Complete the “Health History and Screening of an Adolescent or Young Adult Client” worksheet.
Skin (history of skin disease, pigment or color change, change in mole, excessive dryness or moisture, pruritis, excessive bruising, rash or lesion):
Health Promotion (Sun exposure? Skin care products?):
Hair (recent loss or change in texture): Health Promotion (method of self-care, products used for care):
Nails (change in color, shape, brittleness): Health Promotion (method of self-care, products used for care):
Head (unusual headaches, frequency of headaches, head injury, dizziness, syncope or vertigo):
Eyes (difficulty or change in vision, decreased acuity, blurring, blind spots, eye pain, diplopia, redness or swelling, watering or discharge, glaucoma or cataracts): Health Promotion (wears glasses or contacts and reason, last vision check, last glaucoma check, sun protection):
Ears (earaches, infections, discharge and its characteristics, tinnitus or vertigo):
Health Promotion (hearing loss, hearing aid use, environmental noise exposure, methods for cleaning ears):
Nose and Sinuses (discharge and its characteristics, frequent or severe colds, sinus pain, nasal obstruction, nosebleeds, seasonal allergies, change in sense of smell): Health Promotion (methods for cleaning nose):
Mouth and Throat (mouth pain, sore throat, bleeding gums, toothache, lesions in mouth, tongue, or throat, dysphagia, hoarseness, tonsillectomy, alteration in taste): Health Promotion (Daily dental care – brushing, flossing. Use of prosthetics – bridges, dentures. Last dental exam/check-up.):
Neck (pain, limitation of motion, lumps or swelling, enlarged or tender lymph nodes, goiter):
Neurologic System (history of seizure disorder, syncopal episodes, CVA, motor function or coordination disorders/abnormalities, paresthesia, mood change, depression, memory disorder, history of mental health disorders): Health Promotion (activities to stimulate thinking, exam related to mood changes/depression):
Endocrine System (history of diabetes or insulin resistance, history of thyroid disease, intolerance to heat or cold): Health Promotion (last blood glucose test and result, diet):
Breast and Axilla (pain, lump, tenderness, swelling, rash, nipple discharge, any breast surgery): Health Promotion (performs breast self-exam – both male and female, last mammogram and results, use of self-care products):
Respiratory System (History of lung disease, smoking, chest pain with breathing, wheezing, shortness of breath, cough – productive or nonproductive. Sputum – color and amount. Hemoptysis, toxin or pollution exposure.): Health Promotion (last chest x-ray, smoking cessation):
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