NR 509 Week 7 Assignment; Immersion Skills Lab
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Palpate pinnae & tragus - no nodules or tenderness 8) Cranial nerve # 8 (ACOUSTIC) Whisper test - Have pa琀椀ent cover one ear - Whisper 3 words - Repeat on other side *Hearing intact bilaterally. 9) Inspect eyes—conjunc琀椀va clear and pink, no drainage or lesions present; sclera white and clear. 10) Cranial nerve #2 (OPTIC) Snellen eye chart—tests central vision -Stand 6 feet away from pa琀椀ent. -Have pa琀椀ent cover 1 eye and read smallest line. -Repeat with other eye. -Repeat with both eyes. *Report as 20/20 vision in R eye, L eye, and both eyes. Con琀椀nuing assessment of cranial nerve # 2—test peripheral vision. - Stand at eye level with pa琀椀ent and have pa琀椀ent look straight ahead. - Test peripheral vision from behind shoulders, above head, and from below at waist. Con琀椀nuing assessment of cranial nerve # 2—test pupillary response. - Use light on ophthalmoscope and ask pa琀椀ent to stare at your nose. - Come from side of eye to front. Both pupils constrict, 2 to 3 cm in diameter, respond to light. 11) Cranial nerves #3 (OCULOMOTOR), #4 (TROCHLEAR), & #6 (ABDUCENS) Star or “H” pa琀琀ern—checking extraocular muscles of the eye All extraocular movements are intact equally. 12) Inspect nose—midline, no obstruc琀椀ons, swelling or visible fractures - Use otoscope— 琀椀p nose up with thumb. Inspect le昀琀 turbinate—pink & moist Angle inward to inspect septum—midline, no swelling or bogginess Repeat on other side. 13) Palpate frontal and maxillary sinuses—assess for tenderness Auscultate caro琀椀d arteries—use bell of stethoscope! - Have pa琀椀ent take a breath and hold it—no bruits noted *Repeat on other side. 21) Range of mo琀椀on—NECK Drop chin to chest (checking 昀氀exion) Look up (checking extension) Look over R shoulder, then L shoulder (checking rota琀椀on) Ear to shoulder—both sides (checking lateral 昀氀exion) *All movements intact equally 22) Cranial nerve #11 (SPINAL ACCESSORY) Place hands on pa琀椀ent’s shoulders, have them shrug against resistance—equal and intact bilaterally 23) Heart sounds—5 areas: * Auscultate with diaphragm AND bell of stethoscope while pa琀椀ent is si琀��ng down. 1. Aor琀椀c valve—2nd intercostal space on R sternal border 2. Pulmonic valve—2nd intercostal space on L sternal border 3. Erbs point—3rd intercostal space on L sternal border 4. Tricuspid valve—4th intercostal space on L sternal border 5. Mitral valve—5th intercostal space @ midclavicular line 24) Inspect anterior chest—assess for any obvious deformi琀椀es and symmetry—none found 25) Auscultate lung sounds— have pa琀椀ent breathe in and out through mouth Anterior (6 areas) —good air movement, clear breath sounds bilaterally Posterior (8 areas) —good air movement, clear breath sounds bilaterally 26) Inspect upper extremi琀椀es 33) Palpate all 4 quadrants (had over hand, circular mo琀椀on) Assess for tenderness or palpable masses—no tenderness or masses present 34) Palpate liver: - place hand under pa琀椀ent w/ palm up (costovertebral angle), look @ midclavicular line and press down and upward while instruc琀椀ng pa琀椀ent to take a deep breath in— feeling for lower edge of liver
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