I-HUMAN PATIENTS CASE STUDY: COMPREHENSIVE (HEAD-TO-TOE) PHYSICAL ASSESSMENT

Need clue of a complete comprehensive question to ask the patient, step by step approach so I don’t miss any required question 

I-HUMAN PATIENTS CASE STUDY: COMPREHENSIVE (HEAD-TO-TOE) PHYSICAL
ASSESSMENT

Throughout this course, you have reviewed Learning Resources on various body systems
and completed i-Human Patients Assignments for particular systems. For this i-Human
Patients Assignment, you connect the knowledge and skills you gained from each
individual assessment to perform a comprehensive head-to-toe physical examination.

Note: You must pass the Week 9 Assignment to pass the course.

History: Complete an appropriate health history. (Scores are automatically calculated in
the i-Human platform.),

This criterion is linked to a Learning Outcome Physical Exam: Complete an appropriate
physical exam. (Scores are automatically calculated in the i-Human platform.)

EMR Documentation Chief Complaint and History of Present Illness 5 criteria using
OLDCARTS: 1.) Complete; 2.) Accurate; 3.) Written in Professional Language; 4.) Pertinent
to the Chief Complaint; 5.) Includes Subjective findings only (Evidence of Academic
Integrity Issues will result in a grade of 0.)

EMR Documentation Subjective Data Document Current Medications, PMH, Allergies,
Family History, Social History, Preventive Health, Review of Systems 5 criteria: 1.)
Complete; 2.) Accurate; 3.) Written in Professional Language; 4.) Pertinent to the Chief
Complaint; 5.) Includes Subjective findings only (Evidence of Academic Integrity Issues will
result in a grade of 0.)

EMR Documentation Objective Data Document Physical Exam Findings: 5 criteria: 1.)
Complete; 2.) Accurate; 3.) Written in Professional Language; 4.) Pertinent to the Chief
Complaint; 5.) Includes Objective findings only (Evidence of Academic Integrity Issues will
result in a grade of 0.)

Key Findings: Organize the key findings with the most important first and least important
last. (Evidence of Academic Integrity Issues will result in a grade of 0.)

Problem Statement: Document a brief and accurate problem statement using professional
language that includes the following: 1.) Name or initials, age; 2.) Chief complaint; 3.)
Positive and negative subjective findings; 4.) Positive and negative objective f indings.
(Evidence of Academic Integrity Issues will result in a grade of 0.)

Management Plan: Use the expert diagnosis provided to create a pertinent,
comprehensive, evidenced-based management plan. Address the following criteria in the

plan: 1.) Diagnostic tests; 2.) Medications (write out a complete order, even for OTC meds);
3.) Suggested consults/referrals; 4.) Patient education; 5.) Follow-up, including time
interval and specific symptoms to prompt a return visit sooner; 6.) Provide rationales for
each intervention and include references to support your plan. Clinical practice guidelines
should be utilized as applicable. (Evidence of Academic Integrity Issues will result in a
grade of 0.)