Pt interview 2

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  1. General Questions
    • Fatigue, malaise, weakness
    • Fever, chills, sweats
    • Weight loss/gain
    • Nausea, vomiting, appetite loss
    • Dizziness, lightheadedness
    • Vital signs
    • Insomnia
    • Change in mentation
  2. Integumentary
    • New skin rashes/lesions
    • Recently changed rashes/lesions
    • Nail bed changes
    • Changes in hair growth
    • Loss of hair
    • Pruritis
  3. NMS
    • Joint pain, swelling
    • Vision, hearing, vertigo
    • Changes in muscle tone
    • Atrophy
    • Tremors
    • Paraesthesia
    • Radicular pain
    • Mood swings
  4. Rheumatologic
    • System jt or muscle issue
    • Joint swelling
    • Myalgia
    • Skin rashes
    • Sensitivity to sunlight
    • Raynaud’s phenomenon
    • Nail bed changes
  5. Cardiovascular
    • SOB/fatigue (anything that increase aerobic capacity)
    • Chest pain/heaviness
    • Palpitations
    • Limb pain with activity
    • Abdominal throbbing pain
    • Peripheral edema
    • Persistent cough
    • High or low BP
    • Change in BP or symptoms with change in position
    • Discolored and or painful distal LEs
  6. Pulmonary
    • Cough
    • Sputum, hemoptysis
    • SOB
    • Altered breathing (wheezing)
    • Night sweats
    • Pleural pain
    • Cyanosis, clubbing
  7. Psychological
    • Not when but how long will it take for pt to get better
    • Sleep disturbance
    • Stress
    • Fatigue
    • Changes in personal habits, appetite
    • Depression, confusion, anxiety
    • Irritability, mood changes
  8. Gastrointestinal
    • Does it hurt when eat
    • Abdominal pain
    • Indigestion
    • Difficulty swallowing
    • Nausea/vomiting
    • Diarrhea/constipation
    • Fecal incontinence
    • Rectal bleeding
    • Skin rash followed by joint pain
  9. Hepatic/biliary
    • Changes in taste/smell
    • Anorexia
    • Ascites
    • Asterixis
    • Tremor when wrist extended bc Ammonia is not properly disposed of (shows liver disease)
    • Dark colored urine
    • Light colored stools
    • Jaundice
    • Itching, spider angiomas, palmer erythema
  10. Hematologic
    • Skin/nail bed changes
    • Easy bleeding (bruising, noise, gums)
    • Falls and manual therapy
    • Fatigue, SOB
    • Rapid pulse
    • Headache
    • Confusion
  11. Genitourinary
    • Change in output
    • Change in color, burning, bleeding
    • Incontinence
    • Painful intercourse
    • Noctoria
    • Dysuria
    • Flank pain
    • Change in bathroom habits
  12. Endocrine
    • Hair and nail changes
    • Change in appetite, weight change
    • Fruity breath odor
    • Temperature intolerance
    • Edema
    • Weakness
    • CTS, TTS (Carpal tunnel/tarsal tunnel)
    • Food or electrolyte imbalances
    • Prolonged DTR
  13. Immunologic
    • Skin/nail bed changes
    • Constitutional symptoms
    • Lymph node changes
    • Sleep disturbance
    • Muscle/joint pain
    • Anaphylactic reactions
    • ** Latex Allergy
  14. Cancer
    • Constant, intense pain, night pain
    • Unexplained weight loss (10% in 10-14 days)
    • Loss of appetite
    • Excessive fatigue
    • Changes in lump/mole
    • Change in bowel/bladder habits
    • Proximal muscle weakness
    • Prolonged bleedi

Card Set Information

Author:
jld15
ID:
320969
Filename:
Pt interview 2
Updated:
2016-06-12 20:11:29
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Pt interview
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Pt interview 2
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