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Transient Ischemic Attack Admission Orders **Physician to check appropriate boxes. These orders are not implemented until signed by the physician** 1. Observation Care (Outpatient Status) Stroke unit
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How to fill out 07 transient ischemic attack
How to fill out 07 transient ischemic attack:
01
Begin by providing your personal information, including your name, date of birth, and contact details.
02
Indicate the date and time of the transient ischemic attack (TIA) episode.
03
Describe the symptoms you experienced during the TIA, such as sudden weakness or numbness in the face, arm, or leg, difficulty speaking, loss of balance, or severe headache.
04
Record any medical conditions or risk factors you have that may be related to the TIA, such as high blood pressure, diabetes, smoking, or a history of heart disease.
05
Mention any medications you are currently taking, including dosage and frequency.
06
Provide details of your medical history, including any previous TIAs, strokes, or cardiovascular diseases.
07
If you were taken to the hospital or received medical attention following the TIA, include the name and contact information of the healthcare provider or facility.
08
Answer any additional questions related to your TIA as accurately and thoroughly as possible.
09
Review the form to ensure all sections are completed correctly before submitting it.
Who needs 07 transient ischemic attack?
01
Individuals who have experienced a transient ischemic attack (TIA) or have risk factors for TIA should fill out the 07 TIA form.
02
Patients who have a history of high blood pressure, diabetes, smoking habits, heart disease, or other cardiovascular conditions are particularly recommended to complete the 07 TIA form.
03
Healthcare providers may also request patients who were recently admitted to the hospital following a TIA episode to fill out the 07 TIA form for accurate documentation and further assessment.
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