1. List some nonverbal communication techniques that will facilitate open discussion of
your patient’s problems.
Eye contact; body language; a calm, controlled voice; touch; active listening.
2. Outline the components of the interview that you would use for this patient in the fol-
a. History of present illness—Use the mnemonic OPQRST–ASPN to gather infor-
mation concerning Mr. Harmon’s current problem. What were you doing when
the chest pain started? Did it begin suddenly or gradually. Does anything make
the pain better or worse. Can you describe the pain in your own words? How
bad is it? Can you rate it on a scale of one to ten? How long have you had the
pain? Do you have any shortness of breath, nausea, or dizziness?
b. Past history—Do you have a history of heart problems? Are you being treated
for any other medical problems? Have you ever been hospitalized? Have you had
c. Current health status—Are you taking any medications (including over-the-
counter medications)? Do you have any allergies to medications? Do you
smoke? If so, how many packs per day and for how many years? How much al-
cohol do you drink in a week? Do you take any recreational drugs such as mar-
ijuana, cocaine, or amphetamines? Have you had your cholesterol or
triglyceride levels checked? Any other screening tests?
d. Review of systems
Cardiac —Have you ever had heart trouble, high blood pressure, rheumatic
fever, heart murmurs, chest pain or discomfort, palpitations, shortness of
breath, shortness of breath while lying flat, or peripheral edema? Have you ever
been awakened from sleep with shortness of breath? Have you ever had an ECG
or other heart tests?
Respiratory —Have you ever had any of the following: wheezing, coughing up
blood, asthma, bronchitis, emphysema, pneumonia, TB, or pleurisy? When was
your last chest X-ray? Are you coughing now? If so, can you describe the spu-
Gastrointestinal —Have you ever had any of the following: trouble swallowing,
heartburn, loss of appetite, nausea/vomiting, regurgitation, vomiting blood, in-
digestion? Have you had abdominal pain, food intolerance, excessive belching
or passing of gas? Have you had any black, tarry stools or chronic diarrhea?