Confirmation

An allergy or intolerance describes a patient’s tendency towards hypersensitivity to a certain substance so that an unwanted physiological reaction is expected after exposure to the substance while most people would not exhibit such a reaction to that amount. The observed physiological changes are usually the result of an immunological reaction. The substances can be categorized as follows * Medicine * Medicine category * Ingredient addition * Nutrition * Environmental factor * Animal * Plants * Chemicals * Inhaled allergenic

A problem describes a situation with regard to an individual’s health and or welfare. This situation can be described by the person involved (the patient) themselves (in the form of a complaint) or by their healthcare provider (in the form of a diagnosis for example). The situation can form cause for diagnostic or therapeutic policy. A problem includes all kinds of medical or nursing information that represents a health problem. A problem can represent various types of health problems A complaint finding by patient a subjective negatively experienced observation of the patient’s health. Examples stomach ache amnesia A symptom an observation by or about the patient which may indicate a certain disease. Examples fever blood in stool white spots on the roof of the mouth; A diagnosis medical interpretation of complaints and findings. Examples Diabetes Mellitus type II pneumonia hemolytic-uremic syndrome. A functional limitation a reduction of functional options. Examples reduced mobility help required for dressing. A complication Every diagnosis seen by the healthcare provider as an unforeseen and undesired result of medical action. Examples post-operative wound infections loss of hearing through the use of antibiotics.

A healthcare provider is an organization that offers and provides medical paramedic and or nursing care to patients clients. Examples include hospitals nursing homes doctor’s offices.

A contact is a person not being a healthcare professional who is involved in the patient’s care such as family members caregivers mental caretakers guardians and legal representatives. In addition to identification information such as the name address and contact information can also be entered. The relationship to the patient and the role this person has can be entered as well.

Therapeutic or diagnostic procedure undergone by the patient (the complementary profile [nl-core-Procedure-request]() can be used for therapeutic or diagnostics procedures that the patient will undergo). A procedure can be a simple blood pressure measurement but also a complex heart surgery. In some care settings the term treatment is used instead of the term procedure.