Dyspnea History

Dyspnea
Onset [text] prior to evaluation
Onset while  [text]

Now it is of [text] severity at the time of this evaluation.
At it worst it is of [text] severity. 

The dyspnea is relieved with [text]
[select value="no|YES"] <-- worse lying flat
[select value="no|YES"] <-- exertional
[select value="no|YES"] <-- worse with coughing

[select value="no|YES"] <-- cough [text] productive of sputum
[select value="no|YES"] <-- wheezing
[select value="no|YES"] <-- chest pain
[select value="no|YES"] <-- palpitations
[select value="no|YES"] <-- fever
[select value="no|YES"] <-- diaphoresis

Pertinent PMH:
[select value="no|YES"] <-- COPD
[select value="no|YES"] <-- Asthma.
[select value="no|YES"] <-- CHF
[select value="no|YES"] <-- Coronary Disease
[select value="no|YES"] <-- Prior Intubations
Tobacco use: [text]

Pertinent Medications:
Albuterol recent use up to every [text] and was last used [text] 
Steroid inhaler: [text]
Oral steroids last used: [text]

Pitfalls:
[select value="no|YES"] <-- Pneumothorax history or risk
[select value="no|YES"] <-- Pneumonia history or risk
[select value="no|YES"] <-- unilateral leg swelling
[select value="no|YES"] <-- recent prolonged travel, recent trauma, hypercoagulable state, hormonal therapy
[select value="no|YES"] <-- anxiety related symptoms such as panic, dizziness, or finger paresthesias.
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"]
reference:  
[link url="//www.fpnotebook.com" memo="#1"] Dr. Scott Moses, creator/author of the Family Practice Notebook
[/conditional]
Dyspnea
Onset prior to evaluation
Onset while

Now it is of severity at the time of this evaluation.
At it worst it is of severity.

The dyspnea is relieved with
<-- worse lying flat
<-- exertional
<-- worse with coughing

<-- cough productive of sputum
<-- wheezing
<-- chest pain
<-- palpitations
<-- fever
<-- diaphoresis

Pertinent PMH:
<-- COPD
<-- Asthma.
<-- CHF
<-- Coronary Disease
<-- Prior Intubations
Tobacco use:

Pertinent Medications:
Albuterol recent use up to every and was last used
Steroid inhaler:
Oral steroids last used:

Pitfalls:
<-- Pneumothorax history or risk
<-- Pneumonia history or risk
<-- unilateral leg swelling
<-- recent prolonged travel, recent trauma, hypercoagulable state, hormonal therapy
<-- anxiety related symptoms such as panic, dizziness, or finger paresthesias.
display/hide references

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.17, 6 form elements, 237 boilerplate words, 5 text boxes, 1 drop downs, 6 total clicks
Questions/General site feedback · Help Ticket

Send Feedback for this SOAPnote

This site uses Akismet to reduce spam. Learn how your comment data is processed.

More SOAPnotes by this Author: