Anda di halaman 1dari 4

RESTLESS LEG SYNDROME

CHIEF COMPLAINT

Restless leg syndrome

HPI

SYMPTOM LIST
•Unpleasant sensations in their calves, thighs, feet or arms
•Deep-seated
•Creeping
•Crawling
•Jittery
•Tingling
•Burning
•Aching
•Numbness
•Starts during inactivity
•Relief by movement
•Worsening of symptoms in the evening
•Nighttime leg twitching

SEVERITY
•Mild
•Moderate
•Severe
•Normal
•Increased
•Decreased
•Stable
•No significant change from prior visit

ONSET
•Sudden
•Gradual

DURATION
•Recent
•Few days
•Many days
•Few weeks
•Many weeks
•Few months
•Many months
•Few years
•Many years

FREQUENCY
•Intermittent
•Continuous

AGGRAVATED BY

RELIEVED BY

NOTES

HISTORY (PMFSH)

PAST HISTORY
•Diabetes
•Peripheral neuritis
•Hypertension

ALLERGY-Drugs
-Environment

FAMILY HISTORY
•Diabetes
•Hypertension

SOCIAL HISTORY
•Habits
o Tobacco
o Alcohol
o Drugs
•Occupation

ROS

PHYSICAL EXAMINATION

TESTS TO BE ORDERED

•Hb%
•Serum electrolytes
•Serum calcium
•Urinalysis

ASSESSMENT/PLAN & INSTRUCTIONS/EDUCATION

•Correct the iron deficiency with taking iron supplements.


•Take pain relievers
•Soaking in a warm bath and massaging legs can relax muscles.
•Apply warm or cool packs.
•Try relaxation techniques, such as meditation or yoga.
•Establish good sleep hygiene.
•Regular exercise may relieve symptoms of RLS, but overdoing it at
the gym or working out too late in the day may intensify symptoms.
•Avoid caffeine
•Cut back on alcohol and tobacco
•Stay mentally alert in the evening.

MEDICATION

 Pramipexole
 Carbidopa
 Levodopa
 Codeine
 Acetaminophen
 Clonazepam
 Eszopiclone
 Ramelteon
 Temazepam
 Zaleplon
 Zolpidem
 Gabapentin

FOLLOW UP

 Keep a sleep diary.


 Stretch out your day. Begin and end your day with stretching
exercises or gentle massage.