Record patient’s physical and behavioral status.

Recording should include

  • physical illness
  • neurological check
  • vital signs
  • response to medication
  • abnormal behaviors
  • assessments.

Process/Skill Questions:

  • What are the normal ranges of adult vital signs?
  • What illnesses might require that intake and output records be maintained? Are intake and output records maintained at mental healthcare facilities?
  • To whom should the MHT report observations regarding the patient’s response to medications?
  • How do facilities document physical and behavioral changes?