assess2

Question 1

– name, address, age, sex, marital
status, occupation, insurance provider, religious
affiliation

Answer 1

Biographic data

Question 2

the reason for visit. It should be
recorded in the client’s own words.

Answer 2

Chief complaint

Question 2

previous illness , immunizations, food
or drug allergies, accidents or injuries, previous
hospitalization, medications being taken.

Answer 2

Past History

Question 3

to ascertain risk factors for
certain diseases, ages of siblings, parents,
grandparents, current state of health or if deceased
and the reason, and most importantly familial
diseases

Answer 3

Family History of Illness

Question 4

– personal habits, diet (description of a
typical diet), sleep patterns, any difficulty in ADL
(eating grooming, elimination, locomotion),
Instrumental ADLs (shopping transportation,
housekeeping laundry or manage medications

Answer 4

Lifestyle

Question 5

family relationships support systems in
times of stress, effect of illness on family, ethnic
affiliation, educational history, occupational history,
economic status and home or neighborhood
conditions.

Answer 5

Social Data

Question 6

major stressors, Usual coping
pattern, communication style (able to verbalize
emotions).

Answer 6

Psychological Data –

Question 7

all health care resources
the client is currently using and has used in the past

Answer 7

Patterns of healthcare

Question 8

use of senses.

Answer 8

Observing

Question 9

while the nurses are taking the
nursing health history. It is usually planned.

Answer 9

Interviewing