Subjective and Objective Symptoms, Essay Example

Current Symptoms (stomach, heart, lungs) Client states no problems exist with breathing while resting, although he occasionally is breathless when he exercises. The client also complains of occasional acute stomach pains after having eaten a big meal- heart burn is a common ailment occurring roughly three times a month.  Finally, patient complains of having  various infections on his foot.

C- infection on foot is red with noticeable puss

O- roughly 2 months

L- over the last two toes on the right foot

D- comes and goes after treatment

S- goes through a cycle of roughly 3 months

P- physician prescribes antibiotic to get rid of infection

A – No other symptoms for the infection

Client says that infection reoccurs every three months, and is sensitive to the touch.  The consistency of the infection maintains a similarity over that time period.

Family HX- The patient has a history of prostate cancer and high blood pressure.  Both of the patient’s parents had a history of high blood pressure that led to a heart attack in the father.  The father also was diagnosed with prostate cancer relatively early at the age of 55.  The patient’s mother also had lupus.

Objective Symptoms:

Vital Signs

Inspection- There is clear unevenness in the abdominal area that rifts into the abdominal wall.  Repeated pushing on stomach leads to

Auscultation- A bruit was produced indicating possible alteration of arterial blood flow in the abdomen area.

Palpation- Abdominal tenderness exists towards the upper abdominal wall.

Percussion-  Normal.