A History of Physical Examination Texts and the Conception of Bedside Diagnosis. ... Throughout this paper we construct a difference between a “bedside diagnosis,” made when the physician and patient are in each other's presence, and a “remote diagnosis,” made when the patient and physician are separated.
A health history is a collection of data that provides a detailed profile of the patient's health status.
Nurses use therapeutic communication skills and interviewing techniques during the health history to establish an effective nurse-patient relationship. Physical examination is an important tool in assessing the client’s health status.
Approximate 15 % of the information used in the assessment comes from the physical examination.
this document includes all the essential headings under which physical examination of the patient is done. it helps in collecting the objective information from the patient
In this topic the student will be easily learn about how to collect history from the patient and also helpful nursing students to write their care plan and care study.
this topic explains the nature of pain, signs and symptoms of pain, different types of pain, factors influencing pain, assessment of pain and pharmacological and non pharmacological management of pain.
A health history is a collection of data that provides a detailed profile of the patient's health status.
Nurses use therapeutic communication skills and interviewing techniques during the health history to establish an effective nurse-patient relationship. Physical examination is an important tool in assessing the client’s health status.
Approximate 15 % of the information used in the assessment comes from the physical examination.
this document includes all the essential headings under which physical examination of the patient is done. it helps in collecting the objective information from the patient
In this topic the student will be easily learn about how to collect history from the patient and also helpful nursing students to write their care plan and care study.
this topic explains the nature of pain, signs and symptoms of pain, different types of pain, factors influencing pain, assessment of pain and pharmacological and non pharmacological management of pain.
It is very useful for mental health nursing student...
Mental health assessment determine patient is experiencing abnormalities in thinking and reasoning ability, feelings or behavior....
Oxygen therapy has been in use for centuries. Oxygen)(O2) is gas used as a drug/medication and a such should be prescribed and administered in the right manner with regards to presenting indications for it's use[1]; which is always in the case of hypoxaemia[2]. It has side effects and specific risks, but, with objective monitoring and administration, it is a potent therapy for the patient with respiratory condition
Other indications include:
Increased work of breathing
Increased myocardial work and/or Myocardial infarction
Pulmonary hypertension[5]
Pre-oxygenation in induction and difficult intubation.
Pre and post suctioning[6]
Postoperative oxygenation especially in abdominal and chest surgeries[7]
Hyperbaric oxygen therapy indicated in decompression sickness, gas embolism, gas gangrene and carbon monoxide poisoning.
Anaemic Hypoxia : it’s benefits is limited due circulatory deficit[8].
In aerosol drug delivery.
GENERAL EXAMINATION
CLINICAL SYMPTOMS
On observation kindly check for symptoms like:
1. Decreased level of consciousness: seen in end-stage renal disease (ESRD).
2. Obvious scars: check previous abdominal surgery.
3. Pallor: Suggestive of underlying anaemia (e.g. erythropoietin deficiency).
4. Shortness of breath: may be due to pulmonary oedema secondary to advanced renal disease.
5. Oedema: typically presents as swelling of the limbs (e.g. pedal oedema) and abdomen (i.e. ascites). In the context of a renal system examination, possible causes could include nephrotic syndrome and end-stage renal disease (due to anuria).
6. Cachexia: muscle loss that is not entirely reversed with nutritional supplementation associated with end-stage renal failure due to protein-energy wasting (PEW).
7. Uraemic complexion: a yellow colour of the skin caused by uraemia in advanced chronic kidney disease.
8. Cushingoid appearance: facial puffiness and weight gain may be due to the use of high dose corticosteroids for renal transplant immunosuppression or glomerulonephritis.
he water to be used for the preparation of haemodialysis fluids needs treatment to achieve the appropriate quality. The water treatment is provided by a water pre-treatment system which may include various components such as sediment filters, water softeners, carbon tanks, micro-filters, ultraviolet disinfection units, reverse osmosis units, ultrafilters and storage tanks. The components of the system will be determined by the quality of feed water and the ability of the overall system to produce and maintain appropriate water quality.
ntubation is a process where a healthcare provider inserts a tube through a person's mouth or nose, then down into their trachea (airway/windpipe). The tube keeps the trachea open so that air can get through. The tube can connect to a machine that delivers air or oxygen.
RAPID SEQUENCE INTUBATION:
Rapid sequence induction (RSI) is a set of actions during induction of anaesthesia in unfasted patients or patients at risk of aspiration/regurgitation of gastric contents.
INDUCTIION AGENT:
Induction agents (sedatives) are integral to the performance of rapid sequence intubation (RSI). They provide amnesia, blunt sympathetic responses, and can improve intubating conditions.
CRICHOID PRESSURE:
Cricoid pressure is applied by an assistant using the thumb and second finger; the first finger stabilizes the thumb and finger on the cricoid ring. press directly backwards at a force of 20-30 newtons against the cervical vertebrae.
endotracheal tube selection
Endotracheal tube selection for male is 8.0 and for female is 7.5
Formula for endotracheal tube children in paediatrics is
[(Age/4) + 4] for uncuffed tubes
[(Age/4) +3.5] for cuffed tubes
Immunization is defined as the procedure in which vaccine is injected into body to produce immunity against specifics diseases or it’s a process of protecting person from diseases by vaccination.
• Vaccine term was coined by Louis pasteur.
• Vaccine is a substance that is introduced into the body to prevent the disease produced by certain pathogens.
• Vaccine consists of dead pathogens or live attenuated (artificially weakened) organisms.
• The vaccine induces immunity against the pathogen, either by production of antibodies or by activation of T lymphocytes.
• Edward Jenner produced first live vaccine. He produced the vaccine for smallpox from cowpox virus.
Ventilator associated pneumonia (VAP) was defined as per the Center of Disease Control (CDC) as a pneumonia that occurs in a patient who was intubated and ventilated at the time of or within 48 h before the onset of the event. Pneumonia was identified using a combination of radiological, clinical, and laboratory criteria
Scrub typhus, also known as bush typhus, is a disease caused by a bacteria called ORIENTIA TSUTSUGAMUSHI.
Scrub typhus is spread to people through bites of infected chiggers (larval mites).
Most cases of scrub typhus occur in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia. Anyone living in or travelling to areas where scrub typhus is found could get infected
Scrub typhus is not transmitted directly from person to person; it is only transmitted by the bites of vectors
Chiggers are abundant in locales with high relative humidity (60%–85%), low temperature (20°C–30°C), low incidence of sunlight, and a dense substrate-vegetative canopy.
Occupational risk is higher in farmers (aged 50–69 years), females.
Deep vein thrombosis (DVT), is the formation of a blood clot in a deep vein, most commonly the legs.[2][a] Symptoms may include pain, swelling, redness, or warmth of the affected area. About half of cases have no symptoms. Complications may include pulmonary embolism, as a result of detachment of a clot which travels to the lungs, and post-thrombotic syndrome.[2][3]
Risk factors include recent surgery, cancer, trauma, lack of movement, obesity, smoking, hormonal birth control, pregnancy and the period following birth, antiphospholipid syndrome, and certain genetic conditions. Genetic factors include deficiencies of antithrombin, protein C, and protein S, and factor V Leiden mutation. The underlying mechanism typically involves some combination of decreased blood flow rate, increased tendency to clot, and injury to the blood vessel wall.
The term inotropic state is most commonly used in reference to various drugs that affect the strength of contraction of heart muscle (myocardial contractility). However, it can also refer to pathological conditions. For example, enlarged heart muscle (ventricular hypertrophy) can increase inotropic state, whereas dead heart muscle (myocardial infarction) can decrease it.
Blood product transfusion and massive transfusionpankaj rana
Blood transfusion
Plastic bag 0.5–0.7 liters containing packed red blood cells in citrate, phosphate, dextrose, and adenine (CPDA) solution
Plastic bag with 0.5–0.7 liters containing packed red blood cells in citrate, phosphate, dextrose, and adenine (CPDA) solution
ICD-9-CM 99.0
MeSH D001803
OPS-301 code 8-80
MedlinePlus 000431
[edit on Wikidata]
Blood transfusion is generally the process of receiving blood or blood products into one's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells, plasma, clotting factors, and platelets.
Dengue virus rarely causes death. However, the infection can progress into a more serious condition known as severe dengue or dengue hemorrhagic fever. Symptoms of dengue hemorrhagic fever include: bleeding under the skin. frequent vomiting.
Nosebleeds are very common in young children, affecting most at some time or another. From the outset, it is important to be aware that nosebleeds will often settle down on their own, sometimes requiring medical treatment, but that major underlying causes (blood clotting problems or abnormalities in the nose) are very rare.
Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool.
Malignant hyperthermia (MH) is a disease that causes a fast rise in body temperature and severe muscle contractions when someone with the MH gets general anesthesia. MH is passed down through families. Hyperthermia means high body temperature.
In hospitals, nursing homes, and other healthcare settings, possible sources of
violence include patients, visitors, intruders, and even coworkers. Examples include
verbal threats or physical attacks by patients, a distraught family member who may
be abusive or even become an active shooter, gang violence in the emergency department,
a domestic dispute that spills over into the workplace, or coworker bullying.
The Glasgow Coma Scale (GCS) is a neurological scale which aims to give a reliable and objective way of recording the conscious state of a person for initial as well as subsequent assessment. A patient is assessed against the criteria of the scale, and the resulting points give a patient score between 3 (indicating deep unconsciousness) and either 14 (original scale) or 15 (more widely used modified or revised scale).
Cardiac tamponade
Synonyms Pericardial tamponade
Hemorragic effusion.jpg
A very large pericardial effusion resulting in tamponade as a result of bleeding from cancer as seen on ultrasound. Closed arrow - the heart; open arrow - the effusion
Specialty Cardiac surgery
Symptoms Shortness of breath, weakness, lightheadedness, cough[1]
Usual onset Rapid or more gradual[2]
Causes Cancer, kidney failure, chest trauma, pericarditis, tuberculosis[2][1]
Diagnostic method Symptoms and ultrasound of the heart[2]
Treatment Drainage (pericardiocentesis, pericardial window, pericardiectomy)[2]
Frequency 2 per 10,000 per year (US)[3]
Cardiac tamponade, also known as pericardial tamponade, is when fluid in the pericardium (the sac around the heart) builds up, resulting in compression of the heart.
Child abuse or child maltreatment is physical, sexual, or psychological maltreatment or neglect of a child or children, especially by a parent or other caregiver. Child abuse may include any act or failure to act by a parent or other caregiver that results in actual or potential harm to a child, and can occur in a child's home, or in the organizations, schools or communities the child interacts with.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
2. INTRODUCTION
There are many situations in
which the patient may be
unable to give a history (e.g.,
they are unconscious, delirious,
demented, or dysphasic). In
these situations, health care
member should make an effort
to speak to all who can help to
fill in the gaps regarding what
happened to the patient.
3. • When taking a history from a source other than the
patient, be sure to document clearly that this is the case
and the reason(s) for the patient being unable to speak
for themselves.
• Useful sources of information include the following:
• Relatives, guardians, and cohabitants
• Close friends and roommates
• Primary care physician (PCP) or other members of the
primary care team
• Pharmacist
• Staff at the nursing home or residential or other facility
• Ambulance personnel
• Anyone who witnessed the event.
4.
5. PATIENT PROFILE
• This is the essential identifying and biographic
information required by the facility.
• Typically included in the PP will be the patient’s
name, address, and DOB.
• Other information included in the PP may include
age, religion, nationality, marital status, and contact
information as requested by the individual facility.
6. CHIEF COMPLAIN
• This is the patient’s chief symptom(s) in their own
words. It should generally be no more than a single
sentence.
• If the patient has several symptoms, present them
as a list that can expand on later in the history.
• Ask the patient an open question, such as, “What’s
the problem?” or
“What made you come to the hospital?”
7. HISTORY OF THE
PRESENTING ILLNESS
• Here you are asking about and documenting details of the
presenting complaint. By the end of taking the HPI, you and
readers of the record should have a clear idea about the
nature of the problem and of exactly how and when it started,
how it has progressed over time, and what impact it has had
on the patient in their general physical health, psychology,
and social and working lives. The HPI is best tackled in two
phases.
• First, ask an open question (as for the CC) and allow the
patient to talk through what has happened for about 2
minutes. Don’t interrupt! Encourage the patient with nonverbal
responses and take discreet notes. This allows you to make
an initial assessment of the patient in terms of education
level, personality, and anxiety. Using this information, you can
adjust your responses and interaction. It should also become
clear to you exactly what symptom the patient is most
concerned about.
8. • In the second phase, you should revisit the whole story,
asking more detailed questions
• A mnemonic for remembering the important factors in
analyzing pain or a symptom is O3PQRST.
• Onset, Previous occurrences, Provoking factors,
Palliative factors (including prescribed and home
treatments attempted), Quality (such as characteristics
of pain), Radiation (site of onset and any radiation),
Severity, and Timing
9.
10.
11. For pain, determine
• Site (where is the pain is worst—ask the patient to point to the site
with one finger)
• Radiation (does the pain move anywhere else?)
• Character (i.e., dull, aching, stabbing, burning)
• Severity (scored out of 10, with 10 being the worst pain imaginable)
• Mode and rate of onset (how did it come on—over how long?)
• Duration
• Frequency
• Exacerbating factors
• Relieving factors
• Associated symptoms (e.g., nausea, dyspepsia, shortness of
breath)
12. PAST MEDICAL HISTORY
• Some aspects of the patient’s past illnesses or
diagnoses may have already been covered. Here,
you should obtain detailed information about past
illnesses and surgical procedures.
• When was it diagnosed?
• How was it diagnosed?
• How has it been treated?
13. SPECIFIC CONDITIONS TO INCLUDE
IN PAST MEDICAL HISTORY
• Diabetes
• Rheumatic fever
• Jaundice
• Hypercholesterolemia
• Hypertension
• Angina
• Myocardial infarction
(MI)
• Stroke or transient
ischemic attack (TIA)
• Asthma
• Tuberculosis (TB)
• Epilepsy
• Anesthetic problems
• Blood transfusions
• Childhood illnesses and
sequelae
14. ALLERGIES
• Any allergies should be documented separately
from the drug history because of their importance.
• Ask if the patient has any allergies or is allergic to
anything if they are unfamiliar with the term
allergies. Be sure to probe carefully, as people will
often tell you about their hay fever and forget about
the rash they had when they took penicillin. Ask
specifically if they have had any reactions to drugs
or medication; don’t forget to inquire about food or
environmental allergies.
15. DRUG HISTORY
• Here you should list all the medications that the patient is
taking, including the dosage and frequency of each
prescription. If the patient is unsure about their medications.
• Eye drops
• Inhalers
• Sleeping pills
• Oral contraception
• OTC drugs (bought at a store or pharmacy), vitamin
supplements
• Herbal remedies
• Illicit or “recreational” drug use
16. ALCOHOL
• You should attempt to quantify, as accurately as
possible, the amount of alcohol consumed per week, and
establish if the consumption is spread out evenly over
the week or concentrated in a smaller period.
Alcohol amounts of common drinks
• For typical strength alcoholic beverages the following
contain approximately 0.54 ounces of ethanol.
• 12 ounces beer
• 5 ounces of wine
• 1.5 ounces of 80 proof distilled spirits
17. SMOKING
• Attempt to quantify the habit in pack-years:
1 pack-year is 20 cigarettes (1 pack) per day for 1
year (e.g., 40/day for 1 year = 2 pack-years; 10/day
for 2 years = 1 pack-year).
• ask about passive smoking
18. FAMILY HISTORY
• The FH details the following:
• Makeup of the family, including age and gender of
parents, siblings, children, and extended family, as
relevant Health of the family
• document the age and cause of death for all
deceased first-degree relatives and for other family
members felt appropriate.
20. SOCIAL HISTORY
• This is to document the details of the patient’s personal
life that are relevant to the working diagnosis, the
patient’s general well-being, and recovery or
convalescence. The Social History will help in
understanding the impact of the illness on the patient’s
functional status.
• Marital status
• Sexual orientation
• Occupation (or previous occupations if retired)
• Does the patient own their accommodation or rent it?
• Are there any stairs? How many?
21. • Does the patient have any aids or adaptations in
their house (e.g., rails near the bath)?
• Does the patient receive any help on a daily basis?
• Does the patient have relatives living nearby?
• What hobbies does the patient have?
• Does the patient own any pets?
• Has the patient been abroad recently or spent any
time abroad in the past?
• Does the patient drive?
22. REVIEW OF SYSTEMS
• Prior to the exam, you should perform a screening of
the other body systems relevant to the chief complaint.
When conducting the comprehensive exam, review of
all systems is necessary and use of a cranial–caudal
approach to the review may be most appropriate.
• Not only is the finding of unexpected symptoms
important, the absence of particular symptoms may be
of even greater significance, therefore, always
document significant negatives.
23. • The questions asked will depend on any previous
discussion(s).
• General symptoms
Weight change (loss or gain), change in appetite
(loss or gain), fever, lethargy, malaise
• Skin symptoms
Lumps, bumps, sores, ulcers, rashes, itch
• Sensory symptoms
Vision problems hearing deficits
• Respiratory symptoms
Cough, sputum, hemoptysis, shortness of breath,
wheeze, chest pain
24. • Cardiovascular symptoms
Shortness of breath on exertion, paroxysmal nocturnal
dyspnea, chest pain, palpitations, ankle swelling, orthopnea,
claudication
• Gastrointestinal symptoms
Dysphagia, indigestion, abdominal pain, nausea, vomiting,
a change in bowel habit, constipation, diarrhea, rectal blood
loss
• Genitourinary symptoms
Urinary frequency, polyuria, dysuria, hematuria, nocturia,
menstrual problems, impotence
25. • Neurological symptoms
Headaches, dizziness, tingling, weakness, tremor, faint,
seizures, convulsions, epilepsy, blackouts or other loss of
consciousness
• Psychological symptoms
Depression, anxiety, sleep disturbances
• Endocrine symptoms
Intolerance to heat or cold
• Musculoskeletal symptoms
Aches, pains, stiffness, swelling