With the patient’s concerns and health history in mind, and after good hand hygiene, you are ready forthe physical examination.What areas of physical examination are important in this patient? Does this hurt?No.Okay. How about now? Downloaded From: by a VA Medical Center--Long Beach User on 04/09/2020
Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved. Page 3 Check the patient’s pharynx. Say, “ah.” Ahhhhh… I do seem some white patches on your tonsils in the back of your throat. Check the patient’s upper palate. I do see some spots on the roof of your mouth as well. Palpate the patient’s anterior cervical lymph nodes. Any tenderness here? Not really. Palpate the patient’s posterior cervical lymph nodes. These lymph nodes feel enlarged. How about tenderness here? Yeah, they’re pretty tender. Check the patient’s heart and lungs. Your heart and lungs are fine. I am going to check your stomach area now. Perform a careful abdominal exam, listening in all four quadrants. Perform light palpation…and deep palpation of the abdomen. Palpate and percuss the patient’s liver. With the patient supine, palpate the patient’s spleen. Okay, take a deep breath in…and let it all the way out. Does that feel tender? Yeah, that does feel a little tender. Now just to be sure, I am going to check your spleen with you lying on your right side. With the patient on the right side, palpate the patient’s spleen diagonally toward the shoulder, starting at about the umbilical area up to the left costal margin. Take a deep breath in…and let it all out. Any tenderness here? Yeah, that does feel a little tender. Check the patient’s lower extremities for petechiae or edema. Diagnostic Considerations Downloaded From: by a VA Medical Center--Long Beach User on 04/09/2020
Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved. Page 4 List your diagnostic considerations in order of importance and explain your rationale.Press pause and list your answers. Resume when you are ready to receive feedback.
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