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Koilonychia: absent
Leukonychia: absent
Edema: absent
Dehydration: absent
Pulse: 92 b/min
Blood pressure: 130/70 mm Hg
Temperature: 101 F
Cont..
Deep palpation:
Liver:Liver is palapable 3 cm from the right costal margin in right mid-clavicular
line,tender,has smooth surface,sharp margin,firm in consistency.Upper border of liver
dullness is in the right 5th intercostal space.
Spleen: Not palpable
Kidneys: Not palpable or ballotable
Percussion:
Percussion note: Tympanic.
Shifting dullness: Absent
Auscultation:
Bowel sound: Present
No hepatic Bruit
Respiratory System:
Inspection:
Shape of the chest: normal
Movement of the chest symmetrical
Respiratory rate: 22 breath/ min
No visible apical impulse, engorged blood vessel
Palpation:
Trachea -centrally placed
Apex beat- in left 5th ICS
Chest expansion : normal
Vocal fremitus: normal
Percussion: Resonant on both side
Auscultation: Breath sound vesicular
No added sound
Vocal resonance - normal
Cardiovascular System
Precordium examination:
Inspection:
Size & shape: Normal
No visible apex beat
No visible engorged vein
Palpation:
Apex beat:Position of apex beat in left 5th intercostal space 9 cm from midline
No thrill, No parasternal heave
Auscultation:
Heart sound: Normal in all four auscultatory areas
Murmurs : Absent
Nervous system
Bed rest
Diet-Normal
Inj Ampicillin 1gm
Inj Gentamicin 80mg
Inj Metronidazole 500mg
Tab paracetamol 500mg
Cap omeprazole 20mg
Napa Suppositery -SOS