crab
Forum Junior
Topics: 9
Posts: 42
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hi everybody,
this forum is indeed a boon for all of us preparing for usmle 
my query today is-- in any case like loss of consciousness or dizziness which may have orthostatic changes as 1 of the reasons,do we measure orthostatic changes in vital signs as part of the physical exam or do we order it in the work-up?personally,i would certainly prefer latter 
but what is the right way to go about it?
waiting for guidance :roll:
good luck to all
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| crab
Forum Junior
Topics: 9
Posts: 42
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:? somebody please <:help:>
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| bobby
Forum Guru
Topics: 136
Posts: 569
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order as work up.
it is of little use and time consuming re-taking the vital signs, since you will not consider it for d/d. you are required to use only theirs.
___________________
if you haven't any charity in your heart, you have the worst kind of heart trouble.
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| crab
Forum Junior
Topics: 9
Posts: 42
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thanks bobby
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| docsa
Forum Newbie
Topics: 3
Posts: 9
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but y in usmw given in HTN. refill case to check B.P????????/
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| crab
Forum Junior
Topics: 9
Posts: 42
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docsa,HTN refill case is the only situation where they expect u to check BP.hope this answers ur query.
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| Sophia1
Topics: 3
Posts: 14
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If you do not do orthostatic vs,then how do you write in PN? just write : vs WNL,need check orthostatic change.Then at workup write check orthostatic vs. Is that OK?
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| crab
Forum Junior
Topics: 9
Posts: 42
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to save time in PN, within PE just write " vs-wnl "(depending on the values given on the doorway information) & then order "check orthostatic vital signs"as ur 1st work-up.
that's it.good luck.
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| CSobsessed
Forum Senior
Topics: 6
Posts: 144
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"...HTN refill case is the only situation where they expect u to check BP..."
Why should I do this? Because I find my nurse unreliable? She checked BP for me and it is on the door among vital signs. There is so much to ask in this case ( medications, symptoms,complications, the whole PMH) and to do: the whole CV sitting and supine plus auscultation of the lungs plus abdomen( brui, pulsatile mass) plus fundoscopy. Plus you have to counsel the patient on monitoring, medications, diet, exersise... Cheking BP with unfamiliar cuff in stress situation will take time of half of what you should do. Just a thought...
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