Health Assessment
Weight and height (BMI calculator)#
Overweight and obese individuals are at increased risk for developing diabetes, angina, myocardial infarctions, hypertension, stroke, and many other chronic conditions associated with high morbidity and mortality.
Consider a Nutrition risk assessment.
A body mass index (BMI), calculated by dividing a person’s weight in kilograms with the person’s height in meters squared (kg/m x m, or (lbs/ inches x inches) x 703) may suggest a healthy vs. less healthy weight to height ratio.
- A BMI < 18.5 is defined as underweight.
- A BMI 18.5-24.9 is defined as healthy.
- A BMI > 25 is defined as overweight.
- A BMI > 30 is defined as obesity.
Fatigue?#
Weakness and fatigue may be signs of reduced blood flow to the muscles and other tissues. This can be caused by an ineffective and failing heart.
Patients with increasing levels of fatigue may also suffer from anemia; hemoglobin levels should be measured.
Shortness of breath upon exertion?#
Shortness of breath caused by exercise is common and is usually not a pathologic condition.
Pulmonary congestion caused by congestive heart failure (CHF)) may present as shortness of breath.
Shortness of breath can also be present with different diseases of the lung, respiratory tract, and respiratory muscles, severe kidney failure, and hyperthyroidism.
Orthopnea?#
Symptoms of shortness of breath with less and less activity or when lying down suggest worsening congestive heart failure. Patients with congestive heart failure may need extra pillows when supine to breathe more easily.
Nocturnal dyspnea may result in sudden attacks of shortness of breath during sleep, which may awaken the person.
Swollen ankles?#
Swelling of the feet and ankles may be a sign of right-sided congestive heart failure (CHF); left-sided CHF is usually accompanied by pulmonary congestion and shortness of breath.
Ankle swelling associated with CHF is often described as “pitting edema.” Poking the edematous site will cause an indentation in the tissue that is present for a short time even after the pressure is removed.
Frequent urination and thirst?#
At a blood glucose level above 160-180 mg/dL, the body will excrete additional water to compensate for the loss of glucose that, at this level, passes through the kidneys into the urine. This manifests as frequent (more than 6 times per night) urination (polyuria) and accompanying excessive thirst (polydipsia).
Patients with polyuria and polydipsia may have uncontrolled diabetes mellitus.
Excessive hunger?#
Polyuria is often accompanied by loss of weight due to the loss of calories (ie, glucose in the urine). Excessive hunger (polyphagia) is a compensatory mechanism to regain calories and weight. This phenomenon is often expressed by patients with uncontrolled diabetes mellitus.
Heat intolerance?#
Patients with hyperthyroidism have an increased body metabolism and many body functions speed up (eg, tachycardia, high blood pressure, tremors of the hands).
Many patients with hyperthyroidism may also experience heat intolerance, feeling hot even in cold temperatures.
Easy bruising?#
Pathologic conditions associated with easy bruising are most commonly caused by quantitative or qualitative platelet disorders. Platelet disorders may sometimes be associated with spontaneous gingival bleeding.
Lack of platelets (thrombocytopenia) can be caused by different diseases and conditions, such as bone marrow dysfunction, cirrhosis, or idiopathic thrombocytopenic purpura.
Platelet dysfunction can be associated with von Willebrand disease or acquired through various diseases or medications. These diseases include kidney disease, leukemia, multiple myeloma, liver cirrhosis, and systemic lupus erythematosus (SLE). Medications affecting platelet function include aspirin, ticlopidine, and NSAIDs.
Spontaneous bleeding from the nose?#
Spontaneous epistaxis may be associated with bone marrow disorders, hereditary blood disorders, leukemia, liver disease, or organ and cell transplants. It may also be associated with certain platelet disorders.
Changes in coordination?#
Lack of coordination is commonly caused by chronic alcohol abuse, but it can also be caused by strokes, neoplasms, or multiple sclerosis. Incoordination is sometimes accompanied by dysarthria, manifesting as slurred speech, among other symptoms.