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Patients History

The document contains a patient's profile including demographic data, current health status, past medical history, family health history, gynecologic history, and lifestyle and health practices. It collects information about the patient's personal details, medical conditions, family health issues, reproductive health, daily routines, nutrition, exercise, stressors, and more.

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Marimiel Pagulayan
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58 views2 pages

Patients History

The document contains a patient's profile including demographic data, current health status, past medical history, family health history, gynecologic history, and lifestyle and health practices. It collects information about the patient's personal details, medical conditions, family health issues, reproductive health, daily routines, nutrition, exercise, stressors, and more.

Uploaded by

Marimiel Pagulayan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

PATIENT’S PROFILE

DEMOGRAPHIC DATA

Patient’s name:
Sex:
Birthdate:
Age:
Time and date of admission:
Attending physician:
Birthplace:
Permanent Address:
Nationality:
Religion:
Marital Status:
Occupation:
Health Care Financing:
Source of Medical Care:
Diagnosis:

CURRENT HEALTH STATUS

C
O
L
D
S
P
A

PAST MEDICAL HISTORY


Problems @ birth:
Childhood illnesses:
Immunizations to date:
Adult illnesses (physical, emotional, mental)
Surgeries:
Accidents:
Prolonged pain or pain patterns:
Allergies:
Physical, emotional, social or spiritual weakness:
Physical, emotional, social or spiritual strength:

FAMILY HEALTH HISTORY


Age of parents (living? Date of death):
Parents’ illness and longevity:
Grandparents’ illness and longevity:
Aunts’ and uncles’ ages, illness, and longevity:
Children’s ages, illness or handicaps and longevity:

GYNECOLOGIC HISTORY

Age when patient had her menarche:


Period length:
Cycle length
Pregnancy info (kamo nla bahala sisz)
GTPALM:

LIFESTYLE AND HEALTH PRACTICES


Description of a typical day (am to pm)
Nutrition and weight management:
24-hour food recall
Who purchases and prepares meals
Activities on a typical day:
Exercise habits and patterns:
Use of medications and other substances:
Self concept:
Self responsibilities:
Social activities for fun and relaxation:
Type of work, level of job satisfaction, work stressors
Finances:
Stressors in life and coping strategies used:
Residency, type of environment, neighborhood, environmental risks:

PSYCHOSOCIAL HISTORY
(Refer to chapter 7, Health Assessment book: Weber&Kelley, 6 th edition)

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