Final answer:
Documenting 'NAD' in the constitutional section does not contradict noting 'mild respiratory distress' in the pulmonary section, because these notes refer to observations of different aspects of the patient's health status in a physical exam.
Step-by-step explanation:
If you document 'NAD' (No Abnormalities Detected) in the constitutional section of a physical exam, it usually means that there are no significant findings to note regarding the patient's general appearance and vital signs. However, this would not necessarily contradict a statement written in the pulmonary exam section stating 'There is mild respiratory distress.' The constitutional section evaluates the patient's overall state, while the pulmonary exam focuses on the respiratory system specifically. So, it is possible for a patient to appear generally well on overall examination while still exhibiting mild issues when their respiratory system is further assessed.
The signs of respiratory distress might include shortness of breath or a crackling sound upon auscultation, which doesn't affect the overall constitutional finding but are specific to the pulmonary system examination. In clinical practice, it's quite common for different systems to exhibit varying degrees of abnormalities, and hence, documenting findings this way is appropriate and not contradictory.