Healthy Weight Care Assistant

Weight Status: <%=patient.bmi.value%>%tile for age, sex, and height
Systolic Blood Pressure: <%=patient.sbptile.value%>, Diastolic Blood Pressure: <%=patient.dbptile.value%>
Pertinent History
Basic Documentation
Beyond the Basics: Diet
Beyond the Basics: Activty
Beyond the Basics: Sleep & Screen Time
Family History
NoneMomDadBroSis
Diabetes
Obesity
Hypertension
High Cholesterol
Early Heart Disease
Sudden Death
Not reviewed in Care Assistant
Comorbidity Screen
YesNo
Polyuria or polydipsia
Snoring or sleep apnea
Headaches
Acne or skin changes
Lower extremity pain
Irregular periods
Fatigue
Diagnosis
BMI 85th-95th percentile
BMI >95th percentile
Acanthosis
Acne
Diabetes
Elevated Blood Pressure
Fatigue
Headache
Hirsutism
Hyperlipidemia
Hypothyroidism
Hypertension
Irregular Menses
Lower Extremity Pain
PCOS
Pseudotumor Cerebri
Sleep Apnea
Snoring
Transaminitis
Vitamin D deficiency
Vitamin D insufficiency
Xanthoma
Total Chol./HDL, Back Ofiice
Last: Tot.Ch <%=patient.totalChol.value%>
Last: LDL <%=patient.LDL.value%>
Last: HDL <%=patient.HDL.value%>
Last: TG <%=patient.tg.value%>
Last: nonHDL <%=patient.nonHDL.value%>
Lipid Profile
Last: Tot.Ch <%=patient.totalChol.value%>
Last: LDL <%=patient.LDL.value%>
Last: HDL <%=patient.HDL.value%>
Last: TG <%=patient.tg.value%>
Last: nonHDL <%=patient.nonHDL.value%>
Lipid Profile
Last: Tot.Ch <%=patient.totalChol.value%>
Last: LDL <%=patient.LDL.value%>
Last: HDL <%=patient.HDL.value%>
Last: TG <%=patient.tg.value%>
Last: nonHDL <%=patient.nonHDL.value%>
Lipid Profile
Last: Tot.Ch <%=patient.totalChol.value%>
Last: LDL <%=patient.LDL.value%>
Last: HDL <%=patient.HDL.value%>
Last: TG <%=patient.tg.value%>
Last: nonHDL <%=patient.nonHDL.value%>
ALT & AST
Last: ALT <%=patient.alt.value%>
Last: AST <%=patient.ast.value%>
ALT & AST
Last: ALT <%=patient.alt.value%>
Last: AST <%=patient.ast.value%>
ALT & AST
Last: ALT <%=patient.alt.value%>
Last: AST <%=patient.ast.value%>
Glucose
Last: <%=patient.glucose.value%>
Glucose
Last: <%=patient.glucose.value%>
Glucose
Last: <%=patient.glucose.value%>
HgbA1c
Last: <%=patient.hgba1c.value%>
HgbA1c
Last: <%=patient.hgba1c.value%>
HgbA1c
Last: <%=patient.hgba1c.value%>
PCOS Evaluation Panel
PCOS Evaluation Panel
PCOS Evaluation Panel
Vitamin D (25-OH)
Last: <%=patient.vitD.value%>
Vitamin D (25-OH)
Last: <%=patient.vitD.value%>
Vitamin D (25-OH)
Last: <%=patient.vitD.value%>
Sleep Study
Results
X-Ray - SCFE, Stable
X-Ray - SCFE, Unstable
X-Ray - Blounts Series Left
X-Ray - Blounts Series Right
Referral to Healthy Weight
Referral to Adolescent
Referral to Nutrition
Referral to ENT
Referral to Endocrine
Referral to Gastroenterology
Referral to Lipid Clinic
Referral to Nephrology
Referral to Ophthalmology
Referral to Orthopedics
Referral to PCOS Clinic
Referral to Pseudotumor Clinic
Referral to Sleep Clinic
Goals & Objectives (Plan and AVS)
Replace sweetened beverages
Increase Fruits/Veggies
Avoid Whoa Foods
Skip Less Meals
Be More Active
Limit Screen Time
Family Meals
Improved Sleep
5-2-1-0
Limit Screen Time
Everyday Physical Activity
Structured Physical Activity
Go Slow, WHOA! Foods
Limit Sweetend Drinks
Increase Fruit & Veggies
Heart Healthy Diet
Healthy Snacks
Cookbooks & Websites
Follow Up
2 wk1 mo3 mo6 mo12 mo/Next WCV
Next visit:
Visit the Clinical Pathway for references and more details
Follow up questions for diabetes
Polyuria
Yes
No
Polydipsia
Yes
No
Nocturia
Yes
No
New onset enuresis
Yes
No
More Details
Supplemental Family History
Family History
NoneMomDadBrotherSisterMGMMGFPGMPGF
Diabetes
Obesity
Hypertension
High Cholesterol
Early Heart Disease
Sudden Death
Not reviewed in Care Assistant
Follow up questions for pseudotumor
Pseudotumor screening questions
YesNo
Daily headaches
Tinnitis
Worse lying down
Visual disturbances
Other details
Follow up questions for PCOS, hyperlipidemia and Cushings
Severe acne
Yes
No
Excessive body or facial hair
Yes
No
Balding or hair loss
Yes
No
Acanthosis or persistent 'dirty' skin
Yes
No
Abdomen/back striae or stretch marks
Yes
No
Xanthomas (fatty skin bumps)
Yes
No
More Details
Follow up questions for PCOS
Severe acne
Yes
No
Excessive body or facial hair
Yes
No
Balding or hair loss
Yes
No
More Details
Follow up questions for SCFE and Blounts
Hip pain
Yes
No
Knee pain
Yes
No
Limp
Yes
No
Trauma or injury
Yes
No
More Details
Details for fatigue
Follow up questions for sleep apnea and disordered sleep
Snoring 3 or more nights a week
Yes
No
Witnessed gasping during sleep
Yes
No
Daytime sleepiness
Yes
No
Frequent napping
Yes
No
Disrupted sleep
Yes
No
More Details
Additional details/Diet recall
Barriers to eating healthy
What are some of the things that make trying to eat healthy easy for your family?
Concerning Behaviors
YesNo
Eat out of boredom?
Guilt surrounding eating?
Grazing?
Skipping breakfast?
Eating with the TV?
Eating alone?
Average day, freq. of:
012345+
Fruits (servings)
Vegetables (servings)
Sweet drinks/juice (servings)
High fat/sugar foods
Foods high in calcium/Vit. D
Home prepared meals/snacks
Beyond the Basics: Sleep & Screen Time
Beyond the Basics: Activity
Organized sport participation
Yes
No
Is it safe to be outside
Yes
No
Home fitness activities/strategies?
What are the barries to getting active?
Beyond the Basics: Diet
Average day, freq. of:
012345+
Fruits (servings)
Vegetables (servings)
Sweet drinks/juice (servings)
High fat/sugar foods
Foods high in calcium/Vit. D
Home prepared meals/snacks
Concerning Behaviors
YesNo
Eat out of boredom?
Guilt surrounding eating?
Grazing?
Skipping breakfast?
Eating with the TV?
Eating alone?
Additional details/Diet recall
Barriers to eating healthy
What are some of the things that make trying to eat healthy easy for your family?
Basic Documentation
5-2-1-0 Questions
012345+
Servings of fruits/vegetables per day
Hours of screen time per day
Hours of physical acivity per day
Servings of juice/sweetened beverages per day
During an average week, how many days of the week do you eat dinner together as a family?
Sleep Question(s)
< 5678910+
How many servings of fruits and vegetables does your child eat on an average day?
How many hours of screen time (computer, TV, inactive video games, tablet, cell phone, etc.) does your child spend watching on an average day?
How many servings of juice or sweetened beverages does your child drink on an average day?
Hours of sleep, on average
During an average week, how many days of the week do you eat dinner together as a family?
During an average week, how many days of the week does your child get 1 hour or more of physical activity?
Additional details/Diet recall