SPE #1 S&S Review/Prep

Question 1

-malaise most common early symptom
-fever, chills, & sweats
-specific infected S&S
-tender lymph nodes

Answer 1

Infections S&S

Question 2

-swollen + NON-TENDER lymph nodes (hard/immobile)
-P! similar time of night
-Unexplained weight loss of ≥ 5-10%
-Fever,chills,sweats (night) *in absence of infection

Answer 2

Cancer S&S

Question 3

-P! in the neck, trunk (thoracic, lumbar, and abdominal), pelvic and/or shoulder regions due to multiple levels of interventions)
-dysphagia; swallowing difficulty
-food aversion/intolerance
-N&V
-bowel dysfunction (color, shape, constipation)

Answer 3

Gastrointestinal S&S

Question 4

-P! in neck and/or upper shoulder
-Thorax P! (shared T2-4 innervation) possibly exacerbated by:
-deep inspiration
-coughing
-trunk motion
-reaching
-Cyanosis
-SOB, wheezing, and/or altered breathing patterns

Answer 4

Respiratory S&S

Question 5

-Family Hx of Heart Attack > 60
-P! in chest (angina) w/wo upper thorax, neck UE, and or face (due to shared T2-4 innveration)
-L UE more common
-UE P! is in ulnar n. distribution medially into little finger
-Especially upon exertion
-Nausea
-SOB/Wheezing
-Dizziness/Lt. headedness (syncope)

***Show of Peripheral Vascular S&S:
-LE edema including weight gain indicated impaired R ventricle
-Diminished pulses

Answer 5

Cardiovascular S&S:

Question 6

-N&V
-Dizziness
-Visual or auditory dysfunction
-Worst HA ever may be an impending stroke

Answer 6

Neurological S&S:

Question 7

What are you looking for in infections?

Answer 7

–observation
–lymph nodes (>2cm in diameter), firm, immobile, tender
--heat
–swelling
– possible abdominal quadrant assessment
–check vital signs

Question 8

What are you looking for in cancer review?

Answer 8

–observation
–palpation of lymph nodes (NON-tender)
–temperature

Question 9

What are you looking for in a cardiovascular review?

Answer 9

–observation
–vitals
–ankle brachial index
–LE systolic BP/UE systolic BP
– > .9 can be used for prediction

Question 10

What are you looking for in a respiratory review?

Answer 10

–observation
–vitals
–breath sounds w/stheoscope, precussions

Question 11

What are you looking for in a GI review?

Answer 11

–observation
–abdominal assessment

Question 12

What are example questions you can ask after receiving a chief complaint? (3)

Answer 12

“So what brings you in today?”
“I see you’re here for _______ pain”
“Can you describe/point to where P! at? (local/reffered)

Question 13

Describe abnormal lymph nodes of cancer.

Answer 13

> 2cm, firm, immobile, NON-TENDER due to limited inflammation w/typical slow growth of most cancer

Question 14

What are you looking for in a neurological review?

Answer 14

–observation
–neurological tests specific to region (dermatomes, DTR, myotomes,etc

Question 15

What are must complete components or you fail?

Answer 15

–introduce yourself
–wash your hands/hand sanitizer
–handshake (optional)
–ask for NAME and DOB
–ask for consent

Question 16

Onset/Context: example questions to ask? (3)

Answer 16

“When did you first notice the P!”
“Do you know of anything specific that you did to cause this P!?”
“Have you done anything differently in your daily routine recently?”

Question 17

Symptoms Description: example questions to ask? (4)

Answer 17

“Can you describe your P! for me?”
**“Do you have any other symptoms besides P!?” **
“Have your symptoms gotten better or worse”?
“Do you have any numbness or tingling?

Question 18

Symptoms behavior: example questions to ask? (3)

Answer 18

“What makes symptoms better?”
“What makes symptoms worse?”
“Is there ever a time you don’t notice symptoms?”

Question 19

Symptoms range: example questions to ask? (2)

Answer 19

“On a scale of 1-10, 1 being no pain and 10 being you need to go to the hospital what is your pain at currently?”
“ “On a scale of 1-10, 1 being no pain and 10 being you need to go to the hospital what is your pain at usually?”

Question 20

Daily impact: example questions to ask? (2)

Answer 20

“How do your symptoms affect your daily activities?”
“What time of the day do you notice at its worst?”
—–If at night “does your symptoms affect your sleep?”
IF yes, “Do you wake up around the same time?”

Question 21

Prior treatment and results: example questions to ask?

Answer 21

“Have you been seen for this before?”
-Yes- “What was your prior treatment?”

Question 22

Medications/Supplements: example questions to ask?

Answer 22

“Are you currently taking any medications or supplements?”
–Dosage: “What is the dosage”
–Frequency: “How often”
–Do medications help?

Question 23

Diagnostic tests: example questions to ask?

Answer 23

“Have you had any imaging done?”
IF yes: “How long ago?” – “What did the imagining show”

Question 24

Prior injuries/surgeries: example questions to ask?

Answer 24

“Have you had any prior surgeries?”
“Have you had any prior injuries?”
Yes: What, When, How recovery?

Question 25

PMH: example questions to ask?

Answer 25

“Have you had any medical complications in the past?”
“Do your intermediate family members have any medical complications?”

Question 26

Social Hx: exmaple questions to ask?

Answer 26

“Do you drink”
“Do you smoke”
“Do you do any recreational drugs”

IF yes: how often, how long

Question 27

Patient perspective/goals: example questions to ask?

Answer 27

“What do you wish to accomplish while in PT?”

Question 28

What must you do in conclusion of the SPE? (3)

Answer 28

summarize assessment + plan
ask final questions
thank them