Here you can read our free Guide of HIM-FPX 4610 Assessment Two Skin Progress.
Instructions of HIM-FPX 4610 Assessment Two Skin Progress
History and Physical (H&P)
Translate into medical terms or abbreviations the common terms found in the history and physical (H&P) of a patient who presented to an emergency room with a number of issues. Spell all medical terms or abbreviations and common terms correctly on the provided template.
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Introduction
This second assessment continues to explore medical terminology related to various body systems, general structures, and functions of the human body, including the digestive and nervous systems, as well as psychiatry terminology. Our focus in this assessment will be on the nervous system. The nervous system is a complex network of nerves and cells that carries messages to and from the brain and spinal cord to various parts of the body. The nervous system includes the central peripheral nervous systems. Your suggested resources address how the nervous system functions and what jobs it performs. They also focus on diseases, treatments, and diagnostic studies related to the nervous system.
In the assessment you will review a patient’s history and physical (H&P), another common document found in acute care settings. You will translate the common terms in the H&P into the correct medical terms or abbreviations.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
- Competency 2: Use medical terminology and abbreviations related to general structures and functions of the human body.
- Identify common terms related to general structures and functions of the human body correctly.
- Translate common terms related to general structures and functions of the human body into medical terms or abbreviations correctly.
- Competency 3: Use medical terminology and abbreviations related to body systems.
- Identify common terms related to body systems correctly.
- Translate common terms related to body systems into medical terms or abbreviations correctly.
- Competency 6: Spell and pronounce basic medical terms.
- Spell common and medical terms or abbreviations correctly.
- Competency 7: Communicate in a professional manner.
- Provide citations and references in APA style.
Instructions
Review the H&P below for a patient who presented in the emergency room with a number of issues. Pay close attention to the present and past history, medications, allergies, social and family history, review of systems, physician exam, and assessment and plan. Next, download the Patient History and Physical Template [DOCX] and complete all of the following on the template:
- Select 15 common terms from the H&P.
- Translate the 15 selected common terms into medical terms or abbreviations.
- Spell the common and medical terms correctly.
- Cite in correct APA style the references you used to perform your translation. Click Evidence and APA for additional guidance on how to ensure your citations and references conform to APA guidelines.
Patient H&P
History of Present Illness:
This is a 54-year-old female who presented to the emergency room with a headache in the back of her head and double vision. She also complains of being able to see only from half of her eye. These symptoms began suddenly while she was out walking her dog about 45 minutes ago. A family member brought patient directly to the emergency room for evaluation.
Past Medical History:
- High blood pressure.
- High cholesterol.
- Irregular, rapid heartbeat.
- IBS.
- Cholelithiasis with cholcystectomy.
Medications:
Diovan 80 mg with hydrochlorothiazide 12.5 mg daily.
Allergies:
None.
Social History:
Non-smoker, no alcohol.
Family History:
Both parents and older sibling died from a stroke. Grandparents had extensive colon polyps.
Review of Systems:
She has bilateral vision defects. Denies dizziness, weakness, or numbness. Denies shortness of breath, problems breathing, and chest pain. Denies nausea, vomiting, and blood in stool. No bladder or bowel changes. No edema or skin changes to arms and legs.
Physician Exam:
- General: Patient appears to be a well-developed, well-nourished female. Alert and oriented to person, place, and time.
- Vital Signs: Stable.
- Skin: No discoloration, no tissue breakdown.
- Head, Eyes, Ears, Nose, Throat: Pupils equal, round, and reactive to light; eye muscle movements are intact.
- Chest: Clear.
- Heart: Irregular, rapid rhythm.
- Abdomen: No guarding, some tenderness related to the IBS.
- Arms and Legs: No leg swelling.
Assessment and Plan:
- Headache in the back of the head with vision changes. Obtain a computed tomography scan and magnetic resonance imaging scan. Depending on test results may need to consider an artery repair procedure.
- High blood pressure: Continue home meds.
- Irregular, rapid heartbeat: Continue home meds.
Additional Requirements
- Format: Ensure you complete all columns on the Patient History and Physical Template.
- Scoring Guide: Be sure to review the scoring guide for this assessment so you understand how your faculty member is going to evaluate your work.
Resources
Use the resources linked below to help complete this assessment.
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The Digestive System
Chabner, D. (2017). The language of medicine (11th ed.). St. Louis, MO: Saunders. Available in the courseroom via the VitalSource Bookshelf link.
- Chapter 5, “Digestive System,” pages 139–186.
- Chapter 6, “Additional Suffixes and Digestive System Terminology,” pages 187–214.
The Nervous System
Chabner, D. (2017). The language of medicine (11th ed.). St. Louis, MO: Saunders. Available in the courseroom via the VitalSource Bookshelf link.
- Chapter 10, “Nervous System,” pages 343–398.
- Chapter 17, “Sense Organs: The Eye and the Ear,” pages 697–748.
Mental Disorders
Chabner, D. (2017). The language of medicine (11th ed.). St. Louis, MO: Saunders. Available in the courseroom via the VitalSource Bookshelf link.
- Chapter 22, “Psychiatry,” pages 921–958.
Activity
Click Vila Health: Medical Terminology to complete an interactive activity in which you will hear a discussion between a doctor, a patient, and the patient’s family about the patient’s condition. Access the Nervous System tab. This activity will give you an opportunity to assess your knowledge of medical terminology related to the nervous and other body systems. After completing this activity, you will be well prepared to successfully complete your assessment.
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STEP-BY-STEP GUIDE on HIM-FPX 4610 Assessment Two Skin Progress
Introduction to HIM-FPX 4610 Assessment TWO
This Owlisdom How-To Guide aims to assist students in translating standard terms found in a patient’s history and physical (H&P) into correct medical terms or abbreviations. The HIM-FPX 4610 Assessment Two Skin Progress enhances your understanding of medical terminology, mainly focusing on the nervous system, and ensures you can accurately communicate medical information in a professional setting. You will complete the task efficiently and effectively by following the outlined steps.
Review the Patient’s History and Physical (H&P)
To start the HIM-FPX 4610 Assessment Two Skin Progress, we will thoroughly read and analyze the patient’s history.
- Carefully read through the patient’s H&P document, noting standard terms describing symptoms, conditions, or treatments.
- Pay special attention to terms related to the nervous system but include general terms.
Select 15 common terms from the H&P.
Translate the 15 selected common terms into medical terms or abbreviations.
Select 15 Common Terms
Next, in HIM-FPX 4610 Assessment Two Skin Progress. We will select 15 terms related to the case and translate those medical terms.
- Identify and list 15 standard terms from the H&P. These terms should be relevant and cover various aspects of the patient’s condition and treatment.
- Ensure the selected terms are diverse, encompassing symptoms, diagnoses, and procedures.
- For each of the 15 selected standard terms, provide the correct medical term or abbreviation.
- Double-check the spelling of both the standard terms and their medical translations.
- Utilize spell-check tools or medical dictionaries to confirm accuracy.
Cite the references you used to perform your translation in the correct APA style. Click Evidence and APA for additional guidance on ensuring your citations and references conform to APA guidelines.
APA Style Citations and References
As the rubric requires, we will cite the resources in APA format at the end of the HIM-FPX 4610 Assessment Two Skin Progress.
- Cite all sources used for translations in the correct APA style. This includes medical dictionaries, textbooks, and credible online resources.
- Refer to the “Evidence and APA” section for additional guidance on formatting citations and references according to APA guidelines.
Demonstration of Proficiency
By completing the HIM-FPX 4610 Assessment Two Skin Progress, you will demonstrate your proficiency in several key competencies:
Competency 2: Use medical terminology and abbreviations related to general structures and functions of the human body. Correctly identify and translate standard general structure and function terms into medical or abbreviations.
Competency 3: Use medical terminology and abbreviations related to body systems. Identify and correctly translate standard terms related to body systems into medical terms or abbreviations.
Competency 6: Spell and pronounce basic medical terms. Ensure all standard and medical terms or abbreviations are spelled correctly.
Competency 7: Communicate professionally. Provide proper citations and references in APA style.
Note: These competencies are manageable and designed to guide you through the assessment. With careful attention to detail and the use of reliable resources, you will be able to complete the task successfully.
Closing
Completing the HIM-FPX 4610 Assessment Two Skin Progress will improve your ability to translate standard terms into medical terminology and enhance your overall communication skills in a medical context. The key takeaways include understanding the importance of accurate translation, ensuring proper spelling, and adhering to APA citation guidelines. This How-To Guide will aid you with the skills essential for effective communication in healthcare and will be valuable in your future career. In the next module of HIM-FPX 4610, we will explore Assessment Three on Health Topic Approval.
