Class 12, 13, 14: Chapters 4, 27: (The Complete Health History, the Compete Health Assessment, Reassessment of the Hospitalized Adult and the Functional Assessment ofthe Older Adult and the Complete Health History) (Bold are ones that answer themselves)1. Describe color changes seen over time with bruises.Light skinned personRed-blue or purple immediately after or within 24 hours of trauma then progresses to blue to purple(12-36hours), blue-green, yellow, and brown to disappearing. (Ch12 pg 237) (ch7 p108 second column at the bottom)2. Review correct documentation techniques used in recording Health History information and “tips” as presented in the PP presentation. (PP on ch4)Health History on an AdultBiographical data Name Address and phone number Age and birth date Birthplace Sex Marital status Race Ethnic origin Occupation: usual and presentPQRSTUPast Health- Childhood illnesses- Accidents or injuries- Serious or chronic illnesses- Hospitalizations- Operations- Obstetric history- Immunizations- Last examination date- Allergies- Current medicationsFamily history Age and health or cause of death of relatives Health of close family members  Family history of various conditions such as heart disease, high blood pressure, stroke, diabetes, blood disorders, cancer, sickle-cell anemia, arthritis, allergies, obesity, alcoholism, mental illness, seizure disorder, kidney disease, and tuberculosis Family tree (genogram) to show this information clearly and conciselyCross-Cultural Care Additional questions for new immigrants• Biographical data• Spiritual resource and religion: assess if certain procedures cannot be done• Past health: what immunizations, if any• Health perception How does person describe health and illness How does person see problems he or she is now experiencing• Nutrition: taboo foods or food combinationsReview of Systems- General overall health state- Skin- Hair- Head- Eyes- Ears- Nose and Sinuses- Mouth and Throat- Neck- Breast- Axilla- Respiratory system- Cardiovascular- Peripheral vascular- Gastrointestinal- Urinary system- Male genital system- Female genital system -Sexual health- Musculoskeletal system- Neurologic system- Hematologic system- Endocrine systemFunctional assessment, including ADLs Self-esteem, self-concept Activity and exercise Sleep and rest Nutrition and elimination Interpersonal relationships and resources Spiritual resources Coping and stress management Personal habits Alcohol CAGE testHave you ever thought you should Cut down your drinking?Have you ever been Annoyed by criticism of your drinking?Have you ever felt Guilty about your drinking?Do you drink in the morning, an Eye opener? Illicit or street drugs Environment and work hazards Intimate partner violence Occupational healthCHILDRENHealth history adapted to include information specific for age and developmental stage of child Biographic data Source of history• Person providing information and relation to child• Your impression of reliability of information• Any special circumstances, e.g., use of an interpreter• Reason for seeking careChildren: history of present Illness Parent’s intuitive sense of problem often accurate; even if proven otherwise, this gives an idea of parent’s area of concern Parent’s coping ability and reaction of other family members to child’s symptoms or illnessChildren: developmental history Growth Milestones Current development for children 1 month through preschool School-age childAdolescent: heeadsss psychosocial interviewMethod of interviewing focuses on assessment of Home environment, Education and employment, Eating, peer-related Activities, Drugs, Sexuality, Suicide and depression, and Safety from injury and violence-Home-Education and employment-Eating-Activities-Drugs-Sexuality-Suicide and depression-SafetyOlder adult Includes same format described for younger adult, plus additional questions• These questions address ways in which ADLs are affected by normal aging processes or by effects of chronic illness or disability• No specific age at which to ask these additional questions; use them when it seems appropriate• Important to recognize positive health measures: what they are doing to help themselves stay well Older people have spent a lifetime with traditional health care that searches only for pathology and what is wrong with their health May be pleasant surprise to have a health professional affirm things they are doing right and note health strengthsOlder adult: reason for seeking care May take time to figure out why older person has come for an examination• Aging person may shrug off symptoms as evidence of growing old and be unsure whether it is worth mentioning• Some older people have a conservative philosophy toward their health status and come for care only when something is seriously wrong• Older person may have many chronic problems, such as diabetes, hypertension, or constipation• Final statement should be person’s reason for seeking care, not your assumption of problemOlder adult: past health General health in past 5 years Accidents or injuries, serious or chronic illnesses, hospitalizations, operations Last examination Obstetric status Current Medications- Also consider following issues:- Some older persons take large number of drugs prescribed by different physicians- May use over-the-counter medications for self-treatment- Some share medications with neighbors or friendsOlder adult: functional assessment including ADLs Self-concept, self-esteem Occupation Activity and exercise Sleep and rest Nutrition and elimination Interpersonal relationships and resources Coping and stress management Environment and home safety hazards3. Review types of assessment: complete health assessment, emergency assessment, episodic (or focused) and follow-up. (ch1p 7-8)Complete Data base: A complete health history and full physical examination. It describes current and past health state and forms a baseline against which all future changes can be measured. Collected carried out in primary care settings; generally upon the first visit if the client is not presenting with a high priority problem. Focused or Episodic Data Base: This is for a limited or short term problem. You collect a “mini” database, smaller in scope and more targeted than a