Objective Data Physical Examination - Vital Signs. Lymph nodes, thyroid. - Chest. Change in basilar breath sounds, dullness, or rales to suggest lower lobe pneumonia or effusions. Cardiomegaly, murmur, gallop. - Abdomen. Inspect for organomegaly, peristaltic waves, distension, flank bulging, surgical scars.
Bowel sounds present, increased, decreased, rushes, high pitched, bruits.
CVA tenderness, pulses intact, edema. Laboratory - Minimum Lab. CBC with differential, platelet and reticulocyte counts, urinalysis and culture, SMA 18 for pain not characteristic of pain episodes, change in jaundice, vomiting or diarrhea. Chest x-ray, ECG, and supine and upright abdomen if patient meets admission criteria. Pain is usually diffuse, steady, involves back and extremities, and is characteristic for patient.