Patient is edentulous . Apical rate is now 80 and regular. There are no heart murmurs. Lungs are clear to auscultation and percussion, unchanged from the initial survey. There are no crepitance or palpable irregularities over the thorax rib cage.
Bowel sounds are hypoactive.
Liver, spleen, and kidney are nonpalpable. Femoral pulses are normal and equal. Both shoulders have full range of motion on active and passive movement, as do elbows. The right wrist appears swollen. Although the patient does not want to move it, it has full range of motion on passive range of motion exam.