ANSWER
Question 1: Using Subjective Information to Assess Headaches
The nurse should specifically ask the following questions to ascertain the etiology of the headache:
When did the headache begin to bother you? Was it gradual or abrupt?
Location: What part of the head—frontal, temporal, or occipital—is it?
Character: What kind of pain—dull, throbbing, or sharp—can you describe?
How much time does the headache last? Is it intermittent or continuous?
Level of severity: How bad of a headache is it, on a scale of 0 to 10?
Related Symptoms: Are you experiencing any additional symptoms like light or sound sensitivity, nausea, vomiting, stiff neck, or changes in your vision?
Triggers or Aggravating Factors: Does anything, such as movement, coughing, or strong light, exacerbate the headache?
Relieving Factors: Does anything (like rest or medicine) help with the headache?
History: Do you have a history of headaches like this? How were they handled, if at all?
Medication: Did you take any drugs to treat the headache, and if so, how well did they work?
Systemic Symptoms: Do you have any further symptoms, such as chills or fever, that could point to an underlying infection?
Second Question: Neck Lymph Nodes
The following lymph nodes in the neck area should be palpated by the nurse:
In front of the ears is called the preauricular.
Behind the ears is the posterior auricular region.
Occipital: At the skull’s base.
Jugulodigastric (tonsillar): At the mandibular angle.
Beneath the jawline is the submandibular.
Underground: Beneath the chin.
Above the sternocleidomastoid muscle is the superficial cervical region.
Deep Cervical Chain: Along the sternocleidomastoid muscle’s deeper facets.
Along the trapezius muscle is the posterior cervical region.
Above the clavicle is the supraclavicular region.
Question 3: Head and Neck Objective Data
The following should be checked and felt by the nurse:
Head:
Dimensions, symmetry, and form.
bumps, soreness, or abnormalities present.
integrity of the skin and distribution of hair.
Face:
facial feature symmetry.
lesions, swelling, or discoloration.
Neck:
Check for symmetry, alignment, and any obvious swelling or lumps. Check for tracheal deviation or jugular vein distention (JVD).
Palpation: The size and consistency of the thyroid glands.
swelling, soreness, or induration of the lymph nodes.
The carotid pulses are present.
Motion Range (ROM): Check for limits or pain.
Extra Examinations:
Egophony: A sign of consolidation that is present in bacterial pneumonia.
Tenderness in the neck: In severe situations, this could be a sign of meningitis or a related musculoskeletal strain.
Question 4: Differences in Physical Exam Considering Age
The physical examination may differ in the following ways according to the patient’s advanced age of 72 years:
Examine the skin for signs of thinning, dryness, or lesions brought on by aging.
Lymph Nodes: Unless there is a pathology, like an infection or cancer, older persons frequently have smaller or less palpable lymph nodes.
Thyroid Gland: To prevent discomfort, a delicate approach is necessary. It may be nodular or fibrotic.
Range of Motion: Carefully evaluate to prevent pain or strain from arthritis or age-related joint stiffness.
Neurological Assessment: Pay close attention to any cognitive abnormalities or signs of confusion, as these may point to hypoxia or a systemic illness.
Vital Signs: Pay special attention to your pulse and blood pressure because tachycardia or hypotension could be signs of dehydration or systemic involvement.
Citations
Szilagyi, P. G., and L. S. Bickley (2020). The 13th edition of Bates’ manual on physical examination and taking a history. Kluwer Wolters.
In 2019, Seidel, H. M., Benedict, G. W., Ball, J. W., Dains, J. E., & Kwong, J. The 9th edition of Mosby’s Guide to Physical Examination. Elsevier.
QUESTION
Week 4 Discussion
P.A. is a 72-year-old woman who presents to the family practice with her 40-year-old daughter. The daughter states that her mother has been confused lately and is complaining of a headache, shortness of breath, and a cough. The cough has been persistent for 6 days, and a fever developed 2 days ago. The patient states that she is bringing up yellow-green mucus and has a cough, which gets worse at night. Vital signs are T 100.5, P 88, R 16, and BP 110/55. Lungs are positive bilaterally for wheezing, positive egophony. A chest x-ray examination reveals consolidation indicative of bacterial pneumonia. Labs and culture results are pending for specific antigen. The nurse proceeds with the physical examination of the head, face, neck, and associated lymphatic system.
Question 1
When performing a review of systems, the nurse obtains subjective data concerning the patient’s headache. What specific questions will assist the nurse in determining the cause of the headache?
Question 2
The nurse proceeds to palpate the lymph nodes. Which lymph nodes are located in the neck?
Question 3
When performing the physical examination, what objective data should the nurse inspect and palpate for the head and neck?
Question 4
How might the physical examination vary given the patient’s age?
**Please be sure to include 2 references in APA format within the last 5 years and respond to at least 2 participating classmates, with a substantial descriptive answer.**