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Family Medical History

by | Feb 3, 2022 | Uncategorized

 

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• For the Demographics section, you will need to include the person’s initials, date of birth, age at the time of the interview, gender, race, relationship status and occupation.
• In the Perception of Health section, you want to address how the person defines health, how they feel about their current health status and if they have any concerns. You will need to include their health goals for the present as well as in the future. You could also include how they see their healthcare providers helping them with these goals.
• In the Past Medical History section, you will need to include childhood illnesses, accidents/injuries, serious or chronic illnesses, hospitalizations, operations, immunizations, last examination date, allergies with the reaction and all current medications including nonprescriiption/OTC medications, herbal medications and supplements. If the person is female, you will need to include their obstetric history also.

• For the Family Medical History section, you can use a pedigree or genogram such as the sample in your textbook on page 49 or you can write it out. Either way, you will need to include the gender, relationship and age of the immediate blood relatives in at least three generations of the person you interviewed. Consider including the aunts/uncles, nieces/nephews and cousins as well. The medical condition of each person along with any significant health information should be included in this section. Be sure to identify anyone in the family with the specific diseases listed in the last paragraph of the Family History section of your textbook on page 50.
• The Review of Systems is all subjective data. There should be absolutely positively no objective findings here. This is the place for the patient to tell the healthcare provider what is or is not present in each area. Use the Review of Systems section in the textbook as a guide for the areas that you need to include in the RUA.
• Under developmental considerations, you will indicate the person’s stage of cognitive development using Piaget’s theory as well as their stage of psychosocial development using Erickson’s theory.
• In the cultural considerations section, you will identify any religious or spiritual beliefs and practices that the person follows. You will need to identify any dietary restrictions and if there are any restrictions on medical procedures/interventions that can be done.

• Living situation, leisure activities, exercise pattern, sleep pattern and perceived level of stress should be identified in the psychosocial considerations portion of the paper. You will want to include how these things are helping or hindering the person from reaching their health goals.
• In the collaborative resources section, you will identify the presence or absence of resources from the family, community and healthcare providers/system. You will want to address how the presence or absence of these resources has effected the person and their ability to meet their health goals.

 

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