Propedeutica medica barbara bates pdf download single plate clutch pdf download dark continent mark mazower pdf download english to gujarati dictionary pdf. 1-16 of 59 results for 'barbara bates guide to physical examination' Bates' Guide to Physical Examination and History Taking Sep 9, 2016. Bickley MD FACP.
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C H A P T E R 11 C H A P T E R 1 A N O V E R V I E W O F P H Y S I C A L E X A M I N A T I O N A N D H I S T O R Y T A K I N G 1 The techniques of physical examination and history taking that you are about to learn embody time-honored skills of healing and patient care. Your abil- ity to gather a sensitive and nuanced history and to perform a thorough and accurate examination deepens your patient relationships, focuses your patient assessment, and sets the direction of your clinical thinking. The quality of your history and physical examination governs your next steps with the patient and guides your choices from the initially bewildering array of secondary testing and technology. Over the course of becoming an accomplished clinician, you will polish these important relational and clinical skills for a lifetime. As you enter the realm of patient assessment, you begin integrating the es- sential elements of clinical care: empathic listening; the ability to interview patients of all ages, moods, and backgrounds; the techniques for examining the different body systems; and, finally, the process of clinical reasoning. Your experience with history taking and physical examination will grow and expand, and the steps of clinical reasoning will soon begin with the first moments of the patient encounter: identifying problem symptoms and abnormal find- ings; linking findings to an underlying process of pathophysiology or psycho- pathology; and establishing and testing a set of explanatory hypotheses. Work- ing through these steps will reveal the multifaceted profile of the patient before you.
Paradoxically, the very skills that allow you to assess all patients also shape the image of the unique human being entrusted to your care. Clinical Assessment: The Road Ahead This chapter provides a road map to clinical proficiency in three critical areas: the health history, the physical examination, and the written record, or “write-up.” It describes the components of the health history and how to or- ganize the patient’s story; it gives an approach and overview to the physical ex- amination and suggests a sequence for ensuring patient comfort; and, finally, it provides an example of the written record, showing documentation of find- ings from a sample patient history and physical examination. By studying the subsequent chapters of the book and perfecting the skills of examination and history taking described, you will cross into the world of patient assessment— gradually at first, but then with growing satisfaction and expertise. After you work through this chapter to chart the tasks ahead, you will be directed by subsequent chapters in your journey to clinical competence. Chapter 2, Interviewing and the Health History, expands on the techniques An Overview of Physical Examination and History Taking An Overview of Physical Examination and History Taking THE HEALTH HISTORY: STRUCTURE AND PURPOSES 2 B A T E S ’ G U I D E T O P H Y S I C A L E X A M I N A T I O N A N D H I S T O R Y T A K I N G and skills of good interviewing; Chapters 3 through 16 detail techniques for examining the different body systems. Once you master the elements of the adult history and examination, you will extend and adapt these techniques to children and adolescents. Children and adolescents evolve rapidly in both temperament and physiology; therefore, the special approaches to the inter- view and examination of children at different ages are consolidated in Chap- ter 17, Assessing Children: Infancy Through Adolescence.
Finally, Chapter 18, Clinical Reasoning, Assessment, and Plan, explores the clinical reasoning process and how to document your evaluation, diagnoses, and plan. From this blend of mutual trust, respect, and clinical expertise emerges the timeless re- wards of the clinical professions. THE HEALTH HISTORY: STRUCTURE AND PURPOSES As you read about successful interviewing, you will first learn the elements of the Comprehensive Health History. For adults, the comprehensive his- tory includes Identifying Data and Source of the History, Chief Complaint(s), Present Illness, Past History, Family History, Personal and Social History, and Review of Systems. As you talk with the patient, you must learn to elicit and organize all of these elements of the patient’s health. Bear in mind that dur- ing the interview this information will not spring forth in this order!
How- ever, you will quickly learn to identify where to fit in the different aspects of the patient’s story. As you gain experience assessing patients in different settings, you will find that new patients in the office or in the hospital merit a comprehensive health history; however, in many situations a more flexible focused, or problem- oriented, interview may be appropriate. Like a tailor fitting a special garment, you will adapt the scope of the health history to a number of factors: the pa- tient’s concerns and problems; your goals for assessment; the clinical setting (inpatient or outpatient; specialty or primary care); and the amount of time available. Knowing the content and relevance of all components of the com- prehensive health history allows you to choose those elements that will be most helpful for addressing patient concerns in different contexts. The components of the comprehensive health history structure the patient’s story and the format of your written record, but the order shown here should not dictate the sequence of the interview. Usually the interview will be more fluid and will follow the patient’s leads and cues, as described in Chapter 2.
Each segment of the history has a specific purpose, which is sum- marized below. These components of the comprehensive adult health history are more fully described in the next few pages. The comprehensive pediatric history appears in Chapter 17.
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