Course 3: HPI and ROS

Question 1

How is the HPI different from the ROS?

Answer 1

• HPI focuses on the story about the chief complaint and its associated Sx
• ROS is a checklist of symptoms. It includes cc, associated Sx, and all other complaints the pt may have

Question 2

Elements of HPI

Answer 2

Onset, timing, location, quality, severity, modifying factors, associated Sx, context

Question 3

What if the pt is unable to provide information?

Answer 3

HPI/ROS limited by…

Question 4

Why is it important to document if the pt has had similar Sx in the past?

Answer 4

Because it is less likely that their current Sx are life threatening if they have survived similar Sx in the past

Question 5

Details important to document if the pt has been evaluated in the past for a similar complaint

Answer 5

What Sx prompted the prior evaluation?
How long ago did the prior evaluation occur? 
Who did they see? (Name and specialty)
What treatment did they receive?
Did it help?
What Dx was given? Prior test results?

Question 6

Order of HPI

Answer 6

1) Chief complaint and onset
2) Quality, severity, location, radiation
3) Associated symptoms, pertinent negatives
4) modifying factors (what makes it better/worse? Treatments tried?)
5) context (similar symptoms? Recent evaluations? Initiating factor that brought patient to ED)

Question 7

Why should you always pay special attention to the complaints of chest pain and SOB?

Answer 7

Direct concern for MI

Question 8

Three past surgical histories that indicate that the patient has a history of CAD.

Answer 8

Angioplasty, CAGB, stents

Question 9

Cardiac catheterization

Answer 9

Insertion of a catheter with ejection of dye into the coronary artery, used to diagnose CAD

Question 10

Stress test

Answer 10

Measures the hearts ability to respond to physical stress to determine if there is adequate blood flow to your heart during increasing levels of activity.

Question 11

Two types of stress test

Answer 11

Exercise (treadmill) stress test and nuclear stress test for patients with a medical problem that prevents them from exercising. They use a medication to stress the heart (mimicking exercise)

Question 12

Risk factors for an MI

Answer 12

CAD, HTN, DM, dyslipidemia, smoking, FHx of CAD

Question 13

Risk factors for a PE

Answer 13

Known DVT, PMHx of DVT or PE, FHx of DVT or PE, recent surgery, CA, Afib, immobility, pregnancy, BCP, smoking

Question 14

Risk factors for a CVA

Answer 14

HTN, HLD, DM, Hx TIA/CVA, smoking, FHx CVA, AFIB

Question 15

Significance of HPI

Answer 15

HPI is the story of the Sx and events that led to the patient’s ED visit. It includes the chief complaint (CC) and the associated Sx