Help needed - Completed Health Assessment Example

[missbelinda]

Hi. I am new to this site and hope that someone can help me. I am a first year student and have already interviewed my patient, however i am really unsure on how to word it all up for my assigment which is due next Monday. I have the Nursing Health Assessment and Physical Examination form filled in roughly, just need some guidance. Is there anyone that can email me direct an example of one that has been filled out so i can get an idea on how to word it. Thank you.

[SarcasticLVN]

So basically a head to toe assessment? I always start with vitals, if they are alert and oriented, speech etc and then just go by each system. You can use the physical assessment form as your guide. If you would like an example of a full assessment you can message me and I'll send you one :)

[missbelinda]

Hi and thanks for replying. Ok so what i have done is interviewed a friend of a friend and filled out the form that uni gave me, getting the biographical data, subjective data, family history and psychosocial data. From here i have to form 4 nursing diagnoses on 4 separate care plans...i am usure if i have made it too hard for myself as the patient was an elderly lady who didnt have a great deal of problems.. Is this maybe where i am going wrong? Thank you