NR 509 Week 7 Assignment; Physical Assessment (Head-to-Toe) Video Outline
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▪ Test CN 8 (Acous琀椀c) : Using the Whisper test, stand behind pa琀椀ent & cover mouth with hand while pa琀椀ent covers their ear, whisper 3 words & have the pa琀椀ent repeat them. (Right side: “One, Two, Three”; Le昀琀 side: “Four, Five, Six”) Note hearing is intact bilaterally. EYES ▪ Inspect sclera & conjunc琀椀va : Note the conjunc琀椀va are pink & moist with no drainage or lesions. Note the sclera are white & clear. ▪ Test CN 2 (Op琀椀c) : Test gross visual acuity & peripheral/central vision—has 3 parts: 1st: Use the Snellen eye pocket chart & stand 6 feet away. Have the pa琀椀ent read the lowest line possible while covering the le昀琀 eye, the right eye, & then using both eyes. Note the pa琀椀ent’s visual acuity. (20/20) nd 2 : (Have pa琀椀ent stand) Ask the pa琀椀ent to look straight ahead without moving their head. Standing in front of the pa琀椀ent, test their peripheral vision by moving hands from behind the pa琀椀ent to in front & ask them to tell you when they see your hands. (Come from behind, below, & above.) rd 3 : (Use light source) Check the pa琀椀ent’s pupillary response to light by having the pa琀椀ent look at your nose & bring light from side to each eye to look for constric琀椀on of the pupils. Note that bilateral pupils are 2-3 mm, equal, round, & reac琀椀ve to light. ▪ Test CN 3, 4, & 6 (Oculomotor, Trochlear, & Abducens) : Using a “star” or “H” pa琀琀ern with your finger, have the pa琀椀ent follow it with their eyes only. Note that all extraocular eye movements are intact bilaterally. NOSE ▪ Inspect nose : Note the nose is midline & straight with no obvious deformity or swelling. ▪ Inspect nasal turbinates & septum : (Use otoscope) Use your thumb to 琀椀p the pa琀椀ent’s nose up & insert the otoscope to visualize the lateral nose—note the turbinates are moist & pink without swelling. Then visualize the medial nose—note the septum is straight with no devia琀椀on. ▪ Palpate frontal & maxillary sinuses : Palpate the frontal (lower forehead above medial eyebrows) & maxillary (below the cheeks & above the teeth on the sides of the nose). Note any tenderness. THROAT & MOUTH ▪ Inspect the pa琀椀ent’s throat & mouth : (Use otoscope) Lips: Note they are moist & pink. Teeth: Note there are no obvious cracks or decay. Gums: Note they are moist & pink with no swelling, redness, or bleeding. HEART ▪ Auscultate all 5 areas with the diaphragm and repeat with the nd bell Aor琀椀c valve: 2 intercostal space at R sternal border nd Pulmonic valve: 2 intercostal space at L sternal border rd Erb’s point: 3 intercostal space at L sternal border Tricuspid: 4th intercostal space at L sternal border Mitral: 5th intercostal space at midclavicular line ANTERIOR CHEST ▪ Inspect for obvious deformi琀椀es & symmetry : Note the chest is symmetric & no obvious deformities. ▪ Auscultate lung sounds in anterior lung 昀椀elds : Ask pa琀椀ent to take
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