the chief complaint of headache. Christopher D states that head...

NR 511 WEEK 3 CASE STUDY DISCUSSION PART 1 WITH ANSWERS NR511 Week 3 Case Study Part 1 CC: “eye discomfort” History of present illness: This patient is a 19-year-old male who presents to the student health center today with complaints of bilateral mild to moderate eye discomfort describe as “gritty” and “like sand in my eye” with some tearing and itching which started 2-3 days ago. He rates his discomfort a 2/10 and constant. There is no aggravating or relieving factors noted. H...

What is important to note in a pt's medical record? -Orders section -Admission note/history and physical (H&P) -Progress notes -Reports What is under the Orders section? -Meds that may affect tx -Activity orders- request if not there -Positioning restrictions -Exams ordered -Laboratory values 00:51 01:13 What is under the subjective portion of a pt's history? -History of present illness -Medical/surgical history, risk factors, allergies -Occupation, lifestyl...

Which of the following medications are prescribed to cancer patients to eradicate the cancer or for prophylaxis? I. Tamoxifen II. Anastrozole III. Januvia IV. Crestor I and II The definition of a best medical record for a RADV audit is: A. Documentation validates the CMS requested HCCs, contains all the necessary documentation elements and has an additional HCC not requested by CMS B. Documentation that validates all the requested HCCs C. Documentation that validates the requested...

Cathy, 48 F CC: Difficulty breathing with exercise HPI: Cathy is a 48year old female who comes in to the clinic with complains of increased difficulty breathing with exercise. She reports an onset of about 2 weeks ago after recovering from a spring cold. She reports breathlessness that requires her to use 2 puffs of albuterol before running, without effect. She admits to low endurance and energy making it difficult for her to run her usual 5mile run. Cathy denies any chest tightness ...

Focused Exam: Alcohol Abuse (Part 3 of 3) C487 Psych/Mental Health Clinical - Aug 2018, C487 Return to Assignment Reflections Documentation Review Nursing Admitting... Mental Status Note SBAR Nursing Admitting Note Student Response Model Documentation Chief Complaint right wirst pain following a car accident Ms. Adler has a sprained (R) wrist due to an MVA caused by impaired driving. She is a self- harm risk and expressed passive suicidal ideation. H...