Expansion Questions Flashcards
Expansion Questions for Patient Assessments
Acute Abdomen (6)
Type of pain- steady, intermittent
Vomiting- frequency, color, appearance
ETOH history
GYN history- LMP, unusual discharge, pregnancy
Dietary habits- dyspepsia, fatty food intolerence
Bowel habits- frequency, appearance, color
Asthma (6)
Severity/frequency of past attacks
Asthma medications- inhalers, frequency of use
Hospitalized for this in the past
Intubated for this before
Changed or stopped meds recently
Meds/treatments that have worked in the past
Behavioral (9)
Current C/C or situation- per pt and bystander
Thoughts, threats or previous destructive behavior
History or active alcohol or drug abuse
Bizarre or abrupt change in behavior
Recent crisis
Hallucinations/ delusions- severity?
Interaction with family and friends
Onset, previous history, previous disorders, family history
Suicidal- plan, detailed
Diabetes (6)
Insulin dependent- type, dose, amount Compliant with medications Normal diet, exercise, BG BG monitored daily? Recent illness/ infection Family history
Drowning (4)
Length of submersion
Fresh/ saltwater
Water temp
Trauma
Head- Neck- Spinal Trauma (9)
Loss of consciousness Current LOC Symptoms- dizziness, vertigo, HA, N/V MOI- restrained, helmet Previous event Aggravating factors- ETOH, drugs Regionalized tingling, numbness, weakness, paralysis HA- where and how pain presents Changes in vision, hearing, sensation and/or motor function
Body Cavity or Abdominal Trauma (7)
Location of pain/tenderness
Respiratory effort- easier or more difficult
MOI- what caused injury
Projectile- range, size, entrance and/or exit
Puncture- knife size, object diameter, clean
Safety precautions- seat belt, airbag, body armor
Special physical- breath sounds, neck veins, SQ air, trach midline
OB/ GYN (6)
LMP- normal duration, average flow Is pregnancy possible? Contraceptives used Trauma to reproductive system Current blood loss or vaginal discharge Previous OB history- gravida/para, abortions, c-sections, miscarriages, previous infections
Pulmonary Embolus (5)
Recent surgery, prolonged bed rest, fractures, pregnancy or postpartum bleeding
Cardiac irregularities- afib, valve problems
Personal or genetic varicose veins
Special physical- breath sounds, JVD
See respiratory distress
Respiratory (6)
HPI
Orthopnea (positional)
Coughing- productive, hemoptysis, color
Pain- location, onset, duration/radiation/increase with resp
Body temp
Special physical- breath sounds, JVD, accessory muscle use
Seizures (8)
History of seizures- epilepsy
Medication and compliance
Describe seizure activity- post/current, full body/ jacksonian
Frequency of seizures. Can they be controlled. Warning/ aura?
PMH of ETOH, head trauma, diabetes, infection, fever, CVA, HTN
Length of seizure- normal?
Length of postictal- normal?
Special physical- breath sounds, core temp, BG, trauma exam
Syncope (8)
Position prior to event Duration of event Symptoms prior to event Associated symptoms PMH including previous syncopal episodes Meds and compliance R/O other med emergencies- CVA, seizures, AMI, etc. ECG
Unconscious/ Unknown (6)
Med history- HTN, PE, ETOH/drug abuse, recent infection, trauma
Med alert tags, ID, med info in wallet
Complete trauma exam- check nuchal rigidity of trauma can be ruled out
S/S ETOH, alcoholism, jaundice, ascities, angioedema
Investigate bystanders or witness about preceding symptoms or events
Vitals include BG and core temp
Poisoning (6)
PMH When was it taken What was taken Anything else taken Interventions- dilution, ipecac Last meal
Chest pain
Dyspnea? breath sounds N/V Hx syncope Previous AMI Increase in pain with respiratory cycle Tenderness upon palpation of chest wall ECG
CVA (9)
Previous TIA Onset and change of symptoms (stuttering vs. maximal) Hx of afib Onset <3hr Time last seen normal Head injury Recent surgery Coumadin/ Warfarin/ other anticoagulant Pregnant
