SDO TARLAC PROVINCE SCHOOL HEALTH UNIT

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 PERTINENT FINDINGS PER SYSTEM 🞅 Decreased Mobility
A. HEENT 🞅 Pale Nailbeds
🞅 Essentially Normal 🞅 Weak Pulses
🞅 Abnormal Papillary Reaction
🞅 Others :
🞅 Cervical Lymphadenopathy H. Neurological Examination
🞅 Dry Mucus Membrane 🞅 Essentially Normal
🞅 Icteric Sclerae 🞅 Abnormal Gait
🞅 Pale Conjunctiva 🞅 Abnormal Position Sense
🞅 Sunken Eyeball
🞅 Abnormal Sensation
🞅 Sunken Fontanelle
🞅 Abnormal Reflex/es
🞅 Others :
🞅 Poor/Altered Memory
B. Chest/Breast/ Lungs
🞅 Poor Muscle Tone/Strength
🞅 Essentially Normal
🞅 Poor Coordination
🞅 Asymmetrical Chest Expansion
🞅 Others :
🞅 Decreased Breath Sounds
🞅 Wheezes NCD HIGH-RISK ASSESSMENT (FOR 20 YRS OLD AND ABOVE) 1.
🞅 Lumps Over Breast Eats processed food (ex. Instant Noodles, Burgers, Fries, Fried Chicken
🞅 Crackles/Rales Skin, etc) and Ihaw-ihaw Weekly?
🞅 Retractions 🞅 Yes 🞅 No
🞅 Others : 2. Eats 3 servings of Vegestable Daily?
C. Hea 🞅 Yes 🞅 No
🞅 Essentially Normal 3. Does at least 2.5 hours of moderate-intensity physical actiovity?
🞅 Displaced Apex Beat 🞅 Yes 🞅 No
🞅 Heaves/Trills 4. Was patient diagnosed as having Diabetes?
🞅 Irregular Rhythm 🞅 Yes 🞅 No 🞅 Do not know
🞅 Muffled Heart Sounds 5. Was patient diagnosed as having Diabetes?
🞅 Murmurs 🞅Polyphagia 🞅 Polydipsia 🞅 Polyuria
🞅 Pericardial Bulge FBS/RBS: __________Date Taken: _______
🞅 Others : Total Cholesterol: ______Date Taken: ________
D. Abdomen Urine Ketone: _________Date Taken: ________
🞅 Essentially Normal Urine Protein: __________ Date Taken: _________
🞅 Abdominal Rigidity
🞅 Abdominal Rigidity Angina or Heart Attack 🞅 Yes 🞅 No
🞅 Hyperactive Bowel Sounds 1. Have had any pain/discomfortpressure/heaviness in your chest?
🞅 Palpable Mass/es 🞅Yes 🞅 No
🞅 Tympanitic/Dull Abdomen 2. Do you get the pain in the center/left chest or left arm?
🞅 Uterine Contraction 🞅Yes 🞅 No
🞅 Others : 3. Do you get it when you walk uphill or hurry?
E. Genitourinary 🞅Yes 🞅 No
🞅 Essentially Normal 4. Do you slowdown if you get the pain while walking?
🞅 Blood Stained in Internal Examination 🞅Yes 🞅 No
🞅 Cervical Dilation 5. Does the pain go away if you standstill or if you get medication?
🞅 Presence of Abnormal Discharge 🞅Yes 🞅 No
🞅 Others : 6. Does the pain go away in <10 minutes?
F. Digital Rectal Examination 🞅Yes 🞅 No
🞅 Essentially Normal 7. Have you ever had severe chest pain across the front of your chest
lasting for half an hour or more?
🞅 Enlarge Prostate
🞅 Mass 🞅 Yes 🞅 No
* If YES to number 3, 4, 5, 6 and 7, the patient have ANGINA/HEART
🞅 Hemorrhoids
ATTACK, must see a doctor.
🞅 Pus
Stoke and TIA 🞅 Yes 🞅 No
🞅 Not Applicable
8. Have you ever had difficultyin talking, weakness of arms or legs on
🞅 Others :
the one side of the body? 🞅 Yes 🞅 No
G. Skin/Extremities *If YES to number 8, you may have TIA/Stroke, must seek a doctor.
🞅 Essentially Normal
🞅 Cyanosis/Mottled Skin
🞅 Clubbing
🞅 Edema/Swelling
🞅 Cold Clammy
🞅 Decreased Mobility
🞅 Cyanosis/Mottled Skin
🞅 Pale Nailbeds
🞅 Edema/Swelling
RISK LEVEL
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🞅<10% 🞅 10% TO 20% 🞅 20% TO 30% 🞅30% TO <40% 🞅 ≥ 40%