Patient with Chronic Diseases/health Conditions Worksheet
Description
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edical Nutrition
Final Project
PART 1: PATIENT CASE STUDY
Chief complaint:
History of present illness:
Example (please delete the example before submitting your final project): Mr. Smith is a 64year-old white male with a history of coronary artery disease, hypertension, and diabetes
mellitus type 2 coming in for gradually worsening shortness of breath when he exerts himself.
He also notes increased lower extremity edema.
HISTORY
Medical history:
Surgical history:
Family history:
Social history:
Occupation:
Home environment:
Tobacco use:
Alcohol use:
Vital signs:
Height:
Weight:
BMI:
BP:
Additional relevant physical assessment (optional):
Pertinent Labs (please add additional rows as needed)
Lab
Reference value
Patientàvalue
Example: HbA1C (%)
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