@NYCking It's hard to point out what is limiting you, however I would suggest reviewing common admit diag workups for the patients that you are seeing in the outpatient clinic. For instance, if you have a patient presenting on day X, with fever of Y temp, then what does your brain jump to when you think about likely symptoms that would present itself on the ROS?
Vital Signs - SIRS criteria
- hypotension?
- new onset tachycardia?
- respirations per minute? - tachypneic?
- temperature too high? temperature too low?
What would you be asking yourself that you would expect to see on ROS?
- Neuro - Altered mental status? Neck stiffness? New sensitivity to light?
- Integumentary - are they diaphoretic?
- Respiratory - are they SOB? Expiratory wheezing? SOB? CTAB?
- Musculoskeletal - generalized weakness or specific pain to a site?
- Gastrointestinal - tenderness to palpation around bladder area?
- Genitourinary - diminished urine production? UTI?
What are the usual treatments that you see for patients with infections?
- Pain management/Antipyretics - Tylenol
- Antibiotics - Rocephin, Zosyn, Levaquin, Bactrim, Zithromax-
- Antivirals - Zovirax
What are the usual tests that you see for an infection workup?
- CBC: White blood cell count?
- Venous lactate?
- Urinalysis, urine cultures
- Blood cultures (suspect bacteremia/sepsis)