Herzing University NSG NSG-121 – Choose a patient and do a complete health history interview using the provided Health History Questionnaire

Assignment on Health History Questionnaire

For this assignment, you will perform an assessment and then write up your findings in a paper.

Choose a patient and do a complete health history interview using the provided Health History Questionnaire. Your patient can be anyone that you personally know (do not complete this on an actual patient that you are caring for). This includes biographical, past health history, a complete review of the systems, social history, family history, and functional assessment.

• After completing the health history questionnaire, summarize your findings using the headings provided below.
• Submit your summary in a typed, double-spaced document which includes a title page and headings.

Requirements

Content: 70% of grade

• Biographic data (please use alias to protect student’s privacy) (5 points)
• Past health history (10 points)
• Current health, meds (5points)
• Review of systems (20 points)
• Social history (10 points)
• Family history (10 points)
• Functional assessment (10 points)

Grammar: (5 points)

• Grammar
• Spelling
• Sentence Structure
• Punctuation

APA format: (2 points)

• Title Page
• Headings
• Typed
• Double-spaced

Record your observations on a Word document. Submit the completed assessment Word document and questionnaire.

Sample Answer Health History Questionnaire

Title: Health History Assessment

Biographic Data:
Patient Alias: Jane Doe
Age: 35 years
Gender: Female
Occupation: Marketing Manager
Marital Status: Married
Address: 123 Main Street, Anytown, USA

Past Health History:
1. Childhood Illnesses: The patient reported having occasional respiratory infections during childhood but had no significant chronic illnesses.
2. Adult Illnesses: No major illnesses or chronic conditions were reported.
3. Hospitalizations: The patient had a cesarean section for the birth of her child five years ago. No other hospitalizations were reported.
4. Surgeries: Cesarean section, no other surgeries.
5. Allergies: The patient reported no known allergies to medications, food, or environmental factors.
6. Medications: The patient currently takes a daily multivitamin and occasionally uses over-the-counter pain relievers as needed.

Current Health and Medications:
1. General Health Status: The patient described her current health as generally good, with no significant complaints.
2. Current Medications: Daily multivitamin.
3. Pain: The patient reported occasional headaches, which are relieved by over-the-counter pain relievers.
4. Chronic Conditions: No known chronic conditions were reported.
5. Immunizations: Up to date on routine vaccinations.

Review of Systems:
1. General: The patient denied fever, chills, fatigue, or unexplained weight loss.
2. Skin: No significant skin issues reported. No rashes, lesions, or changes in pigmentation.
3. Head: Occasional headaches reported, no other head-related symptoms.
4. Eyes: No visual changes, no eye pain, and no history of eye disorders.
5. Ears: No hearing loss, tinnitus, or ear infections reported.
6. Nose and Sinuses: No nasal congestion, sneezing, or sinus pain reported.
7. Throat and Mouth: No sore throat, difficulty swallowing, or oral health issues reported.
8. Cardiovascular: No history of heart disease, chest pain, or palpitations.
9. Respiratory: No history of chronic respiratory conditions or frequent respiratory infections.
10. Gastrointestinal: No significant gastrointestinal symptoms or disorders reported.
11. Genitourinary: No urinary tract infections or abnormalities reported.
12. Musculoskeletal: No joint pain, stiffness, or limitations in range of motion reported.
13. Neurological: No history of seizures, numbness, tingling, or weakness reported.
14. Endocrine: No known endocrine disorders or symptoms reported.
15. Hematologic: No history of bleeding disorders or anemia reported.
16. Immunologic: No known immunodeficiency disorders or recurrent infections reported.

Social History:
1. Occupation: The patient works as a marketing manager for a large corporation.
2. Exercise and Physical Activity: The patient engages in moderate exercise, such as jogging, three times a week.
3. Substance Use: The patient denied tobacco, alcohol, or illicit drug use.
4. Diet: The patient follows a balanced diet, consuming a variety of fruits, vegetables, lean proteins, and whole grains.
5. Sleep Patterns: The patient reported a regular sleep pattern, averaging 7-8 hours of sleep per night.
6. Stress and Coping Mechanisms: The patient reported experiencing moderate stress levels due to work demands but copes through exercise, hobbies, and spending time with loved ones.

Family History:
1. Parents: Mother – Hypertension, Father – Diabetes
2. Siblings: No known significant medical conditions in siblings.
3. Children: One child, no significant medical conditions reported.
4. Grandparents: No known significant medical conditions in grandparents.

Functional Assessment:
1. Activities of Daily Living (ADLs