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RATIONALE
This tool is valuable for evaluating patients with early-stage disease, both to assess the level of disease and to determine

the patient's ability to care for him- or herself.

These skills are considered more complex than the basic activities of daily living as measured by the Katz Index of ADLs The instrument is most useful for identifying how a person is functioning at the present time, and to identify improvement or deterioration over time.

Women are scored on all 8 areas of function; historically, for men, the areas of food preparation, housekeeping, laundering are excluded. Clients are scored according to their highest level of functioning in that category. A summary score ranges from 0 (low function, dependent) to 8 (high function, independent) for women, and 0 through 5 for men.

This instrument is intended to be used among older adults, and


can be used in community or hospital settings.

The instrument is not useful for institutionalized older adults.


It can be used as a baseline assessment tool and to compare baseline function to periodic assessments.

Operates telephone on own initiative; looks up

and dials numbers....................................................1


Dials a few well-known numbers............................1 Answers telephone, but does not dial...................1 Does not use telephone at all...................................0

Takes care of all shopping needs independently.........1

Shops independently for small purchases ..................0


Needs to be accompanied on any shopping trip .. 0

Completely unable to shop .........................................0

Plans, prepares, and serves adequate meals independently...1 Prepares adequate meals if supplied with ingredients........0 Heats and serves prepared meals or prepares meals but does not maintain adequate diet ........................0 Needs to have meals prepared and served ....................0

Maintains house alone with occasion assistance (heavy work)...1 Performs light daily tasks such as dishwashing, bed making..1
Performs light daily tasks, but cannot maintain acceptable level of cleanliness 1

Needs help with all home maintenance tasks ....................1


Does not participate in any housekeeping tasks.................0

Does personal laundry completely...................................1

Launders small items, rinses socks, stockings, etc .........1


All laundry must be done by others .................................0

Travels independently on public transportation or drives own care.........1

Arranges own travel via taxi, but does not otherwise use public transpo..1
Travels on public transportation when assisted or accompanied by another....1 Travel limited to taxi or automobile with assistance of another....0 Does not travel at all ...............0

.Is responsible for taking medication in correct dosages at correct time ........................................1 Takes responsibility if medication is prepared in advance in separate dosages................................0 Is not capable of dispensing own medication...................0

Manages financial matters independently (budgets, writes checks, pays rent and bills, goes to bank); collects and keeps track of income..1 Manages day-to-day purchases, but needs help with banking, major purchases, etc ................................1 Incapable of handling money ............................................0

IADL with four scales that measured domains of functional status, Physical Classification(6-point rating of physical health), Mental Status Questionnaire (10-point test of orientation and memory),

Behavior and Adjustment rating scales (4-6-point measure of


intellectual, person, behavioral and social adjustment), and the PSMS (6-item ADLs).

Gravida Para Abortion Miscarriage

Problems with infertility Dates of previous pregnancies Infant weight

Past Obstetrics History

Length of labor

Womans Types of perception of deliveries past Multiple births pregnancy, Abortions labor and Maternal, fetal delivery for and neonatal herself and complications effect on her family

Expected Date of Confinement


The average length of a pregnancy is 40 weeks, or 280 days, from the first day of the last normal menstrual period. Calculating EDC - add nine months and seven days to the date -3months +7days +1 year

Appearance and evaluation of color. Pulse Grimace or reflex irritability. Activity Respiratory effort

Auscultate the heart rate for 1 full minute Measure the degree of respiratory effort Evaluate muscle tone by attempting to strengthen each proximity individually. Evaluate the newborns reflex irritability. Use a flicking motion of two fingers against the newborns sole to reflex irritability Inspect the newborns color.

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Pediatric additions to
Health assessment

Head circumference

Height/weight

Weight

immunization

The following list illustrates the content of a complete review of systems

Average weight,
weight loss Gain

general state of health sense of wellbeing

Strength ability to conduct usual activities exercise tolerance

Skin/Breast
Rash, itching Pigmentation moisture or dryness changes in hair growth or loss nail changes Breast lumps Tenderness Swelling nipple discharge

Eyes/Ears/Nose/Mouth/Throat

Headaches Vertigo lightheadedness, injury

Vision
double vision tearing blind spots pain

Eyes/Ears/Nose/Mouth/Throat

Nose bleeding Colds Obstruction discharge Dental difficulties gingival bleeding, dentures

Neck stiffness Pain Tenderness masses in thyroid or other areas

Cardiovascular

nocturnal paroxysmal dyspnea


Precordial pain, substernal distress, palpitations., syncope dyspnea on exertion Orthopnea

Edema Cyanosis Hypertension heart murmurs varicosities, phlebitis, claudication

Respiratory

Pain shortness of breath Wheezing Stridor

cough

respiratory infections

hemoptysis, tuberculosis fever or night sweats

Gastrointestinal

Appetite Dysphagia Indigestion abdominal pain Heartburn nausea, vomiting hematemesis,

Jaundice constipation or diarrhea abnormal stools flatulence Hemorrhoids recent changes in bowel habits

Genitourinary

dysuria,

Urgency
frequency infections

nocturia, hematuria, polyuria, oliguria, Stones color of urine,

Nephritis hesitancy change in size of stream dribbling

acute retention or incontinence Libido potency, genital stores, discharge venereal disease

Musculoskeletal

Pain Swelling redness heat of muscles or joints,

limitation of motion, muscular weakness, Atrophy Cramps

Neurologic/Psychiatric

Convulsions Paralyses Tremor Incoordination parathesias

Predominant mood "nervousness" (define) emotional problems previous psychiatric care unusual perceptions,

Allergic/Immunologic Lymphatic/Endocrine

Reactions to drugs, Food and insects, skin rashes trouble breathing

Anemia bleeding tendency, previous transfusions and reactions, Rh incompatibility

Gracias a todos!!

Video Presentation is due on Friday April 28, 2012 At 11:00am; Nursing Office

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