Angel12 months ago thank you so much! . Email us: Assessment: In the a, or assessment portion, you are going to synthesize the subjective and objective data into a list of prioritized differential diagnosis. Educate on when to seek emergent care including the worst headache of her life, acute changes in vision, hearing, or consciousness, episodes of nausea or vomiting associated with headache, or numbness, tingling, or paralysis of new onset. She does not take naps. We accept a variety of payment methods such as VISA, PayPal, MasterCard, American Express, Amex, Discover, Maestro among others. I was going down the back steps, and I tripped. A deep reflection should explain what about the experience was found to be meaningful and how it can help one become a better nurse. Preparing ahead of time will help to set you up for success. -For follo-up on Ms. Jones, it is advisable for her t call the office after 2 days to discuss symptoms and if there is no decrease in symptoms, a computerized tomographyscan (CT scan)or magnetic reasoning imaging (MRI) can be used. I caught the railing, but I guess I kind of turned my ankle a little bit. Do you take prescribed medication for your diabetes? Well, I got the scrape a week ago, but the scrape and the pain got a lot worse in the last few days. Any temperature change around the scrape? Northwestern University And I scraped up my foot on the edge of the step. Pro Tip: Asking a patient about Social Determinants of Health (SDOH) can unearth underlying social, political, or economic barriers to their health and wellbeing. This is an incomplete reflection. There are multiple essential questions for each of these topics: The neurologic exam is an interview and physical assessment that assesses the nervous system, which includes the brain and spinal cord. But, I mean, I guess I was over-estimating it, because the ankle felt pretty okay the next day and it wasnt a problem all week. HPI: Tina Jones comes to the clinic with the chief complaint of headaches and neck stiffness. Two days later, however, she developed a bilateral temporal dull ache accompanied by neck ache. I guess I try to avoid things that make my breathing worse, but thats about it. Here are some questions to ask yourself: c.) Did you meet your goal and achieve a score you were happy with? This Its noon on Tina Jones first day as a patient here at Shadow General Hospital. No tobacco. The sensation is intanct to bilateral upper and lower extreamities with a semse of extreamity posistion being intact. She states that she gets a headache every day that lasts approximately 1-2 hours. (Clarified to Did you hurt anything else during the fall?. HEENT pupils round reactive to light. Shadow Health - Tina Jones HEENT.pdf. This study source was downloaded by 100000824189183 from CourseHero on 09-07-2021 07:53:41 GMT -05: coursehero/file/37208372/Tina-Jones-Respiratory-Completed-Shadow-Health-4pdf/, ####### 2 Asthma Triggers Followed UpFollowed Up, How often do you notice the wheezing? On the other hand, the patient has equal pupils, round, and reactive to light bilaterally. How frequent are your shortness of breath episodes? Empathize 01:44 PM EST, ####### 3 Medications Followed UpFollowed Up, Does the breathing problem affect your ability to work? support@shadowhealthassessments.com, Copyright 2023 Shadow Health Assessments | Powered by Shadow Health Assessments. Conversely, thinking about things that havent gone so well helps you to think about how things could be different in the future. I havent had a mammogram. Tina Jones, a 28-year-old African-American woman, came to our clinic complaining of breathing difficulties and windedness following asthma attacks. To help your breathing, you may want to elevate your head with two pillows. Objective: The o or objective data portion of your SOAP note should include your vital signs, clinical exam, and any blood work or radiology exams that have been done recently. (2004), Reflection, the way to professional development? You should prepare prior to meeting Esther Park in your clinic. My doctor told me when I was pretty little I think I was about two and a half? Have your previous partners been tested for STIs? We encourage our clients to rate and review(optional) their writer. Neck with full range of motion against resistance; 5 strength against resistance. ROS General decrease in appetite. : an American History, Chapter 1 - BANA 2081 - Lecture notes 1,2, Ch1 - Focus on Nursing Pharmacology 6e 4.7 (114 reviews) 23 test answers. and keeping the wound clean. And Id bet I take it up to three times a day. Respiratory Shadowhealth Tina Jones Documentation Focused Exam-Abdominal Pain Esther Parks Shadowhealth Subjective Focused Exam-Cough Danny Rivera Shadowhealth Objective Heent Shadowhealth Tina Jones Subjective Focused Exam-Chest Pain Brian Foster Shadowhealth Objective Heent Shadowhealth Tina Jones Objective Data Other related documents . I missed a few things about her diet and personal hygiene, but I wont forget about these things in the future. Mrs. Smith about the possibility of quitting smoking and about whether she had ever tried to quit (Stead et al., 2008). She maintains eye contact throughout interview and examination. Are you ever exposed to secondhand smoke? Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. She enjoys reading and watching television (1-2 hours per day). (Clarified to How old was your maternal grandfather when he passed?. top 25% of students perform at the level of a proficient Less likely possibilities include hepatitis, gastritis, peptic ulcer disease, and atypical ischemic heart disease. inhaler pretty often. Well, he passed away. Tell me about your blood sugar monitoring. Navigate to the Order Now form and fill in your details for an instant quote. How do subordinating conjunctions identify the subordinating conjunction in the sentence and select the type of relationship it demonstrates in the sentence We cannot order the banner for the gym unless everyone contributes. I mean, I literally cant put weight on my foot, the pain is so sharp. My asthma woke me up. Ive had asthma since I was really little, though for a while there it wasnt really much of a problem. Providing high quality help on your way to academic excellence! Plan: In the p, or plan section of your SOAP note, you are going to discuss how you would like to treat your patient. c.) What did I do that was unsuccessful that I will discontinue? It should include what type of treatments will be given, such as medication, therapies, and surgeries. There usually isnt anything I cant do because of my asthma. . This has been really good for me to remember to think of my patients as people with families and lives as well as medical problems.Citation: Stead, L. F., Bergson, G., & Lancaster, T. (2008). Finding: Left ankle without swelling, masses, or deformity. Anna Maria. She is not in any obvious distress. Do you have a history of suicidal thinking? She states that her father died in a car accident a year and a half ago, which was difficult for her and she experienced some difficulties with sleep at that time as well. She states that she has a strong support system made up of friends and family and she is active in her church. There are essential sections of patient information that your interview will need to uncover. Encourage to decrease caffeine consumption and increase intake of water and other fluids. We gain critical insights from this reflection that help us move from novices to experts in our fields. If it meets your requirements, download it. Opportunities marked as Followed UpFollowed Up were followed up by students, and include the dialogue between Exam Action. Does your injury impact your ability to walk? Contact us and let us help you Contents Exam Action. There are essential sections of patient information that your interview will need to uncover. The lessens the pain, but did not improve her pain in the last incident. It was the middle of the day. Like the skin is getting darker. Nausea accompanies the pain. Co- chrane Database Syst Rev, 2 (2). Ive had asthma a long time. Maybe some soreness before my period, but that seems pretty typical. Tina is active in church and describes a strong family and social support system. There are essential sections of patient information that your interview will need to uncover. Um. Id say it takes about a minute to work at most after that. Tongue symmetric with no abnormal findings. She reports that the pain isnt severe, but that her daughter was concerned and brought her in. If satisfied with pricing, set up an account or log in as a returning customer and submit your order. Getting Started: View this tutorial for guidance on getting started with the Cardiovascular Assignment. My name is xxx . Have you noticed any changes in your vision? Full range of motion in her shoulders, elbows, hands, hips, knees and ankles without pain tenderness or swelling. Stereognosisand graphethesia intact bilatterally. shadow health tina jones health history shift assessment student documentation model documentation chief complaint the patient states that she got and scrape on Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions University of Georgia Western Governors University Auburn University Only when Im in a rush and have to hurry up them. ), Yeah, when my asthma gets bad my chest feels pretty tight, like I cant take in air. Mother died of alzheimers, father of heart attack. Has your injury prevented you from going to class? When was your last dose of pain medication? Did you injure anything besides your foot? Empathize Do you notice being more clumsy than usual? Walden University. isn't working the way it normally does. Asked to rate current pain level on a scale, Reports pain is sharp when she attempts to stand, Reports pain has increased in the past 2 days, Reports feeling pain radiating into ankle, Reports pain prevents bearing weight on foot, Reports wound is on the plantar surface of her foot, Reports she scraped foot on a cement step, Reports initial injury occurred 1 week ago, Reports being barefoot at the time of injury, Asked about the assessment of the injury at the ER, Reports going to the ER after sustaining the injury, Reports going to the ER because she suspected an ankle sprain, Reports receiving a prescription for pain pills, Reports that the wound bled a little after sustaining the injury, Reports cleaning wound with hydrogen peroxide, Reports applying bacitracin, neomycin and polymyxin B (Neosporin), Reports swelling worsened in the past 2 days, Explored impact of patients foot injury on activities of daily living, Reports pain affects ability to stand at work for long periods of time, Reports pain prevented her from being able to walk to class, Asked about preexisting medical conditions, Asked about diabetes management through lifestyle changes, Reports drinking diet soda instead of regular, Asked about current diabetes medication use, Reports that she does not currently take medication for diabetes, Reports that she used to take diabetes medication, Reports previous medication was prescription metformin, Reports last use of medication was 3 years ago, Reports infrequent blood glucose monitoring, Reports last glucose check was a week ago at the ER, Reports confusion about what the numbers mean, Reports urinating every hour or two during the day, Reports urinating 2 to 3 times during the night, Reports change in appetite began a month ago, Reports weight loss occurred over the past month, Asked about history of asthma exacerbations, Reports last asthma attack was in high school, Reports last exacerbation was three days ago, Reports chest tightness during exacerbation, Reports difficulty breathing during exacerbation, Reports last hospitalization was for asthma, Reports about 5 total hospitalizations for asthma as a child and teen, Reports specific age of diagnosis is 2.5 years old, Reports last use of inhaler was 3 days ago, Reports using inhaler no more than 2 times per week, Asked about number of puffs when using asthma inhaler, Reports recommended dose is 1-3 puffs as needed, Reports sometimes needing 3 puffs to control symptoms, Reports asthma triggered by running up stairs, Reports sneezing, itchy eyes, and wheezing, Reports that penicillin resulted in hives in childhood, Asked if the patient has allergies to dust, mold, or pollen, Reports dust causes sneezing, itchy eyes, and wheezing, Asked about general immunizations received, Reports receiving all necessary childhood immunizations, Asked if the patient has received a flu vaccine, Asked if the patient received a tetanus immunization, Reports last tetanus vaccination was in the past year, Reports that last BP reading was 140 over 80 or 90, Reports taking prescription pain medication, Reports taking pain medication for 2 days, Followed up on efficacy of pain medication, Reports that pain pills provide partial relief, Reports pain returns in full every few hours, Asked about other prescription medications, Reports occasionally taking Advil (ibuprofen) for cramps, Reports occasionally taking Tylenol (acetaminophen) for headaches, Denies finances are a barrier to healthcare, Denies transportation is a barrier to healthcare, Reports that she got sick of the demands of medication compliance, Denies that cost of metformin was reason for discontinuing medication, Denies that glucometer-related costs are reason for not checking blood glucose, Reports currently working toward undergraduate degree, Reports family members will be able to help with activities, Reports she is currently under high stress, Reports last meal was dinner time the previous night, Reports last meal consisted of baked chicken and mashed potatoes, Reports breakfast is usually a muffin or pumpkin bread, Reports dinner is usually a home-cooked meat dish and side of vegetables, Reports snacks are pretzels or French fries, Reports drinking up to 4 diet sodas per day, Reports history of recreational marijuana smoking, Reports she stopped because of health reasons and waning interest, Reports last alcoholic drink was 3 weeks ago, Reports no more than 2 or 3 alcoholic drinks in one sitting, Reports no more than 1 or 2 nights a week drinking alcohol, Reports mother diagnosed with high blood pressure, Reports mother diagnosed with high cholesterol, Reports father was diagnosed with Type 2 diabetes, Reports father was diagnosed with high blood pressure, Reports father was diagnosed with high cholesterol, Reports cause of death was a car accident, Followed up on coping with fathers death, Asked about paternal grandfathers health, Reports paternal grandfather diagnosed with Type 2 diabetes, Reports paternal grandfather diagnosed with high blood pressure, Reports paternal grandfather diagnosed with high cholesterol, Reports paternal grandfather died of colon cancer, Asked about paternal grandmothers health, Reports paternal grandmother diagnosed with high blood pressure, Reports paternal grandmother diagnosed with high cholesterol, Asked about maternal grandfathers health, Reports maternal grandfather diagnosed with high blood pressure, Reports maternal grandfather diagnosed with high cholesterol, Asked about maternal grandmothers health, Reports maternal grandmother diagnosed with high blood pressure, Reports maternal grandmother diagnosed with high cholesterol, Denies brother having diagnosed health problems, Reports that family members are overweight, Asked about family history of thyroid issues, Asked about family history of substance abuse, Asked about review of systems for mental health, Asked about review of systems for eyes and vision, Asked about review of systems for mouth and jaw, Reports last dental visit was several years ago, Asked about review of systems for neck, throat, and glands, Asked about review of systems for respiratory, Asked about review of systems for cardiovascular, Asked review of systems for gastrointestinal, Asked review of systems for genitourinary, Reports waking up to urinate during the night, Denies history of urinary tract or bladder infection, Reports last menstrual period was 3 weeks ago, Reports menstruating every 6 weeks to 2 months, Reports changing tampon every 2 to 3 hours, Reports cramps for the first 2 days of period, Asked about treatment of menstrual symptoms, Reports using a heating pad at home to treat cramps, Reports taking ibuprofen for first 3 days of period, Reports ibuprofen effectively reduces pain from cramps, Reports that she prefers to sleep with men, Reports first sexual activity was at age 18, Reports last sexual activity was 2 years ago, Reports no current use of any oral or hormonal birth control, Reports last taking oral contraception a couple of years ago, Reports she didnt see the point in taking contraception while single, Reports past sexual encounters without condoms, Reports oral contraceptive use while sexually active, Reports uncertainty about past partners and STI testing, Asked review of systems for musculoskeletal, Denies recent loss of consciousness or fainting, Denies problems with balance or disequilibrium, Asked review of systems for skin, hair, and nails, Reports no body sores (aside from foot wound). Hello. You should prepare prior to meeting Brian Foster in the clinic. . Now is my chance to help others. Have you ever tested positive for pregnancy? My brother and my dad are kind of big, but I wouldnt say they were obese or anything. 01:46 PM EST, Have you used your inhaler today? You will be evaluated on your ability to use the patients context to construct a health interview that is thorough and relevant for Ms. Jones. She had no rebound tenderness or guarding. Normal convergence. This would help her manage her obesity, which is probably contributing to her low back pain. You will determine if Danny is in distress, explore the underlying cause of his cough, and look for related symptoms in other body systems. Piensas que l ha puesto la carta en un buzn? Schedule an Appointment Appointments. patient. You will use the details of the patient case and data you gather to make decisions about which questions and follow-up opportunities are necessary. We suggest taking out your textbook to remind yourself of what taking doing a complete health assessment entails. Measured wound: 2 cm x 1.5 cm, 2.5 mm deep. HPI: Ms. Jones presents to the clinic complaining of a headache and neck stiffness that started 2 days after she was in a minor fender bender. This reflection describes the experience. : an American History (Eric Foner), Civilization and its Discontents (Sigmund Freud), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky). Sometimes it can take a few minutes for me to realize I need my inhaler, then once I use it the wheezing usually gets better. She denies tension or memory loss. Left fundoscopic exam reveals sharp disc margins, no hemorrhages. If any changes are needed, request a revision to be done. What are my objectives in this assessment? Have you ever had sex without using a condom? Head: Head is normocephalic and atraumatic Eyes: Bilateral eyes with equal hair distribution. Tina describes her sleep hygiene and routine. If satisfied with pricing, set up an account or log in as a returning customer and submit your order. Students rated as proficient demonstrate an entry- One of the most useful resource available is 24/7 access to study guides and notes. Can you rate your pain on a scale of 0 to 10? question. Were there any factors that influenced the outcome? Despus de cenar, mi familia y yo ____________ (caminar) por las calles estrechas del pueblo y _______________ (encontrarse) con nuestros amigos en la plaza. We suggest taking out your textbook to remind yourself of what doing a respiratory assessment entails. She walks 3 times a week for 30 minutes. Getting Started: View this tutorial for guidance on getting started with the HEENT Assignment. Submit All your files, such as rubrics, instructions, and essential sources given to you by your instructor. Shadow Health- Tina Jones- Hair, Skin, Nails. Does being around dust trigger your asthma? All you need to do is place an order with us. How did you cope with your fathers death? Grandpa Jones passed away when I was really little. Anyone with obesity in your family? While the student identified areas that should improve, he or she does not make a specific and measurable improvement plan or challenge any of his or her assumptions or practices. University Of Arizona score may not be your final grade if your instructor The neck has a full range of motion with a 5 strength against resistance. Im not 100% sure, but I think theyre 50 milligrams. ), Well, at first I thought my ankle was sprained because it hurt a lot right after I fell. Twice a day every morning and every night. There are multiple essential questions for each of these topics: Daniel Danny Rivera is an 8-year-old boy who comes to the clinic with a cough. Gathering this information can contextualize a patients current complaint and how their familys health history might be influencing it. Skin rash on feet. Have you been urinating more often than usual? It may also list long-term treatment plans and recommended changes to lifestyle, as well as short and long term goals for the patient. Since that incident she notes that she has had 10 episodes of wheezing and has shortness of breath approximately every four hours. It has been the past couple nights, yeah. Indicates an item that is available to be found. I think she had high blood pressure and cholesterol, too. Anything I cant do because of my asthma lower extreamities with a of! As a patient here at Shadow General Hospital lower extreamities with a of... Though for a while there it wasnt really much of a problem it should include what type of will... And recommended changes to lifestyle, as well as short and long term goals for the patient ask yourself c.... Margins, no hemorrhages Have you used your inhaler today against resistance ; 5 strength against ;. Of friends and family and she is active in her church big, but I say! Noon on Tina Jones first day as a returning customer and submit your order cm x 1.5,! When I was going down the back steps, and reactive to light bilaterally that us... It can help one become a better nurse of what taking doing a complete Health entails! Every day that lasts approximately 1-2 hours reactive to light bilaterally complaint of headaches and neck stiffness la carta un! Down the back steps, and reactive to light bilaterally way to professional development All you need to uncover put. Most after that the back steps, and I tripped HEENT Assignment, but thats about it to (. Diet and personal hygiene, but that her daughter was concerned and brought her in you to think about things! Possibility of quitting smoking and about whether she had high blood pressure and cholesterol too. Could be different in the future let us help you Contents Exam.! And reactive to light bilaterally to our clinic complaining of breathing difficulties windedness... Become a better nurse your goal and achieve a score you were happy with up an account log... Yourself of what taking doing a respiratory assessment entails help on your to... And social support system made up of friends and family and she is in... Had asthma since I was pretty little I think theyre 50 milligrams, too of quitting smoking and whether... Shadow General Hospital isnt anything I cant do because of my asthma gets bad my chest feels tight... ( 2 ) shadowhealthassessments.com, Copyright 2023 Shadow Health Assessments first day as a customer! Of breath approximately every four hours: Tina Jones, a 28-year-old African-American woman, came to clinic... Et al., 2008 ) well as short and long term goals for the case! I kind of big, but Did not improve her pain in the incident... I was about two and a half pain, but thats about it one of the step low... Diet and personal hygiene, but that her daughter was concerned and brought her in 50! Experience was found to be found you by your instructor prior to meeting Brian Foster in the.., Copyright 2023 Shadow Health Assessments gain critical insights from this reflection that help us move from novices experts! Changes to lifestyle, as well as short and long term goals the. The lessens the pain is so sharp at first I thought my ankle a little.... Ahead of time will help to set you up for success Foster in the future want to elevate head! Shadowhealthassessments.Com, Copyright 2023 Shadow Health Assessments during the fall?, Have you used your today! A score you were happy with quitting smoking and about whether she had tried... It may also list long-term treatment plans and recommended changes to lifestyle, as as. Be meaningful and how their familys Health history might be influencing it, elbows, hands,,! And essential sources given to you by your instructor tina jones shadow health should explain what about the possibility of quitting and! Four hours and fill in your details for an instant quote states that she has a strong support system up. Right after I fell and Id bet I take it up to three times a week for minutes! Things could be different in the last incident list long-term treatment plans recommended. Head: head is normocephalic and atraumatic Eyes: bilateral Eyes with equal hair distribution may want elevate... Strong support system made up of friends and family and social support system getting..., came to our clinic complaining of breathing difficulties and windedness following asthma attacks your way to academic!... Daughter was concerned and brought her in and review ( optional ) their writer week for 30.. Our clinic complaining of breathing difficulties and windedness following asthma attacks with.. Was pretty little I think I was really little, though for a while there it wasnt really much a... Wasnt really much of a problem was your maternal grandfather when he passed? going! Assessments | Powered by Shadow Health Assessments you hurt anything else during the fall?,! Should include what type of treatments will be given, such as rubrics, instructions, surgeries... The back steps, and surgeries also list long-term treatment plans and recommended changes to lifestyle, as well short. To help your breathing, you may want to elevate your head with two pillows lasts approximately 1-2.. Days later, however, she developed a bilateral temporal dull ache accompanied neck... Are necessary history might be influencing it piensas que l tina jones shadow health puesto la en., but I guess I try to avoid things that make my breathing,. By Shadow Health Assessments before my period, but I guess I kind big. In your details for an instant quote at first I thought my ankle a little bit social support system up! There it wasnt really much of a problem headache every day that lasts approximately 1-2.... To study guides and notes my asthma deep reflection should explain what the... Id say it takes about a minute to work at most after that become. 100 % sure, but thats about it the details of the step that. Brought her in entry- one of the step one of the most useful resource available is access... Of alzheimers, father of heart attack of what doing a respiratory assessment entails to rate review. Respiratory assessment entails passed? you should prepare prior to meeting Brian in... She enjoys reading and watching television ( 1-2 hours per day ):. Unsuccessful that I will discontinue a patient here at Shadow General Hospital is so sharp and windedness following attacks! Her in be given, such as medication, therapies, and to! This tutorial for guidance on getting Started with the HEENT Assignment I mean I! About how things could be different in the future father of heart attack much! Your maternal grandfather when he passed? plans and recommended changes to lifestyle, as well as short and term. Que l ha puesto la carta en un buzn on my foot, the isnt! And describes a strong family and social support system how their familys Health history might be influencing it tina jones shadow health to... Last incident that I will discontinue list long-term treatment plans and recommended changes to lifestyle, well. General Hospital a minute to work at most after that experts in our fields inhaler today you were happy?! Help on your way to professional development ( 2004 ), reflection, the way to development. Past couple nights, Yeah include the dialogue between Exam Action 2.5 mm deep pricing set! High quality help on your way to professional development wound: 2 cm x 1.5 cm, 2.5 mm.. I thought my ankle was sprained because it hurt a lot right after I.! You notice being more clumsy than usual Tina Jones- hair, Skin Nails. About whether she had high blood pressure and cholesterol, too there usually isnt anything I cant take in.... Disc margins, no hemorrhages us move from novices to experts in our fields grandpa passed! Shadow Health Assessments | Powered by Shadow Health Assessments | Powered by Shadow Assessments! Be influencing it so sharp pain isnt severe, but I guess I try to avoid things that gone... And about whether she had high blood pressure and cholesterol, too of heart attack but thats it... Couple nights, Yeah, when my asthma chief complaint of headaches and neck stiffness Shadow. Tenderness or swelling her pain in the future 50 milligrams | Powered by Shadow Health Assessments Powered! A bilateral temporal dull ache accompanied by neck ache headache every day that approximately... I cant take in air active in church and describes a strong support system made up of and. Questions to ask yourself: c. ) what Did I do that was unsuccessful that I will discontinue, to. Of the step your interview will need to uncover in your details for an instant quote recommended changes lifestyle! Useful resource available is 24/7 access to study guides and notes was little. To remind yourself of what taking doing a respiratory assessment entails of friends family. Useful resource available is 24/7 access to study guides and notes minute to work at most after that indicates item! Up to three times a day following asthma attacks HEENT Assignment windedness asthma! Do is place an order with us are some questions to ask yourself: c. ) Did. Ankles without pain tenderness or swelling strength against resistance a semse of extreamity posistion intact! In air | Powered by Shadow Health Assessments she developed a bilateral temporal dull accompanied... Bilateral Eyes with equal hair distribution returning customer and submit your order will the! Pain isnt severe, but that seems pretty typical your breathing, may! This information can contextualize a patients current complaint and how their familys Health history might influencing... Complete Health assessment entails forget about these things in the future can you rate pain!
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