Read each case analysis do the following for each
• write 5 review of systems (ROS) questions
• 5 physical assessment techniques that would be conducted in a focused physical exam
1. A.E., age 35 years, is five months pregnant and is in the office today for a routine prenatal visit. She complains that her neck feels swollen and that she has been feeling nervous and tired. She also complains about the heat, excessive sweating, and how she “can’t seem to get cool during these summer months.” She attributes all these complaints to her pregnancy.
2. S.T., a 24-year-old graduate student, visits the clinic to report “bad headaches.” She says that her headaches occur two to three times a month and last at least an entire day. The headache centers above and behind her eyes, throbs, and is not relieved by any over-the-counter medications. She says that they get worse when exams are near and she spends time in the library to study. She is worried that the headaches will cause her to fail graduate school.
Case Analysis 2
1. P. W., a 23 year-old recent immigrant, has come to the health care center complaining of night sweats, recent weight loss, and a decrease in energy level. Sputum is blood tinged.
2. G. E., a 52-year-old social worker, has been treated for a deep vein thrombosis for two days. He calls the nurse to come to his room right away. When the nurse arrives, she sees that he is apprehensive, restless, diaphoretic, and extremely anxious. His PaO2 is 82% (previously had been 97% on room air), his heart rate is 116 beats per minute and his blood pressure is 100/56 mm Hg. He is complaining of a sharp chest pain that gets worse when he breathes in and has shortness of breath.
? Case Analysis 3
1. S. D. was discharged yesterday after treatment for heart failure. She appears short of breath when she answers the door for the home health nurse. The nurse also notices crackles that are unrelieved by coughing, +2 edema in both lower extremities, and a third heart sound.
2. B. L., age 65 years, has come to the emergency department with complaints of increasing chest discomfort over the last few weeks, the worst episode happening this morning. History includes type I diabetes mellitus since age 7 years.
Case Analysis 4
1. J. L. had a CVA within the past week. J. L. is easily frustrated, anxious, and fearful, and her speech is slurred. She needs verbal cuing for any task she is asked to carry out. She eats only food on the left side of the tray and responds only when approached from the left side.
2. A 63-year-old man with a long history of insulin-controlled diabetes has come to the emergency department because of burns on his feet. He soaked his feet in the morning and then put on his socks and heavy work boots. After a day’s work, when he took off his shoes and socks, he discovered that the skin of his feet was completely burned off. He states he did not notice a thing all day because his feet are “always numb and tingling.”