Physical Exam Key Points

1. Vital signs and general appearance. Mental status changes, weakness, muscular cramps, and hypotension may all be associated with hyponatremia or decreased intravascular volume.

2. Fluid status. Assess total body water (including both intracellular and extracellular volume). Assess volume status by checking mucous membranes, presence of tears, capillary refill, peripheral edema, ascites, jugular venous distention, tachycardia, hypotension, and murmurs.

3. Abdomen. Palpate for masses or organomegaly consistent with congestive heart failure.

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