Focused Symptom Analysis

Focused Symptom Analysis (PQRST)
Below are three examples (pain, respiratory, and nausea) of how the PQRST mnemonic can be universally applied when assessing any number of symptoms or various Pt complaints.
P	Provocative, precipitating, and palliative factors
	■ Pain: Activity at or before onset. Does anything make mpain better or worse? ■ Respiratory: Activity at or before onset. Factors that lessen or worsen level of distress. ■ Nausea: Last oral intake before onset. Factors that make nausea better or worse.
Q	Ask Pt to describe quality of the symptom.
	■ Pain: Dull, stabbing, achy, pressure, or squeezing. ■ Respiratory: Productive/nonproductive cough, chest heaviness, bronchial tickle/cough reflex. ■ Nausea: Emesis, gagging/dry heaving, nausea only.
R	Ask Pt to describe location and/or whether symptom radiates to another region of body or if there are any related symptoms.
	■ Pain: Location and radiation to another region of body. ■ Respiratory: Related symptoms (e.g., CP, nausea, fever, cough reflex, etc.). ■ Nausea: Related symptoms (e.g., diarrhea, constipation, indigestion, fever, headache, etc.).
S	Assess severity of the symptom.
	■ Pain: Rate pain using 0/10 pain scale ■ Respiratory: Can Pt speak in full sentences or must he or she take another breath after only one–two words? ■ Nausea: Nausea only, emesis, dehydration.
T	Determine timing factors related to symptom.
	■ Determine duration of symptom. ■ Determine if symptom is constant or intermittent. ■ Determine if onset of symptom is sudden or gradual (over minutes, hours, days, or weeks).