Bates Guide to Physical Examination - Health History Questions And Answers Graded A+

(General Survey) General appearance elements - 1. Apparent state of health 2. Level of consciousness 3. Signs of distress 4. Skin color and obvious lesions 5. Dress, grooming, personal hygiene 6. Facial expression 7. Odors 8. Posture, gait, motor activity 9. Height and weight Aspects of Health Promotion and Counseling - 1. Measure BMI/waist circumference 2. Assess dietary intake 3. Assess the motivation to change 4. Provide counseling about nutrition and excercise Barriers to interviewing a patient - 1. Patients curiosity about you - shifting the conversation away from themselves 2. Anxiety - can alter examination findings 3. Silence 4. Depression 5. Crying 6. Seduction 7. Anger 8. Avoiding the full story 9. Finances - not all can afford tests/procedures10. Language differences - use an interpretor if at all possible 11. Literacy - speak to the patient in terms they will understand. Exploring the patients perspective - understand what are the patients... - 1. Feelings about the problem 2. Ideas about the nature and cause of the problem 3. Functional changes and effect on the patient's life 4. Expectations of the disease, clinician, or of health care. General Survey Elements - 1. Physical Appearance 2. Body structure 3. Mobility (gait, balance, ease of movement, use of assistive devices) 4. Behavior Health Recommendations - 1. Reduce sodium to 1500 mg/day 2. Increase vegetables, fruits, whole grains, healthy fats 3. Decrease sugars and solid fats 4. Exercise at least 30 minutes 5 days/week How to structure a Health History - 1. Identifiers 2. Chief Complaint (CC) 3. History of Present Illness (HPI) 4. Past Medical History (PMH) 5. Family History (FH) 6. Personal and Social History (SH) 7 .Review of Symptoms (ROS) In a successful interview you... - 1. generate the patient's story and gather complete and accurate data about the patient2. Establish rapport and trust 3. Build a continuing therapeutic relationship 4. Teach about the health state, health promotion and disease prevention.