If you detect a fruity breath odor:
• Ask the patient about changes in his breathing pattern.
• Ask the patient if he’s experienced increased thirst, frequent urination, weight loss , fatigue , or abdominal pain.
• Ask the female patient if she has had candidal vaginitis or vaginal secretions with it ehing.
• If the patient has a history of diabetes mellitus, ask about stress, infections, and noncompliance with therapy.
• If the patient is suspected of having anorexia nervosa, obtain a dietary and weight history.
PHYSICAL ASSESSMENT
If you detect ammonia breath oder:
• Inspect the patient’s oral cavity for bleeding, swollen gums or tongue, and ulceration with drainage.