WebJan 30, 2024 · Assessment is the first and most critical phase of the nursing process.Incorrect nursing judgment arises from inadequate data collection and may adversely affect the remaining phases of the nursing … Web1.6 Example Documentation. Open Resources by Nursing (Open RN) 1.7 Checklist in General Survey. Open Resources for Nursing (Open RN) 1.8 Learning Services. Unlock Resources used Skilled (Open RN) I Glossary. Candid Resources for Nursing (Open RN) II. Chapter 2 Health History.
Exam Documentation: Charting Within the Guidelines AAFP
WebView full document See Page 1 16. When assessing the child with ear infection you’ve seen that there is pus draining from the ears. The mother tells you that the pus has been present for more than two weeks. What is the classification of this ear infection? a. No ear infection b. Mastoiditis c. Chronic ear infection d. Web2 rows · Apr 13, 2024 · For more information about how to assess PERRLA, extraocular eye movement, and other cranial nerves, ... frosch vero beach
Cheat Sheet: Normal Physical Exam Template ThriveAP
WebFeb 2, 2024 · Sample Documentation of Unexpected Findings. The patient reports awakening with an irritated left eye and crusty drainage but no change in vision. The sclera in the left eye is pink, the conjunctiva is red, and yellow, crusty drainage is present. The … Web5 rows · Physical Assessment: External Ear Structures. (List findings bilaterally) 1. Inspect the ... WebSample Documentation of Expected Findings. The patient reports no previous history of ear or eye conditions. Eyes have white sclera and pink conjunctiva with no drainage … ghrd 13- ija march 13 2023.pdf