Essays /

Health History And Screening Of An Essay

Essay preview

Health History and Screening of an Adolescent or Young Adult Client

Student Name:

Biographical Data
Patient/Client Initials: Phone No:
Birth Date: A Years Sex :Female
Birthplace: Marital Status: Single Race/Ethnic Origin:
Occupation: High School Student Employer: Unemployed
Financial Status: (Income adequate for lifestyle and/or health concerns. Is there a source of health insurance? Employment disability?) She receives health insurance from parents. She is depended, and covered by her mother’s health insurance. Her parents financially support her. Source and Reliability of Informant:

Source is the patient. Patient is very reliable, alert and oriented to time, place, and person.

Past Use of Health Care SysSerious or Chronic Illnesses: None.

Past Health Screening (see “Well Young Adult Behavior Health Assessment History Screening” below) None. Past Accidents or Injuries: When she was seven years, old she fell down and had a fracture on (right) radius. No deformity noted at this time.

Past Hospitalizations: None

Past Operations:

Family History
(Specify which family member is affected.)
Alcoholism (ETOH use/abuse): None
Allergies: Mother has seasonal allergies and brother is allergic to penicillin. Arthritis: None
Asthma: maternal Grand father
Blood Disorders: none
Breast Cancer: paternal Grand mother
Cancer (Other): None
Cerebral Vascular Accident (Stroke): None
Diabetes: None
Heart Disease: Her uncle passed away of heart attack.
High Blood Pressure: None
Immunological Disorders: None
Kidney Disease: None
Mental Illness: None
Neurological Disorder: None
Obesity: None
Seizure Disorder: None
Tuberculosis: None
Obstetric History (if applicable)
Gravida: N/A Term: N/A Preterm: N/A Ab/incomplete: N/A
Course of Pregnancy (length of pregnancy, delivery date, method of delivery, length of labor, complications, baby’s weight, baby’s condition): N/A

Well Young Adult Behavioral Health History Screening
Socio-Demographic Content and Questions:

What organizations or activities (community, school, church, lodge, social, professional, academic, sports) are you involved in? “I am a high school senior preparing to go into college next year. I am an altar server and attend church every Sunday. I am an active member of youth group in church, member of Indian club in the school. I also volunteer in American red cross and shadow a cardiologist two hours/ week.

How would you describe your community?

“My community is a very organized and has a diverse amount of people that are from various countries.”

Hobbies, skills, interests, recreational activities?
She has great interest in music and enjoys singing. She has a passion for dancing, she learned thirteen years Indian classical dance and performed throughout North America.

Military service: Yes_______ No__X_____
If yes, overseas assignment? Yes________ No_________

Close friends or family members who have died within past 2 years? No
Number of relatives or close friends in this area?


Marital status: Single X_____ Married________Divorced_________Separated_________ In serious relationship________ Length of time_________

tem and Health Seeking Behaviors: Has used health care system when in need of health assessment. Client tries to exercise daily and comes to annual checkups.

Present Health or History of Present I...

Read more


.. /pubmedhealth/pmh0001911 06/01/2011 1 17 2 2000 201 2012 36 6t 7th ab/incomplete abdomin abnorm academ accid accommod acn activ actual acuiti address adequ adolesc adult affect age agent ago aid alcohol alert allerg allergi alon also altar alter alway america american amount and/or angina annual antacids/laxatives anyth appar appear appetit appli applic april area arteriosclerosi arthriti aspect assess assign asthma atherosclerosi attack attend avoid away axilla babi back background base behavior bilater biograph biophys biotechnolog birth birthplac bleed blind blood blood/body blur bowel breast breath bridg brittl brother bruis brush c c.l cancer cancer-pubm cardiac cardiologist care cataract caviti center cerebr cessat chang changes/depression characterist check checkup chest chicken childhood chill choic chronic church cigarett circumfer classic claudic clean clear client close club cold colleg color comb come comment communiti complet complic concept concern conclus condit condition condom congest consid consist constip contact content contracept coordin cough countri cours cover cramp cross current cva cycl daili danc danger data date day decreas deform deliveri demograph demonstr dental dentur depend depress describ develop diabet diagnos diagnosi diarrhea die diet difficulti diplopia disabl discharg discolor diseas disord disorders/abnormalities distress divers divorc dizzi done dri drug dryness due dysphagia dysuria ear earach eat ed edelman educ effect effort employ endocrin enhanc enjoy enlarg environment episod equal etoh even ever everi exam exam/check-up examin excercis excess exercis experi experienc expos exposur eye eyeglass famili father fatigu februari fell felt femal feminin financi first five flank flatul floss flow fluid food form found fourteen fractur frequenc frequent friend fruit full function gain gallop gastric gastrointestin general genit get glass glaucoma glucos go goe goiter grand grandmoth gravida great greater groin gross group gum gynecolog hair hands/feet head headach health healthi hear heart heartburn heat help hematolog hemoptysi hemorrhoid hernia hesit high histori hoars hobbi hopeless hose hospit hour hous hygien identifi ill illicit immun immunolog improv includ incom incontin indian indigest infect inform ingest inhal initi injuri insulin insur intercours interest intermitt intoler involv issu itch jarvi joint juli kegel kidney kind knot known labor last learn leg legs/ankles length lesion less life lifestyl light like limit listen live locat lodg long loss lot loui love low lump lung lymph malais male mammogram mandl march marit marri mass matern medic member membran memori menopaus mens menstrual mental method mi militari mo mobil moistur mole monogam mood mosbi mother motion motor mouth move movement much mucous murmur musculoskelet music myopia n.d n/a nail name narrow nasal nation nausea neck need negat neurolog never next night nippl nocturia node nois none nonproduct normal north nose noseble note nourish numb number nurs nutrit obes obstetr obstruct occup old oliguria one oper order ordinari organ orient origin outsid oversea pack pain pap pap-smear parent paresthesia pass passion past patern patient patient/client peni penicillin penil peopl per perfect perform peripher person phone physic pigment place pollut polyuria posit possibl postmenopaus pox practic prayer precaut pregnanc premenopaus premenstru prepar present pressur preterm prevent problem product profession promot prosthet protect pruriti pubm pupil pyrosi q q-tip quality/quantity question race race/ethnic radiat radius rang rare rash rate rational ray reaction reactiv readi realiz reason receiv recent record recreat rectal red refer region regular relat relationship reliabl reparatori requir resist respiratori result retriev review rhythm right risk riski round rout rub run safe safe-sex satisfactori satisfi saunder school sclera screen season see seek seizur select self self-car self-concept self-exam senior sens separ serious server servic seven sever sex sexual shadow shampoo shape short shortsight shower sick sign signific sinc sing singl sinus sitting/standing situat skill skin smear smell smoke social socio socio-demograph sore sound sourc span specifi sport spot sputum st standard state status std steam stiff still stimul stool strain stream stress stroke student suburban sun sunday sunray sunscreen support suprapub surgeri sweat swell symptom syncop sysseri system take tast teeth tem tendenc tender term test testicular textur thick think thirteen though three throat thrombophleb throughout thyroid time tingl tinnitus tip tongu tonsillectomi toothach town toxic toxin tract transfus tri tuberculosi twelv twice two ulcer uncl unemploy unusu upper urgenc urin urinari use use/abuse vagin vagina varicos various vascular veget vein vertigo vision volunt vomit walk warm water weak wear week weight well wheez wipe within word work would x x-ray year yes young youth