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[DOCX File]Sample of Person-Centered Care Plans for Activity, Nursing ...
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Powerlessness/Feelings of Loss of Control. Smoking Cessation. Unsafe Smoking. Social Isolation. Spiritual Distress. Sporadic Attendance. Substance Abuse. Suicidal Actions. Impaired Vision. Activities Person-Centered Care Plans Table of Contents. INTRODUCTION. CARE PLANS. Activity Involvement: Participant Choice to Volunteer. Activity ...
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[DOC File]INSPECTION AND TESTING FORM
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Title: INSPECTION AND TESTING FORM Author: Michael Richard Gammell Last modified by: mgriffith Created Date: 2/3/2009 8:15:00 PM Company: NFPA Other titles
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[DOC File]History and Physical Exam Form
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Weight – Every 6 months, based on necessity Cholesterol Screening Men: 35-65 yrs Women: 45-65 yrs If family history cannot be ascertained and other risk factors are present, blood test should be performed at the discretion of the practitioner. Colon Cancer Screening Annual fecal occult blood testing or
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[DOC File]Emergency Action Plan (Template)
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• Wear layers of loose-fitting, light-weight, warm clothing, if available. If outdoors: • Find a dry shelter. Cover all exposed parts of the body. • If shelter is not available: - Prepare a lean-to, wind break, or snow cave for protection from the wind. - Build a fire for heat and to attract attention.
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[DOC File]Case Management Assessment Form
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Apr 27, 2010 · Yes No Night Sweats Yes No PID Yes No Chills Yes No Thrush Yes No Fatigue Yes No Dysphagia Yes No Malaise Yes No Cold Sores Yes No Weight Loss >10 lbs Yes No Seizures Yes No Loss of Appetite Yes No Change in Vision Yes No Diarrhea > 1wk Yes No Periodontal Disease Yes No Herpes Yes No Short Term Memory Loss Yes No Syphilis Yes No Hepatitis Yes No
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[DOC File]Optional Long Term Care Assessment and Care Planning Tool
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Weight gain or loss (>5% of body weight) Yes No Unable to assess. Insomnia or hyper-somnia (sleeping all the time) Yes No Unable to assess. Psychomotor agitation (inability to sit still/pacing/hand wringing/pulling or rubbing of the skin, clothing, or other objects) or retardation (slowed speech/thinking and body movements)
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[DOC File]PATIENT HISTORY FORM - Hopkins Medicine
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( Recent weight gain; how much____ ( Headaches ( Depression ( Recent weight loss: how much____ ( Dizziness ( Excessive worries ( Fatigue ( Fainting or loss of consciousness ( Difficulty falling asleep ( Weakness ( Numbness or tingling ( Difficulty staying asleep ( Fever ( Memory loss ( Difficulties with sexual arousal ( Night sweats ( Poor ...
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[DOC File]Respirator Fit Test Form
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N/A Note: A new fit test must be performed in the event of significant weight gain/loss (20 lb.), dental work or any facial change that may affect the seal of the respirator. Employee . PASSED . respiratory fit test . Employee . FAILED. respiratory fit test ...
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[DOCX File]TREATMENT PLAN GOALS & OBJECTIVES
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Oct 01, 2017 · Goal: Be free of drug/alcohol use/abuse. Avoid people, places and situations where temptation might be overwhelming. Explore dynamics relating to being the [child/husband/wife] of an [alcoholic/addict] and discuss them each week at support group meetings. Learn five triggers for alcohol & drug use. Reach ____ days/months/years of clean/sober living
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[DOCX File]Sample Patient Discharge Letter
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Author: Priority Health Created Date: 05/07/2013 05:18:00 Title: Sample Patient Discharge Letter Subject: A format for notifying a patient that you are discharging the patient from your practice
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Free printable weight loss templates