|
Clinical Findings include signs—things you can see; symptoms—things your patient tells you about; and test results. Each clinical finding listed in DATA has its own page that describes what a sign, symptom or test result means, as well as ways you can test for that finding.
As you work, remember that a clinical finding might not always be phrased exactly as you’re thinking about it. You may need to be creative and think about different ways to say the same thing.
Example: If your patient has a large bruise on her leg, but you don’t see an entry called bruise. What are some other ways to describe what you have seen? Are there other words for bruising? You may find the symptom listed as Skin discoloration-bruising or Contusion (bruising).
|
