Handbook of Signs & Symptoms

1277 Pages·2015·16.01 MB·English

by  Andrea Ann Borchers (ed.)

HANDBOOK OF
Signs &
Symptoms
FIFTH EDITION
HANDBOOK OF
Signs & Symptoms
FIFTH EDITION
Clinical Editor
Andrea Ann Borchers, PhD, RN
Associate Professor of Nursing
Division of Nursing
Kettering College
Kettering, OH
Acquisitions Editor: Shannon W. Magee
Product Development Editor: Maria M. McAvey
Editorial Assistant: Zachary Shapiro
Production Project Manager: Marian Bellus
Design Coordinator: Elaine Kasmer
Manufacturing Coordinator: Kathleen Brown
Senior Marketing Manager: Mark Wiragh
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Prepress Vendor: SPi Global 5 edition
Copyright © 2015 Wolters Kluwer
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Printed in China
Library of Congress Cataloging-in-Publication Data
Borchers, Andrea Ann, author.
Handbook of signs & symptoms / Andrea Ann Borchers. — Fifth edition.
p. ; cm.
Handbook of signs and symptoms
Preceded by Handbook of signs & symptoms. 4th ed. c2010.
Includes bibliographical references and index.
ISBN 978-1-4511-9425-8
I. Handbook of signs & symptoms. Preceded by (work):II. Title.III. Title: Handbook of signs and
symptoms.
[DNLM: 1. Signs and Symptoms—Handbooks. WB 39]
RC69
616'.047—dc23
2014035784
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including any warranties as to accuracy, comprehensiveness, or currency of the content of this work.
This work is no substitute for individual patient assessment based upon healthcare professionals’
examination of each patient and consideration of, among other things, age, weight, gender, current or prior
medical conditions, medication history, laboratory data and other factors unique to the patient. The
publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare
professionals, and not the publisher, are solely responsible for the use of this work including all medical
judgments and for any resulting diagnosis and treatments.
Given continuous, rapid advances in medical science and health information, independent professional
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LWW.com
This work is dedicated to
Sam, Kim, Tim, Emily, Ellen and Kelly.
You are and always will be the lights of my life.
CONTRIBUTORS
Samuel A. Borchers, OD
Optometrist
Comprehensive Family Eye Care
Centerville, Ohio
Veterans Administration Medical Center
Dayton, Ohio
Clinical Faculty
Primary Care Optometry and Ocular Disease Management
The Ohio State University
Columbus, Ohio
Allison J. Terry, PhD, MSN, RN
Associate Professor of Nursing
Auburn University Montgomery
Montgomery, Alabama
Laura M. Willis, MSN, APRN,FNP-C
Assistant Professor
Kettering College
President, Connect: RN2ED
Family Nurse Practitioner
PREVIOUS EDITION
CONTRIBUTORS
Diane Dixon Abercrombie, PA-C,MA, MMSc
Marsha L. Conroy, RN, BA, BSN,MSN, APN
Ken Ehlers, PA-C, MPAS
Timothy L. Hudson, MS, MEd,CCRN, FACHE
Julia Anne Isen, BSN, MS, FNP-C
Anna L. Jarrett, PhD, ACNP/CNS-BC
Manuel D. Leal, PA-C, MPAS, LCDR
William Pawlyshyn, RN, BSN, MS,MN, APRN, BC
Sundaram V. Ramanan, MD, MS,FRCP, FACP
Richard R. Roach, MD, FACP
Allison J. Terry, RN, PhD, MSN
Pamela Yee, MD
Philip Zazove, MD
FOREWORD
“The CT scan is normal,” the emergency department physician explains to the
resident. “I'm thinking of sending the patient home, but I've only done a cursory
examination.” Ten minutes later, the resident returns. “The patient had a stroke.
She has a positive Homans sign and a positive Babinski's reflex. Arrange a
room.”
As this type of drama plays out every day in hospitals and clinics, eliciting a
thorough history and performing a careful examination continue to be the
cornerstones of clinical practice. Despite marked improvements in technology,
the patient assessment is based on both subtle history clues and an observant
exam. This still yields the highest diagnostic results, not to mention the cost-
benefit ratio and the rapport it establishes with the patient. Those clues should
always direct the technology, not the other way around.
Handbook of Signs & Symptoms, Fifth Edition, is a treasure trove of prompts
and reminders for the clinician. It provides a comprehensive description of
common to unusual patient complaints, coupled with diagnostic testing that is
both routine and specific. It describes physical examination findings in detail and
clarifies the mechanics of performing even rarely used tests.
Signs and symptoms are formatted alphabetically for quick retrieval, and
elicited history is linked to the essentials of the exam. Readers are alerted to
urgent situations in the Emergency Interventions section. Differential diagnoses
are listed under Medical Causes, following the elaboration of the symptom
history and exam findings. Under the heading Other Causes, the clinician is
alerted to medications or herbal remedies that are associated with the patient's
complaint. Special Considerations address pediatric, gender-specific, and
geriatric concerns.
This new edition of the handbook has been updated to include important
signs and symptoms related to diseases that have recently taken center stage in
clinical medicine, including avian influenza, respiratory syncytial virus,
Kawasaki disease, and metabolic syndrome — an epidemic disease that has
become essential to diagnose and manage.
Illustrations are scattered throughout the book to augment the reader's
understanding of particular tests, and tables point out the often subtle differences
in signs and symptoms to help distinguish among the most common complaints.
These visual graphics make great teaching tools, too. The index is invaluable to
the reader looking for a particular, familiar exam finding as well as for the
differential utilizing that finding. The addition of a new appendix that focuses on
obtaining a health history answers the need for comprehensive, reliable, and
consistent documentation information that is important to formatting electronic
medical records.
Handbook of Signs & Symptoms, Fifth Edition, sharpens the novice
clinician's ability to listen to the patient with an ear tuned to critical history and
offers the seasoned clinician an opportunity to hone examination skills. It is an
invaluable tool for maximizing the evaluation of a puzzling patient. Following
the handbook's format provides the clinician with an added measure of security
that the most careful history and educated examination have been performed.

Richard R. Roach, MD, FACP
Assistant Professor
International Medicine Department
Kalamazoo Center for Medical Studies
Michigan State University
East Lansing, Michigan