Carotid artery 24 without bruit bilaterally External jugular vein collapsed at

Carotid artery 24 without bruit bilaterally external

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Brachial 2/4, Tibialis posterior pulse (unable to find). Carotid artery 2/4 without bruit, bilaterally. External jugular vein collapsed at 30 degree HOB, internal jugular venous not visible supine. Apical pulse is 2/4 regular. No chest wall heaves, or lifts. Apical impulse palpated at 5 th intercoastal left midclavicular line. Auscultated with diaphragm and bell 2 nd right and left intercoastal, 3 rd left intercoastal, 4 th left intercoastal, and 5 th left intercoastal. S1 prominent at 5 th intercoastal. S2 prominent at 2 nd intercoastal. Extra heart sounds [S3 and S4], murmurs not auscultated. Respiratory Patient is able to sit erect on edge of bed, relaxed; alert and oriented x3. Relaxed breathing 20breaths/ minute. Skin color is olive with pink undertone, widely scattered papule over back. Papule is raised, 0.5cm, erythematous, and round. Thoracic cage is symmetrical with downward sloping ribs; AP: transverse ratio 1:2. Chest expands symmetrically with respiration. Tactile fremitus symmetric vibrations, diminishing toward base. No lumps, masses or tenderness. Trachea mid-line. Resonance percussed over peripheral lung fields. Vesicular sounds auscultated over peripheral lung fields anterior, posterior and laterally. Bronchovesicular sounds auscultated between scapulae and upper sternum; bronchial sounds auscultated over trachea and larynx. No adventitious sounds (crackles or wheezes) auscultated. Bronchophony: symmetric, indistinct “99” whispered pectoriloquy: faint, muffled “1- 2-3” bilaterally, egophony “eeeee” bilaterally.
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Abdomen Abdomen slightly rounded, no hernia, symmetrical. Skin olive with pink undertones with striae on the right and left lower quadrant. Laproscopic gallbladder removal
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  • Spring '14
  • DebraE.Pile
  • pulse, tenderness, capillary refill, peripheral lung fields

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