review of systems example

4 min read 16-03-2025

The Review of Systems (ROS) is a crucial part of a comprehensive patient history. It's a structured process where the healthcare provider systematically inquires about each body system to identify potential health issues. This article provides examples of how to perform a thorough ROS, covering common systems and highlighting important considerations. Understanding ROS examples is vital for medical students, nurses, and other healthcare professionals.

What is a Review of Systems?

A Review of Systems (ROS) is a detailed inquiry into the presence or absence of symptoms related to each body system. It's not a physical exam; it's a conversation with the patient. The goal is to uncover any symptoms that the patient may have overlooked or not considered significant enough to mention earlier. A well-conducted ROS can significantly impact diagnosis and treatment.

Types of Review of Systems

There are two main types of ROS:

Complete ROS: This involves a comprehensive review of all body systems. It's typically used for new patients or during comprehensive physical examinations.
Focused ROS: This limits the review to systems directly relevant to the patient's chief complaint or presenting problem. It's used for follow-up visits or when time is limited.

Review of Systems Examples: By Body System

Let's explore examples of questions asked during a ROS for various body systems. Remember, the phrasing should be adapted to the patient's understanding and the clinical context.

1. Constitutional Symptoms

Fever: "Have you experienced any fever or chills?"
Weight changes: "Have you noticed any recent weight gain or loss?"
Fatigue: "Have you felt unusually tired or fatigued lately?"
Night sweats: "Have you experienced any excessive night sweats?"

2. Skin

Rashes: "Do you have any rashes, itching, or skin lesions?"
Changes in moles: "Have you noticed any changes in your moles or skin discoloration?"
Hair loss: "Have you experienced any unusual hair loss?"

3. Head

Headaches: "Do you experience headaches? If so, how often, where are they located, and what is their severity?"
Dizziness: "Have you experienced any dizziness or lightheadedness?"
Head injuries: "Have you had any recent head injuries?"

4. Eyes

Vision changes: "Have you noticed any changes in your vision, such as blurred vision or double vision?"
Eye pain: "Do you experience any eye pain or discomfort?"
Eye discharge: "Do you have any eye discharge?"

5. Ears, Nose, and Throat (ENT)

Ear pain: "Do you have any ear pain or ringing in your ears (tinnitus)?"
Hearing loss: "Have you noticed any hearing loss?"
Nasal congestion: "Do you experience nasal congestion or a runny nose?"
Sore throat: "Do you have a sore throat?"

6. Cardiovascular System

Chest pain: "Do you experience any chest pain or discomfort?" (Crucial to further explore location, radiation, and associated symptoms)
Shortness of breath: "Do you experience shortness of breath, especially with exertion?"
Palpitations: "Have you noticed any palpitations or irregular heartbeats?"
Edema: "Do you experience any swelling in your legs or ankles?"

7. Respiratory System

Cough: "Do you have a cough? If so, is it productive (with mucus) or dry?"
Shortness of breath (dyspnea): "Do you experience shortness of breath?"
Wheezing: "Do you experience wheezing?"
Hemoptysis: "Have you coughed up any blood?"

8. Gastrointestinal System

Abdominal pain: "Do you have any abdominal pain?"
Nausea and vomiting: "Have you experienced any nausea or vomiting?"
Changes in bowel habits: "Have you noticed any changes in your bowel habits, such as constipation or diarrhea?"
Heartburn: "Do you experience heartburn or indigestion?"

9. Genitourinary System

Urinary frequency: "Have you noticed any changes in your urination, such as increased frequency or urgency?"
Pain with urination: "Do you experience pain with urination?"
Blood in urine: "Have you noticed any blood in your urine?"
Sexual health: (Questions tailored to the patient's sex and relevant history)

10. Musculoskeletal System

Joint pain: "Do you have any joint pain or stiffness?"
Muscle pain: "Do you experience any muscle pain or weakness?"
Back pain: "Do you have any back pain?"
Limb pain: "Do you have any pain in your arms or legs?"

11. Neurological System

Headaches: (Already covered above, but can be revisited here for detail)
Dizziness: (Already covered above)
Weakness: "Have you experienced any weakness or numbness in your limbs?"
Seizures: "Have you ever had a seizure?"
Loss of consciousness: "Have you ever lost consciousness?"

12. Hematologic System

Easy bruising: "Do you bruise easily?"
Bleeding problems: "Do you experience excessive bleeding?"
Anemia: "Have you ever been diagnosed with anemia?"

13. Lymphatic System

Swollen lymph nodes: "Have you noticed any swollen lymph nodes?"

14. Endocrine System

Thyroid problems: "Have you ever been diagnosed with a thyroid problem?"
Diabetes: "Do you have diabetes?"
Weight changes: (Already covered above, but relevant here)

Important Considerations When Performing a ROS

Patient comfort: Create a relaxed atmosphere. Use clear and simple language.
Thoroughness: Don't rush the process. Allow ample time for the patient to provide complete information.
Documentation: Meticulously record the patient's responses. Use standardized terminology.
Follow-up: If a patient mentions a concerning symptom, ask detailed follow-up questions.
Context: The ROS should be tailored to the patient's age, sex, and medical history.

Conclusion

The Review of Systems is a vital tool for gathering a comprehensive patient history. By utilizing these examples and adapting them to individual circumstances, healthcare professionals can significantly improve the accuracy of their diagnoses and provide the best possible patient care. Understanding the nuances of each body system's potential symptoms is key to effective ROS implementation. Remember that this is a guide, and specific questions may need adjustments based on the individual patient presentation and the clinical setting.