Integumentary Felipe Barbosa Sick Visit ShadowHealth Objective Data
Integumentary Felipe Barbosa Sick Visit ShadowHealth Objective Data
Objective Data Collection: 10 Of 10 (100%)
- Correct
- Partially correct
- Incorrect
- Missed
Auscultated Breath Sounds
1 of 1 point
Breath Sounds (1/3 point)
- Present in all areas
- Diminished in some areas
- Absent in some areas
Adventitious Sounds (1/3 point)
- No adventitious sounds
- Wheezing
- Fine crackles
- Stridor
- Rhonchi
- Rales
Location (1/3 point)
- All areas clear
- Adventitious sounds in anterior right upper lobe
- Integumentary Felipe Barbosa Sick Visit ShadowHealth Objective Data
- Adventitious sounds in anterior right middle lobe
- Adventitious sounds in anterior right lower lobe
- Adventitious sounds in anterior left upper lobe
- Adventitious sounds in anterior left lower lobe
- Adventitious sounds in posterior right upper lobe
- Adventitious sounds in posterior right lower lobe
- Adventitious sounds in posterior left upper lobe
- Adventitious sounds in posterior left lower lobe
Auscultated Heart Sounds
1 of 1 point
Heart Sounds (1/2 point)
- S1 and S2 audible
- S1, S2, and S3 audible
- S1, S2, and S4 audible
- S1, S2, S3, and S4 audible
Extra Heart Sounds (1/2 point)
- No extra sounds
- Gallops
- Murmur
- Friction rub
- Valve clicks
Assessed Location of Rash
1 of 1 point
Plane (1/2 point)
- Left side of torso
- Right side of torso
- Left side of back
- Right side of back
- Left side of body
- Right side of body
Dermatome (1/2 point)
- Cervical
- Thoracic
- Lumbar
- Sacral
- Coccygeal
Assessed Character of Rash
1 of 1 point
Character Of Rash (1/1 point)
- Clustered
- Satellite
- Non-vesicular
- Vesicular
- Dermatomal
- Herald patch
- Bilateral
- Unilateral
Palpated Abdomen Light
1 of 1 point
Tenderness (1/3 point)
- None Reported
- Tenderness Reported
Location Of Tenderness (1/3 point)
- No quadrants tender
- Right upper quadrant
- Right lower quadrant
- Left upper quadrant
- Left lower quadrant
Observations (1/3 point)
- No additional observations
- Masses
- Guarding
- Distention
Palpated Spine
1 of 1 point
Palpated Spine (1/2 point)
- Spinous process nontender to palpation
- Spinous process tender to palpation
- Integumentary Felipe Barbosa Sick Visit ShadowHealth Objective Data
Palpated Spine Accessory Muscles (1/2 point)
- Accessory muscles nontender to palpation
- Accessory muscles tender to palpation
Palpated Rash
1 of 1 point
Palpated Rash (1/1 point)
- Tenderness with palpation
- Non-tender with palpation
Tested Sensation in Legs
1 of 1 point
Right Touch (1/2 point)
- Expected sensation in proximal and distal
- Decreased proximal sensation
- Decreased distal sensation
Left Touch (1/2 point)
- Expected sensation in proximal and distal
- Decreased proximal sensation
- Decreased distal sensation
Tested Sensation in Feet
1 of 1 point
Right (1/2 point)
- Expected sensation
- Decreased sensation
Left (1/2 point)
- Expected sensation
- Decreased sensation
Tested Spine ROM
1 of 1 point
Extension (1/4 point)
- Expected range of motion (approx. 30 degrees)
- Reduced extension
Flexion (1/4 point)
- Expected range of motion (approx. 75-90 degrees)
- Reduced flexion
Lateral Bending (1/4 point)
- Expected range of motion bilaterally (approx. 35 degrees)
- Reduced lateral bending to the right
- Reduced lateral bending to the left
Rotation (1/4 point)
- Expected range of motion bilaterally (approx. 30 degrees)
- Reduced rotation to the right
- Reduced rotation to the left
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