Provocation and Palliation
- What causes it?
- What makes it better?
- What makes it worse?
- What seems to trigger it? Stress? Position? Certain activities? Arguments?
- Does it seem to be getting better, or getting worse, or does it remain the same?
- What relieves it: changing diet? changing position? taking medications? being active? resting?
- What makes (the problem) worse?
Quality and Quantity
- How does it feel, look or sound?
- How much of it is there?
- (This is a difficult one as the rating will
differ from patient to patient.)
- Is it sharp? Dull? Stabbing? Burning? Crushing?
- Try to let patient describe the
pain, sometimes they say what they think you would like to hear.
- If describing a discharge: Thick? Runny? Clear? Colored?
- If describing a psychological problem: Do the voices drown out other sounds?
- Whose voice does it sound like?
Region and Radiation
- Where is it?
- Does it spread?
- Where does the pain radiate?
- Is it in one place?
- Does it go anywhere else?
- Did it start elsewhere and is now localized to
one spot?
- In the case of pain, does it travel:
- Down your back?
- Down your arms?
- Up your neck?
- Down your legs?
Severity and Scale
- Does it interfere with activities?
- How does it rate on a severity scale of 1 to 10?
- How bad is it when it's at its worst?
- Does it force you to sit down, lie down, slow down?
- How long does an episode last?
Timing and Type of Onset
- When did it begin?
- How often does it occur?
- Is it sudden or gradual?
- How long does it last?
- What time did it begin?
- When was the first date it happened?
- What were you doing when you first experienced or noticed it?
- How often do you experience it: hourly? daily? weekly? monthly?
- When do you usually experience it: daytime? night? in the early morning?
- Are you ever awakened by it?
- Does it lead to anything else?
- Is it accompanied by other signs and symptoms?
- Does it ever occur before, during or after meals?
- Does it occur seasonally?
Other questions to ask:
- Any medication or allergies?
- Does it hurt on deep inspiration?
- Activity at onset?
- Any history of pain?
- Is it the same?
- Different?
- Any family history of heart disease, lung problems, diabetes, stroke, hypertension?
- Check LOC.
- Pupils?
- JVD?
- Midline trachea?
- Any recent trauma?
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