Discharge? Nocturia? Indigestion/heartburn? Relieved by Nausea/vomiting? Relieved by^ Usual bowel pattern Constipation? Females: g. Genitourinary/Reproductive:^ Incontinence? Any genital lesions? Any concerns about sexuality/sexual activity? Any problems with: History of ulcers? Length of cycle History of sexually transmitted disease? Date of last menstrual cycle If yes, please explain: Method of birth control used Problems associated with menstruation? Usual voiding pattern Urinary hesitancy? the above problems Type of self-care assistance provided for either of Frequency? Pain/burning? Diarrhea? Odor?^
Penile discharge? Males: Practice breast self-examination? Frequency? Swelling? Lumps? Prostate problems? h. Eyes:^ Yes No Explain Breasts: Pain/tenderness? Blurring? Double vision? Glasses? Itching? Contacts? Swelling? Discharge? Dimpling? Discharge? (^)
12 ●^ THE FOUNDATION FOR PLANNING PSYCHIATRIC NURSING CARE
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