Throat/Neck: NSF
Sore Throat Yes NO Hoarseness Yes NO
Swollen Glands Yes NO Lumps Yes NO
Stiffness Yes NO Pain Yes NO
Other:
Neurological: NSF
LOC: Alert Confused Sedated Somnolent
Speech: Clear Slurred Aphasic Dysphasia
PEARL Yes NO Grip Equal Yes NO
Cooperative Yes NO ________________________________
Oriented to: Person Place Time
Other:
Respiratory: NSF
Dyspnea Yes NO w/ Activity At Rest Retractions
Cough Yes NO non-Productive Productive
Hemoptysis Yes NO Cyanosis Yes NO
Lung Sounds: ____________________________________________
Other:
PM – IV A-07 pg 1 of 1