What are the findings of the review of systems?

From the Guidelines

A review of systems is a comprehensive assessment of a patient's health status across all major body systems, including dermatological, endocrine, gastrointestinal, hematological, and hemoglobinopathy systems, as defined by the American College of Cardiology/American Heart Association task force on clinical data standards 1. The review of systems is a crucial component of a patient's evaluation, as it helps healthcare providers identify potential health issues and develop an appropriate treatment plan.

• The dermatological system includes normal or abnormal clinical findings related to the skin 1.
• The endocrine system includes normal or abnormal clinical findings related to the collection of tissues capable of secreting hormones 1.
• The gastrointestinal system includes normal or abnormal findings related to the stomach and intestines 1.
• The hematological system includes normal or abnormal findings related to abnormalities of the synthesis of hemoglobin, and/or the mechanisms of coagulation 1.
• The hemoglobinopathy system includes normal or abnormal findings related to structural alterations of a globin chain within the hemoglobin molecule 1. When conducting a review of systems, healthcare providers should systematically inquire about symptoms related to each body system, asking specific questions about common symptoms for each system, and document both positive findings and pertinent negatives. The review of systems should be performed methodically, with the depth of the review varying based on the clinical context, and should complement the chief complaint and history of present illness by providing a broader context of the patient's overall health status 1.

From the FDA Drug Label

Stop use and ask a doctor if an allergic reaction occurs. Seek medical help right away.You experience any of the following signs of stomach bleeding: feel faint, vomt blood, have bloody or black stools, have stomach pain that does not get better, pain get worse or lasts more than 10 days, fever gets worse or lasts more than 3 daysredness or swelling is present, new symptons occurringing in the ears or a loss of hearing occurs.

The findings of the review of systems are not explicitly stated in the drug label. However, the label does mention some potential symptoms that may occur, including:

• Stomach pain
• Fever
• Redness or swelling
• New symptoms occurring in the ears
• Loss of hearing
• Signs of stomach bleeding, such as:
  • Feeling faint
  • Vomiting blood
  • Bloody or black stools These symptoms may be relevant to a review of systems, but the label does not provide a comprehensive review of systems. 2

From the Research

Review of Systems Findings

The review of systems is a comprehensive assessment that encompasses various bodily systems to identify potential health issues. The findings of this review can be summarized as follows:

• A comprehensive review of systems is essential in individuals with spinal cord injury or dysfunction to uncover underlying causes of secondary complications, including autonomic dysreflexia 3
• The review of systems should include evaluation of constitutional, head, cardiovascular, gastrointestinal, genitourinary, musculoskeletal, respiratory, skin, neurologic, psychiatric, endocrinologic, hematologic, and immunologic issues 3
• In a clinically relevant bedside assessment, the review of systems should include evaluation of the patient's general appearance, activity, vital sign measurements, pain, and key assessment of the neurologic, respiratory, cardiovascular, integumentary, gastrointestinal, and genitourinary systems 4
• A systematic method of collecting both subjective and objective data is necessary to make accurate clinical judgments and develop interventions appropriate to the healthcare environment 5
• In pediatric cardiac patients, noncardiac issues such as respiratory, gastrointestinal, hematological, renal, and endocrine systems must be recognized and managed to improve clinical outcomes 6

System-Specific Findings

The review of systems can reveal various system-specific findings, including:

• Respiratory system: assessment of respiratory function and identification of potential issues such as respiratory failure 5, 6
• Cardiovascular system: evaluation of cardiovascular function and identification of potential issues such as cardiovascular disease 4, 7
• Gastrointestinal system: assessment of gastrointestinal function and identification of potential issues such as gastrointestinal bleeding 4, 6
• Genitourinary system: evaluation of genitourinary function and identification of potential issues such as urinary tract infections 4, 6
• Neurologic system: assessment of neurologic function and identification of potential issues such as neurologic deficits 3, 4