Physical Assessment of HEENT
As healthcare providers (HCP), evaluating an individual’s health status by conducting a comprehensive physical examination is critical. Physical assessment enables the obtaining of data that facilitates the establishment of assessment cues that prompts care delivery through the nursing process.
Assessment of rashes is fundamental in the integumentary system. Rashes can vary from being simple and can depict an early sign of a life-threatening condition, and they often occur due to infection. Rashes are usually classified based on the morphology of primary lesions. A rash with lesions that are often nonpalpable, circumscribed flat, and less than a centimeter is classified as macule. Papule rash is palpable and solid, with a diameter of up to 0.5 centimeters. Erythematous rash with macular and papular lesions is classified as maculopapular. Further, a nodule presents similarly as a papule; however, they are located more profound in the dermis or subcutaneous tissue. Nodules get differentiated from papules through palpation and their deeper location in the skin, rather than their sizes.
Additionally, a plague is skin rashes often formed by the confluence of papules easily seen since they elevate the area of the skin affected. Vesicles are circumscribed, elevated, fluid-filled lesions originating in the intraepidermal or subepidermal. A skin rash is classified as a pustule if it contains a vesicle and pus, whereas a bulla is a vesicle whose lesion is often more than 0.5 centimeters.
In the physical assessment of the HEENT (head, ears, eyes, nose, and throat), I realized the essence of oral evaluation consideration for a comprehensive evaluation. The inclusion of oral assessment to HEENT to HEENOT is a new clinical assessment tool that prompts me to examine teeth, gums, mucosa, and tongue. The advocation of the tool is consistent with Teaching Oral-Systematic Health (TOSH) program to include a comprehensive oral health assessment (Haber, Hartnett, Allen, et al., 2015).
I have difficulty in the assessment of the twelve cranial nerves, which are linked to neurological assessment. The concept of assessing cranial nerves optic, oculomotor, trochlear, and abducens confuses me. Evaluation of the cranial nerve II remains clear, however, cranial nerves III, IV, and VI assessments remain unclearly conceptualized. Neuroscience nursing remains a challenge, primarily due to a possible lack of measurable criteria (Boudreaux, 2014). Additionally, I have difficulty in differentiating the Weber and Rinne tests. As one of the 8th cranial verve tests, Newman (2018) asserts that conducting the Weber and Rinne tests is difficult to carry out except in specialized settings effectively.
References
Boudreaux, A. (2014). Strengthening your neurologic assessment techniques. Nursing Critical Care, 9(3), 32–37. https://doi.org/10.1097/01.ccn.0000446244.76447.81
Haber, J., Hartnett, E., Allen, K., Hallas, D., Dorsen, C., Lange-Kessler, J., … & Wholihan, D. (2015). Putting the mouth back in the head: HEENT to HEENOT. American journal of public health, 105(3), 437-441.
Newman, G. (2018). How to Assess the Cranial Nerves – Neurologic Disorders. MSD Manual Professional Edition. https://www.msdmanuals.com/professional/neurologic-disorders/neurologic-examination/how-to-assess-the-cranial-nerves.