Nursing Nursing Assignment
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3251HealthHistoryProject.docx|
Content of Health History Project |
Maximum Points Allowed |
Points Received |
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Demographics: Biographical information is complete for date & time, age, gender, DOB, ethnicity, occupation, next of kin with contact number, insurance |
5 points |
|
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Chief Complaint: CC is targeted toward the reason for presentation without the inclusion of extraneous information |
5 points |
|
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History of Present Illness: HPI is fully developed and includes OPQRST, location, duration, character, provocative/palliative factors, pertinent positives and negatives, effects on life |
15 points |
|
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Past Medical History: Elements of the PMH that expand on the CC and HPI are included, medications, allergies |
10 points |
|
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Health Maintenance: |
10 points |
|
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Family History/Genogram: |
5 points |
|
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Social History: |
5 points |
|
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Review of system: Elements of the ROS that expand on the CC and HPI are included, yet irrelevant information is excluded |
15 points |
|
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General Survey: General survey includes vital signs, height and weight, BMI, waist measurement and other relevant data related to CC. |
5 points |
|
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Physical Exam write-up: All/Each system(s) assessed with focus on the CC, HPI, ROS and included specific test for the organ system(s). Appropriate descriptors are used to document the physical findings. |
15 points |
|
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Grammar/Organization: Documentation is clear and well organized without spelling errors. Correct medical terminology is used. Redundant words, phrases, and other distracting information are omitted. Record has a logical flow. |
10 points |
|
|
Total |
100 points |
|
Tennessee State University
School of Nursing- BSN Program
NURS 3251
Health History Project
Health History Project
Course outcome objective: The student collects data for the health history and documents the findings in a systematic and accurate manner demonstrating appropriate verbal, non-verbal and written communication skills.
Process for data collection: The student may choose any client/family member/friend to interview. Should someone other than the client serve as the information source, the student should note this in the demographic information.
Confidentiality: Clients are to be informed that all data collected for the health history is strictly confidential and the client’s name will not be noted in the paper.
Resource guide:
Jarvis, C. (2020). Physical Examination and Health Assessment, 9th Edition. ISBN: 9780323510806
Chapter 4: The Complete Health History is a good place to start.
Jarvis, C. (2020). Physical Examination and Health Assessment, 9th Edition. Study Guide and Laboratory Manual. ISBN: 9780323532037
Evaluation: The Health History Project will be graded according to content and write up. Please see the Health History Project Grading Criteria for further information. The Health History Project can earn a maximum of 100 points and will count as 10% of each student’s final grade in NURS 3251.
Late projects are not accepted. Submit to the correct Dropbox by the due date/time.
Health History Projects should be typed, 12 point font, and double-spaced.
