Policy Manual sample

MDT Home Health Care Agency, Inc. Factors to be charted: APPETITE 1. Very fussy about food, refuses to eat many foods 2. Eats all food served 3. Eats very little 4. Loss of appetite 5. Craving for certain foods 6. Refuses to eat 7. Eats only small amount 8. Desire to eat objects that are not food (chalk, dirt) ARM: 1. Shoulder to elbow 2. Elbow to wrist 3. With accumulation of fat 4. Appears puffy or swollen 5. Artificial arm (rt. or left) ATTITUDE (mental): 1. Not interested in surroundings 2. Has "don't care' attitude 3. Doesn't believe anything said to him/her 4 Quarrelsome, wants to argue, disagreeable 5. Afraid, worried 6. Seems to bear weight of the world 7. Happy, carefree, cheerful BACK: 1. Upper back 2. Small of back 3. End of spine Suggested terms to use: 1. Has definite likes & dislikes concerning food 2.Appetite good 3.Appetite poor 4.Anorexia 5.Parorexia 6.Refused food (reason) 7.Appetite fair 8.Perverted appetite 1.Upper arm (right or left) 2.Lower arm (right or left) 3.Fat 4.Edematous 5.Prosthetic arm (rt. or left) 1.Indifferent 2.Apathetic 3.Distrustful, suspicious 4.Belligerent, quarrelsome, disagreeable. 5.Anxious, fearful 6.Very serious minded 7. Cheerful, optimistic 1.Interscapular region, shoulder area 2.Lumbar region 3.Sacral region Home Health Agency Nursing Manual J-12