Questionnaires

Good morning ma’am before anything else I’d like to introduce myself first I am Keneth Dave J. Aglibut your student
nurse for today and you are I am Mrs. Mary Grace right and how would you like me to call you just call me Grace
okay Grace so before we proceed I need you to verify some of your personal information’s here your complete name
please Mary Grace J. Aglibut and your age I am 47 years old is this your address Mallalatang Tungui Reina Mercedes,
Isabela yeah that's right okay and are you married I’m happily married all right so before getting any further I’d like to
let you know that in order for me to help you today I need to ask you some questions particularly about your health
and medical background and some of your personal circumstances will that be all right with you all right okay and
your answers will be documented so that we will be able to formulate the best care that will suit your need fine do you
have any questions no okay so let's get started so what brings you here today in the hospital Grace well I came here
today I come here today because I am having a problem with my stomach and backpain okay and how long has this
stomach and backpain been therefore I suppose it's been four to five days already okay and have you got any other
symptoms along with this stomach and backpain no all right so on the scale of one to ten ten being the worst and one
being the least how bad is your stomach and backpain well I suppose it's seven to eight seven to eight and do you feel
any pain around your left side of your body or your back or anywhere else in your body yeah there's pain every time
can you describe the pain is it like throbbing stabbing or squeezing perhaps or anything well it's like stabbing okay so
on the scale of 1 to 10 10 being the worst one being the least how bad is the pain that you feel well since it's very
variable pain so it's just three to four okay and have you taken any meds to alleviate the yeah two days ago I went to
the pharmacy and I bought uboprofen it was 500 milligrams and also I bought along with it Advil and to relieve my
backpain from okay and how many days have you been taking this medicines I think it's already two days okay two to
three days okay and have you ever been admitted in the hospital before for any health problems well I have never been
admitted to the hospital because of illness or disease but I have been admitted at the time when I gave birth okay so
you don't have any other illness like diabetes heart problems or asthma like that no okay and I suppose you also don't
have any maintenance medications no all right and how about allergies are you allergic to anything like food or pets
well no I don’t have any allergies okay and do you know if you have any drug allergies not I can remember okay and
you told me a while ago that you are married and that you've got kids and may i know how old are they now my eldest
is 19 years old and my youngest is 15 years old all right and are you still having your menstrual period no okay and
have you experienced any miscarriages no do you have any reproductive problems well i only have menstrual cramps
at the time i still have my period okay all right let's proceed now for family history I’d like to elicit some information
about your family health background will that be all right with you no it's okay okay so do you know if there is any of
your first degree relatives like your mom your dad your siblings ever suffered from any jaundice no was diagnosed to
have an asthma and she always had a severe attacks of asthma okay and what about but my moher was known to have
a very high blood pressure but he doesn't have any heart problems or stroke okay yeah anyone with diabetes yeah my
dad was diagnosed to have diabetes okay any cancer at all no okay mentioned is there any other disease that has ever
affected your family I don't remember him okay and now I’d like a little bit of information about your social
background if that's okay with you and so if you don't mind me asking what is your occupation well I am an online
seller and I usually work at home okay that is very nice and are you happy yes I do all right and have you lately been
exposed to people with fever runny nose or stuff well a week ago my husband had a cough and he is already pooped
okay and at home is everything all right no stressors skills coming every month okay and how about your friends how
frequently you see them well before the pandemic we always get together once a month or twice but since pandemic is
here we can't do that anymore but we still had a connection through social media okay that's good to know that you're
still in contact with them and can I ask you do you smoke at all no I don’t smoke okay do you drink any alcohol I don't
drink alcohol but I drink wine once in a while during special occasions and your diet what kind of food do you usually
eat well I have a garden in my backyard so I usually eat vegetables and also I like mixing it with some pork and some
like chicken also okay and do you exercise well I can't really exercise right now because lately I’m very busy okay
well I highly encourage you to do some exercise because exercising can improve your immunity and also incorporate
fruits in your diet okay anyways we're done with those important data now I’d like to sum up everything that we've
covered and if I get any error feel free to correct me okay okay so you are Mrs. Mary Grace J. Aglibut 47 years old
and you came here in the hospital due to stomach and backpain and has a pain in the stomach. During eating there is a
slight difficulty when you are full your mother was diagnosed with diabetes at high blood pressure and your dad with
asthma aside from those there are no other disease to that has affected your family and that's it is there anything you'd
like to corrector clarify no everything is correct okay so we're done now. Thank you for your cooperating Mrs. Mary
Grace J. Aglibut.