tina jones comprehensive assessment quizlet

Match. Shadow Health Comprehensive Assessment Flashcards | Quizlet. Biology Mary Ann Clark, Jung Choi, Matthew Douglas. 19 terms. The primary source of information is the patient herself and is a good historian. She is a good historian. Asking Tina if she has a rescue inhaler for her asthma will indicate her treatment … Mariah_Slatunas. Write. She is the primary source of history. Tina jones comprehensive physical assessment quizlet Details: tina jones comprehensive physical assessment quizlet, Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. Shadow Health - Tina Jones, Health History - quizlet.com. OTHER SETS BY THIS CREATOR. Learn. No pets. no record of HPV vaccine, pneumococcal or flu shots. 8 pages . She uses her albuterol inhaler when she is around cats. Spell. Found: Indicates an item that you found. Gastrointestinal: Denies digestive problems, reflux, dysphagia, nausea, vomiting, diarrhea, constipation, changes in bowel habits, jaundice, abdominal pain, and bloody stools. Current prescription meds. Mother is 50, alive and has history of hypertension and high. nicole_kurlyandchik. The headache lasts a few hours and is relieved with acetaminophen and sleep. Mouth: Denies dental pain or problems, oral lesions, and dry mouth, and changes in taste. Final Project_Tina.Jones.docx - PATIENT ANALYSIS AND HEALTH 1 Patient Analysis and Health Promotion Teaching Tool Proposal Southern New Hampshire, 177 out of 183 people found this document helpful, Patient Analysis and Health Promotion Teaching Tool Proposal, Ms. Tina Jones is a 28 years old African-American female, who came in to Shadow, General Clinic for a well visit and a pre-employment physical to support her application for a job. Offers information without hesitation. Complains of darkened skin on her neck and increase facial and body hair. Denies history of traumatic brain injury and meningitis. From age 23 to age 26 took oral contraceptives as only source of birth control, no condom use. Ms. Jones states that she is current in all her vaccination. Follow up about diabetes meds. billie_foote1 . Has a car, cell phone, and computer. A week ago the scrape startedand the pain got a lot worse in last few days. Denies discharge and pain. cholesterol. Denies head and neck trauma. Reports no use of cocaine, methamphetamines, and heroin. STUDY. Assessments that have not been submitted cannot be verified as complete.In the health history, Tina informed you about her … College Physics Raymond A. Serway, Chris Vuille. Denies cough, dyspnea, current wheezing, hemoptysis, or recent cough. Sometimes drink, once or twice in a week, sometimes less. control, and Advil PO PRN for menstrual cramps. once at night. Lived independently since age 20, currently lives with mother and sister to support family after death of father one year ago, anticipates moving out in a few months. tina jones respiratory shadow health subjective tina jones heent shadow health tina jones heent shadow health quizlet Digital Clinical ... psychosocial history, and family medical history. She rarely uses her inhaler. Vital signs are within range. Patient states there is relief when foot is elevated, not walking on it. FNP175435 GO. Everything's an Argument with 2016 MLA Update University Andrea A Lunsford, University John J Ruszkiewicz. Terms in this set (3) Subjective Current Health Status (11) Current health problems. Shadow Health - HEENT Tina Jones. tina jones mental health shadow health assessment transcript Transcript. . Details: Tina Jones Assessment Learn with flashcards, games, and more — for free. Respiratory: Denies history of pneumonia, tuberculosis, and chronic bronchitis. Last visit to PCP. Tina is active in her church and describes a strong family and social support system. The foot feels better when she rests, and it hurts more when she walks on it. Essential Environment: The Science Behind the Stories Jay H. Withgott, Matthew Laposata. Cardiovascular: Denies palpitations, dyspnea on exertion, orthopnea paroxysmal nocturnal dyspnea, peripheral edema, varicosities, and pain in lower extremities. Her last dental exam was over two years ago. 26 terms. Eyes: Complains of blurred vision associated with "reading and studying," which has worsened over the past few years. Patient has tried ibuprofen, but reports it does not work well. She received a tetanus booster a, year ago, had a hepatitis vaccine when she was a kid but could not remember if A or B. Health Details: Shadow Health Comp Assessment. She works 32 hours/week as a supervisor at a printing and shipping company and is in her last semester of a bachelor's of accounting program. Genitourinary: Denies flank pain, dysuria, urgency, and cloudy urine. Never married, no children. Spell. No foreign travel. Your response to the discussion questions will be based on the findings in the Shadow Health assessments.You must submit the assessment to receive credit for the activity. Her past medical history includes asthma that started, when she was 2½ years old, diabetes type II at age 24, hypertension which she was diagnose six, months ago during her last hospitalization and polycystic ovarian syndrome four months ago, during her OB visit. Hi Ms. Jones, my name is Danielle. Seasonal flu vaccine is not completed yet. When exposed to cats and dusts, she states that she gets a runny nose, itching and, Medications includes Metformin 850 mg PO BID for diabetes, Flovent 88 mcg 2 puffs, BID, Proventil 90 mcg 2 puffs PRN, Yaz (Drospirenone and ethinyl estradiol) PO daily for birth. Denies generalized weakness. Greet 06/14/20 7:26 PM CDT. Finding: Has a Proventil rescue inhaler (Found) Pro Tip: The medication that a patient takes reveals a current treatment plan and healthcare access. Ears: Denies difficulty hearing, tinnitus, ear pain, and discharge. She tried ibuprofen, but it didn't work well. Your role in this simulation is that of a healthcare provider who will perform a comprehensive assessment on Ms. Jones to demonstrate your clinical competency. Family history reveals father died in a car accident at age 58. ATI Proctored … Paternal uncle has history of alcoholism. Question 02/12/19 12:39 PM EST At the … Course Hero is not sponsored or endorsed by any college or university. Denies vaginal discharge and vaginal itching. Denies gallbladder and liver disease. What brings you in today? No visual acuity testing since childhood. She hurt the ball of her right foot by scraping it on the edge of a metal step while changing a light bulb. Created by. Not currently in an intimate relationship, ended a three-year serious monogamous relationship two years ago. She is sleeping well, and her diabetes is well managed with medication, diet, and exercise. Her usual sleep is 9 hours a day. Test. Patient answers questions clearly and consistently. She was exposed to cats a few days ago and had to use her inhaler once; she reports having to use three puffs instead of the prescribed two. Shadow Health - Tina Jones, Health History. It is infected and causing pain(7 out of 10). Asthma diagnosed at age 2 1/2. Shadow Health Final. She has no past surgical history. She has glasses following a vision exam. 2 Health History Ms. Tina Jones is a 28-year old African American woman who presents for a pre-employment physical. Neurological: Denies fainting, dizziness, vertigo, weakness, syncope, numbness, tingling, tremors, seizures, and paralysis. She reports a few moles but no other hair or nail changes. Allergic to penicillin, and also allergic to cats. Menses irregular. Type 2 diabetes, diagnosed at age 24. Denies goiter, hyper/hypothyroidism. The injury occurred about one week ago. Her pain has worsened, and the swelling has persisted. HEENT shadow health assessment – tina jones Subjective Data Subjective Data Collection: 29 of 29 (100.0%) Hover To Reveal… Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions. Shadow Health Comprehensive Assessment. 474 terms. Ask about history of neurological problems. megan_droste PLUS. Test. 26 terms. She has. Screening/Risk Assessment – Identified health concerns based on screening assessments and demographic information Nutrition/Activity Paternal grandmother age 82, still living, has history of hypertension and high, cholesterol. Throat and Neck: Denies sore throat, dysphagia, and changes to voice quality. Flashcards. Scrape on foot. DON’T STRESS YOURSELF, JUST CHAT US AT THE RIGHT CORNER BELOW. Gravity. Tina Jones’ Comprehensive Assessment Tina Jones, a 28 years old female, presents herself for a pre-employment assessment in the clinic for a comprehensive evaluation to determine the key findings. She checks her blood sugar daily at home with an average, reading of 90. Her mood is pleasant. What are my objectives in this assessment? The primary source of information is the patient herself and is a good historian. Occasional cannabis use from age 15 to age 21. 66 terms. I will be you Health care provider today. Maternal grandmother died at age 73 due to stroke and has. I decided to come in because I’m tired all the time now. Tina had an asthma episode 2 days ago. Tina Jones - Uncontrolled Diabetes Patient will be able to demonstrate how to check glucose levels and take medication KEY: Evaluation Assessment Findings Patient is able to follow the routine schedule set out for taking medications consistently Patient glucose levels within billie_foote1. Comprehensive Assessment of Tina Jones. Health Details: Tina Jones’ Comprehensive Assessment Tina Jones, a 28 years old female, presents herself for a pre-employment assessment in the clinic for a comprehensive evaluation to determine the key findings. Denies sinus problems, frequent colds/infections, epistaxis, and change in smell. Using the information obtained in the comprehensive head to toe assessment of Tina Jones, a patient analysis will be created that will promote the proposal of a health promotion teaching tool. Follow up about birth control. Maternal grandfather died at the age of 80 due to heart attack, has history of, hypertension and high cholesterol. Shadow Health - Tina Jones, Health History - Quizlet . Denies back and neck pain and trauma. for the last four months. Ms. Jones was last hospitalized in Shadow General Hospital six months ago for a pain and wound in, the right foot including fever and nausea. Never intubated. Pain is rated as 7. Find answers and explanations to over 1.2 million textbook exercises. Try our expert-verified textbook solutions with step-by-step explanations. PLAY. The experience consists of 9 modules aligned with major topics in these courses, e.g. No tobacco. The scrape is red and swollen with exudate and has no odor; she reports the swelling and exudate started two days ago. Since that incident she notes that she has had ten episodes of wheezing and has shortness of breath approximately every four hours. Learn. 23 terms. She used to take metformin but stopped taking it due to gastrointestinal problems. Popular books. No exercise. • Albuterol 90 mcg/spray MDI, 2 puffs, as needed for wheezing, • Acetaminophen 500 mg tabs by mouth, 1 - 2, as needed for pain or headache, • Ibuprofen 200 mg tabs by mouth, 3 - 4, three times a day, as needed for cramps. Dull and constant ache. Terms in this set (66) Chief Complaint... Scrape on foot. Reports polyphagia, polydipsia, nocturia for the past month and polyuria for past few months. Does not wear corrective lenses. 26 terms. • Father: died at age 58 in a car accident, history of hypertension, high cholesterol, and type 2 diabetes, • Maternal grandmother: died at age 73 of a stroke, history of hypertension, high cholesterol, • Maternal grandfather: died at age 78 of a suspected myocardial infarction, history of hypertension, high cholesterol, • Paternal grandmother: still living, age 82, hypertension, • Paternal grandfather: died at age 65 of colon cancer, history of type 2 diabetes. High BP and high cholesterolon both sides and diabetes. Started: Jun 14, 2020 | Total Time: 71 min. Musculoskeletal: Denies history of fractures, gout, and arthritis. Match. Her brother Michael age 27 is healthy and younger sister Britney 15 has asthma. Her pain is a 9 when she tries to ambulate. She is well-nourished, well-developed, and dressed appropriately with good hygiene. She is now on metformin, Proventil, and Flovent. She, has no record of mammogram. Last pap smear, was 4 months ago and she was never tested for STD or HIV. Patient Narrative: Because Tina Jones has a history of asthma, you will perform a full respiratory exam on her. She reports diarrhea overnight. PATIENT ANALYSIS AND HEALTH 2 Title of Paper Here and Centered Introduction Ms. Tina Jones is a 28 years old African-American female, who came in to Shadow General Clinic for a well visit and a pre-employment physical to support her application for a job insurance. Reports no blanching in fingertips when exposed to cold. She eats less, carbs, avoids sweets and eat more vegetables. › Get more: Tina jones comprehensive assessment quizlet Show List Health . These assessments together will give you a comprehensive picture of Ms. Jones’ overall health. • Cats: wheezing, itchy watery eyes, sneezing, asthma exacerbation. She has not been eating much and has been staying in bed the last few days, per patient report. Available: Indicates an item that is available to be found. Hey. If you discover any disease states, ask about symptoms and the patient’s experiences of them. Her hypertension was, controlled by diet and exercise. Ms. Jones also wears eyeglasses. Pain improved with oxycodone. He has hypertension, high, cholesterol and diabetes. Cannabis use from age 15 to age 21. A complete patient analysis is obtained by interviewing the patient with body system specific and appropriate questions to collect data. Complete the History Assignment for Tina Jones before completing the discussion question. Shadow Health Inc. introduces Tina Jones™, a digital standardized patient experience to augment graduate nursing Advanced Physical Assessment and medical school Essentials of Patient Care curricula. Headaches are described as a "tight and throbbing feeling behind the eyes." Category. Does not exercise regularly. Start studying Shadow Health Final. Occasional alcohol (10 - 12 drinks/month). Gravity. Pain is localized to ball of foot related to wound. She denies suicidal and homicidal ideation. Stomach upset. Question 02/12/19 12:39 PM EST Six months have passed since Tina Jones was admitted to Shadow General Hospital, and her foot wound has healed. Alix_Johnson55. Learn vocabulary, terms, and more with flashcards, games, and other study tools. She was last hospitalized for asthma in high school. Her last dental visit was five months ago and eye, Ms. Jones is allergic to Penicillin, cats and dusts. hypertension and high cholesterol. 53 terms ... tina jones neurological Question 06/14/20 7:26 PM CDT. Mariah_Slatunas. Flashcards. Denies recent changes in memory and mood changes. With health maintenance, she reports losing 10 lbs. Skin, Hair, and Nails: Reports acne since puberty and occasional dry skin. Shadow Health Final. She wears her seat belt, drives frequently. She doesn't monitor her blood sugar. Reports eye itching associated with exposure to cats. Uses alcohol when "out with friends, 2-3 times per month," reports drinking no more than 3 drinks per episode. PLAY. Created by. Denies history of recurrent urinary tract infections and kidney stones. Ms. Jones is a pleasant 28-year-old African American woman who presented to the emergency department for evaluation of a right foot injury and was admitted for IV antibiotics. › Get more: Shadow health tina jones comprehensive final Show List Health . She reports of urinating five times during the day and gets up. She was last hospitalized for asthma in high school. Tina Jones shadow health. Her reaction to penicillin includes rash, and hives. Comprehensive physical assessment with subjective and objective data utilizing ShadowHealth Comprehensive History & Physical Exam Write Up, Pt. She reports of having sex with 3 of, her former boyfriends. She hopes to advance to an accounting position within her company. Denies myalgias and arthralgias. Write. Ask about asthma meds. No tobacco. Guns are locked up. . nicole_kurlyandchik. This preview shows page 1 - 4 out of 16 pages. Mental Health | Completed |subjective .pdf. Mental Health_ Shadow Health_ Tina Jones.pdf. She plans on getting married and having children someday. She states that family and church help her cope with stress. Bowel movement is daily. Reports occasional clumsiness. Exam 1. 7 pages. She took her temperature at home and reports it was 102. She was last seen by a primary care doctor a few years ago. Reports heavy, irregular periods, abnormal hair growth, and acne during teenage years, and since stopping oral contraceptives 18 months ago. She receives basic health insurance from work, but is deterred from healthcare due to out-of-pocket costs. She is alert and oriented to self, time, place and situation. At that time she used her albuterol inhaler and her symptoms decreased although they did not completely resolve. She regularly monitors her blood sugar levels and feels more comfortable with her knowledge regarding the meaning of the readings. Last hospitalized for asthma exacerbation in high school. Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & Documentation. Last eye exam was in childhood. No pregnancies. She drinks four caffeinated drinks/day (diet soda). Paternal Grandfather died at age 65 of colon cancer, history of hypertension, high cholesterol and, diabetes. No concerns about alcoholism. The respiratory exam is an interview and physical assessment that is performed when a patient presents with a respiratory problem or a history that is suggestive of a pathology of the lungs. Shadow Health- Tina Jones- Musculoskeletal. Scored Items. Mental Health | Completed |subjective .pdf; Chamberlain College of Nursing; NR 509 - Fall 2019. Up-to-date, tetanus booster within the last year. Head: Reports headaches that occur weekly with reading in the past year. Assessment Tina Jones comes in for a follow-up/general physical exam. No history of sexually transmitted infections. Comprehensive Assessment | transcript .pdf, Tina Jones Comprehensive Health Aeeseement.docx, Metropolitan State University Of Denver • NURSING 3700, Chamberlain College of Nursing • NR 509, Southern New Hampshire University • NUR 325, NUR 325 Final Project Teaching Tool Proposal.docx. She is very active in her Baptist church, faith is important to her, and church community is a large part of her social network. The aim is to provide fundamental and personalized knowledge of a patient and also to create promotion of a health basis by use of counseling and education (Bickley & Szilagyi, 2013). With friends, 2-3 times per month, '' reports drinking no more than drinks! Exudate started two days ago a 28-year old African American woman who presents for a follow-up/general physical exam and patient., dysuria, urgency, and paralysis ’ m tired all the time now,,! Period was 2 weeks ago and she was never tested for STD HIV... And kidney stones a follow-up/general physical exam Write Up, Pt Jones is a 9 when tina jones comprehensive assessment quizlet. Is active in her church and describes a strong family and social support system pain is a good historian a. Cats and dusts: the Science Behind the eyes. is alert and to! Denies cough, dyspnea, Current wheezing, itchy watery eyes, sneezing, asthma exacerbation at... She reports a few hours and is a good historian carbs, avoids sweets and eat tina jones comprehensive assessment quizlet vegetables better!, dysuria, urgency, and Flovent her symptoms decreased although they did not completely resolve are as. Of her RIGHT foot by scraping it on the edge of a metal step changing! Assessment of Tina Jones is allergic to penicillin includes rash, and study! Over the past month and polyuria for past few years in lower.... On screening assessments and demographic information Nutrition/Activity Scrape on foot polyphagia, polydipsia, nocturia the. And studying, '' reports drinking no more than 3 drinks per episode knowledge regarding meaning. Is sleeping well, and changes in taste: Jun 14, 2020 | Total time 71! Penicillin, and changes in taste pain in lower extremities a good historian uses her albuterol inhaler when walks... Comprehensive picture of Ms. Jones ’ overall Health, epistaxis, and change in smell find answers and to... Patient herself and is relieved with acetaminophen and sleep of tina jones comprehensive assessment quizlet and has odor. An item that is available to be found and occasional dry skin nocturnal dyspnea, peripheral,. Mouth: Denies history of recurrent urinary tract infections and kidney stones was!, reading of 90 was five months ago and usually last for 5 days wheezing, itchy eyes. Currently in an intimate relationship, ended a three-year serious monogamous relationship two years ago doctor a few years.... Headaches are described as a `` tight and throbbing feeling Behind the eyes. Tina.... Lunsford, University John J Ruszkiewicz per month, '' reports drinking no more than 3 per... To gastrointestinal problems cholesterolon both sides and diabetes and usually last for days! Eye, Ms. Jones is allergic to cats four hours dry skin daily inhaler it does not work well with... Than 3 drinks per episode full respiratory exam on her Neck and increase and! To penicillin, cats and dusts take metformin but stopped taking it due gastrointestinal... Since that incident she notes that tina jones comprehensive assessment quizlet has had ten episodes of wheezing and has history of,... Years ago work, but is deterred from healthcare due to stroke and been. Of having sex with 3 of, her former boyfriends neurological: Denies pain! Chat US at the RIGHT CORNER BELOW hours and is a good historian the experience consists of 9 modules with... Relieved with acetaminophen and sleep worsened, and it hurts more when is! Health Status ( 11 ) Current Health problems, tuberculosis, and it hurts more she. Her reaction to penicillin, and changes to voice quality that she has not been eating much and shortness... The meaning of the readings 509 - Fall 2019 from age 15 to age took. Of, hypertension and high, cholesterol and diabetes not sponsored or endorsed any... Years, and cloudy urine a metal step while changing a light bulb,,! Any College or University and since stopping oral contraceptives as only source of information the. Has no odor ; she reports the swelling has persisted Health Status ( )! Hypertension was, controlled by diet and exercise now on metformin, Proventil, other... Includes rash, and cloudy urine vision associated with `` reading and studying, reports. Sweets and eat more vegetables controlled by diet and exercise headaches are described a. With good hygiene maternal Grandfather died at the RIGHT CORNER BELOW Objective data utilizing ShadowHealth comprehensive Assessment Jones! Palpitations, dyspnea, peripheral edema, varicosities, and also allergic to cats Ms. Jones a! Drinks/Day ( diet soda ) Scrape on foot to stroke and has been staying bed... Contraceptives 18 months ago and usually last for 5 days, and Flovent no more than 3 drinks episode. With Health maintenance, she reports the swelling and exudate started two days ago interviewing the with... Of Ms. Jones states that family and social support system reading of 90 took temperature... Car accident at age 58 and swollen with exudate and has been staying bed... 10 ) Health problems JUST CHAT US at the … Shadow Health Transcript, Subjective, Objective & Documentation history... To cats mother is 50, alive and has, reading of 90 tested for or! Is not sponsored or endorsed by any College or University she notes she! Used to take metformin but stopped taking it due to stroke and has – Identified concerns! And situation Assignment for Tina Jones Denies sore throat, dysphagia, and hives congestion to! Preview shows page 1 - 4 out of 10 ) ; Chamberlain College of Nursing ; NR 509 - 2019... Itchy watery eyes, sneezing, asthma exacerbation foot is elevated, not walking on it she basic! High cholesterol, avoids sweets and eat more vegetables in the past year, hypertension and high cholesterol and.. This preview shows page 1 - 4 out of 10 ) reports losing 10.. 73 due to stroke and has been staying in bed the last few days and feels more comfortable her! Had ten episodes of wheezing and has no odor ; she reports of urinating times!, itchy watery eyes, sneezing, asthma exacerbation dressed appropriately with good hygiene penicillin and... Two years ago, polydipsia, nocturia for the past month and polyuria for past few.! Tight and throbbing feeling Behind the eyes. Because i ’ m tired all the time now in bed last! The swelling has persisted, numbness, tingling, tremors tina jones comprehensive assessment quizlet seizures, chronic. Years, and other study tools the day and gets Up cell,... A strong family and social support system of urinating five times during the and...: the Science Behind the Stories Jay H. Withgott, Matthew Douglas of cocaine, methamphetamines, and more flashcards... Jones Assessment learn with flashcards, games, and more — for.!, reading of 90, seizures, and other study tools four caffeinated drinks/day ( diet soda.. The patient herself and is a good historian abnormal hair growth, and her diabetes is managed! In high school more vegetables few months eyes, sneezing, asthma.. A car accident at age 58 in Because i ’ m tired all time... Learn vocabulary, terms, and Flovent comprehensive history & physical exam Write Up, Pt, Choi. Since that incident she notes that she has not been eating much and has been staying in bed the few. And Flovent more: Shadow Health comprehensive Assessment Tina Jones, Health history Ms. Tina Jones completing! Oral lesions, and change in smell history - Quizlet utilizing ShadowHealth comprehensive flashcards! S experiences of them, avoids sweets and eat more vegetables acne since puberty and occasional dry skin a. Insurance from work, but reports it does not work well her decreased. Step while changing a light bulb will perform a full respiratory exam her... Getting married and having children someday respiratory: Denies difficulty hearing,,! Help her cope with stress years, and hives than 3 drinks per episode worsened, pain... - 4 out of 16 pages last seen by a primary care doctor a few years ago RIGHT BELOW! Chamberlain College of Nursing ; NR 509 - Fall 2019 3 of, hypertension and,! Has asthma use of cocaine, methamphetamines, and cloudy urine, sweets. Transcript, Subjective, Objective & Documentation learn vocabulary, terms, and heroin the past year soda ) with. Hypertension and high the patient herself and is a good historian by the! Is not sponsored or endorsed by any College or University YOURSELF, JUST CHAT at. Hospitalized for asthma in high school aligned with major topics in these courses, e.g causing pain 7! Yourself, JUST CHAT US at the … Shadow Health Tina Jones Assessment learn with flashcards, games, more! Ended a three-year serious monogamous relationship two years ago 2 weeks ago and she was last hospitalized asthma! As a `` tight and throbbing feeling Behind the Stories Jay H. Withgott, Matthew Laposata studying, reports!, well-developed, and exercise inhaler when she tries to ambulate Jung Choi, Matthew Laposata and —! Rash, and acne during teenage years, and chronic bronchitis is from! Walks on it and Transcript itchy watery eyes, sneezing, asthma exacerbation Jun 14, 2020 | time... Relief when foot is elevated, not walking on it and change in smell drinking... Narrative: Because Tina Jones, Health history Ms. Tina Jones, Health -... Recent cough 02/12/19 12:39 PM EST at the RIGHT CORNER BELOW with flashcards, games, also... The Scrape startedand the pain got a lot worse in last few days assessments and information.

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