Review of systems documentation: Difference between revisions
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REVIEW OF SYSTEMS: | REVIEW OF SYSTEMS: | ||
CONST: [] Negative for fever, body aches and chills. | CONST: [] Negative for fever, body aches and chills. | ||
Revision as of 01:22, 19 November 2021
REVIEW OF SYSTEMS:
CONST: [] Negative for fever, body aches and chills.
HENT: []Negative for neck pain/stiffness, headache, congestion, sore throat, swelling.
EYES:[] Negative for discharge/pain or vision changes.
RESP:[] Negative for cough/hemoptysis and shortness of breath.
CV: []Negative chest pain, difficulty breathing, palpitations.
ABD:[] Negative pain, nausea, vomiting.
GU: []Negative increase frequency, dysuria, blood in urine or stool.
MUSC: []Negative for muscle aches, edema.
SKIN: []Negative rash, lesions/sores.
NEURO:[] Negative headache, dizziness, weakness.
[brackets added to be uploaded into dragon for quick editing. This ROS meets CMS standards for level 5 documentation]