6

"Nurse - Client Interaction Analysis"

Appendix

Questions Routinely Addressed during this Interview

PREFERRED NAME & PATIENT'S OWN TELEPHONE NUMBER

RELIGION and MARITAL STATUS

OCCUPATION and NEXT OF KIN

RELATIONSHIP OF NEXT OF KIN and THEIR ADDRESS

TELEPHONE (DAY) TELEPHONE (NIGHT)

EMERGENCY CONTACT NAME + EMERGENCY CONTACT RELATIONSHIP

EMERGENCY CONTACT TELEPHONE ........ (DAY) ........ (NIGHT) ........

ADDRESS DATE & TIME OF ADMISSION and SOURCE OF ADMISSION

DIAGNOSIS and REASON FOR ADMISSION

RELEVANT MEDICAL HISTORY MEDICATION BEING TAKEN ON ADMISSION

MEDICATION BROUGHT IN BY PATIENT

ALLERGIES

DESCRIPTION OF STATE OF SKIN ON ADMISSION

BLOOD PRESSURE + PULSE + RESPIRATION + TEMPERATURE HEIGHT & WEIGHT (ANY RECENT CHANGES?)

URINALYSIS , ALCOHOL INTAKE , SMOKING ,

VALUABLES BROUGHT IN

ANY ADDITIONAL COMMENTS ?

MODEL OF CARE TO BE USED

WARD SISTER , NAMED NURSE , and ASSOCIATE NURSES

PHYSIOTHERAPIST'S COMMENTS  

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