NURS 9222 7) David Carter Pt. 2 WELL EXPLAINED ANSWERS
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Course
NURS 9222 (NURS9222)
Institution
Northwest Arkansas Community College
Mental Health Case: David Carter, Part 2
Documentation Assignments
1. Document findings associated with your screening of Mr. Carter using the AIMS scale.
The patient had no abnormal facial expression
No smacking, puckering, or pouting of the lips and perioral area
No jaw biting or...
Documentation Assignments
1. Document findings associated with your screening of Mr. Carter using the AIMS scale.
• The patient had no abnormal facial expression
• No smacking, puckering, or pouting of the lips and perioral area
• No jaw biting or clenching
• No abnormal tongue movements
• No tremors or abnormal extremity movements
• No abnormal neck, hip, or shoulder movements
2. Document Mr. Carter’s performance of activities of daily living and his intake and output for the day.
Mr. Carter’s thoughts are more organized and coherent and he denies any hallucinations at the
moment. His paranoia has lessened significantly and he is eating hospital food and taking his
medicaitons consistently.
3. Document all laboratory tests ordered for Mr. Carter and their results.
4. Identify and document key nursing diagnoses for Mr. Carter.
• Readiness for enhanced health management
• Readiness for enhanced self-care
• Readiness for enhanced knowledge: Medication
• Readiness for enhanced coping
• Readiness for enhanced resilience
.
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