W#6 Health Assessment (replies)

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Respond to your peers’ post and include the following:

· Insight on a solution to an identified peer challenge.

· Resources that may be helpful related to your peers’ post.

POST # 1 AYME

(Ayme’s initial Post)

Reflect on the focus area or system(s) for the week.

· What challenges might you anticipate in completing this assessment?

· What differences might you anticipate when assessing patients across the lifespan?

· Share findings from scholarly resources that help in the performance of this assessment.

The assessment of the HEENT is one of the routine nursing physical examinations. For instance, many hospital visits are due to respiratory infections as well as injuries affecting the HEENT. This makes this area of assessment quite common in daily practice. The regularity of HEENT assessments/ examinations does not however make this is an easy area of clinical examination. For instance, one of the challenges that one may anticipate relates to the patient’s lack of cooperation due to a myriad of factors including pain or impaired cognitive capabilities. As Bickley (2017), even though HEENT examination is objective, the assessment findings are usually based on the patient’s subjective account such as hearing and vision patterns or even taste patterns. Therefore, the subjective aspect of HEENT physical examination makes it particularly challenging since the responses provided by a patient may be inaccurate. On the other hand, this assessment area houses multiple organ systems that work both independently and dependently. These compounds the challenge in HEENT assessment since one finding may translate to multiple possible physiological and diagnostic implications. As such, as Harding, Kwong, Roberts, Reinisch & Hagler (2019), the propensity to misdiagnose in HEENT is high especially when one lacks sound knowledge about the possible systemic symptoms that manifest via HEENT.

   Besides, assessing patients across the lifespan poses additional and unique challenges. For instance, one of the challenges touches on the patient’s inability to cooperate due to underlying cognitive and perception weaknesses. For example, young children and older adults have poor cognitive and perception capabilities, thus making it hard to rely on their perceived stimuli for assessment. Besides, elderly persons may have underlying conditions such as dementia that makes it hard to fully win their cooperation in the physical examination of HEENT.

   Despite these challenges, various evidence-based strategies can be used to enhance diagnostic accuracy. According to Dains, Baumann & Scheibel (2016), it is always important to engage a high level of intuition and keen observation to collect additional clues from the patients' behavioral effects when subjected to certain stimuli such as smell or sound among other stimuli used in HEENT assessment. As Jarvis (2018) asserts, it is also important to use assessment aids such as the ophthalmoscope among others when conducting HEENT assessments to ensure that all the clues are collected. When dealing with children who have impaired self-expression skills, it is important to enroll the assistance of the parent in terms of interpreting a child’s reaction to certain stimuli or assessment technique as well as use children-friendly methods of winning their cooperation such as offering rewards and other extrinsic motivation aspects (Perry, Hockenberry, Alden, Lowdermilk, Cashion & Wilson, 2017).

References

Bickley, L. (2017). Bates' guide to physical examination and history taking (12th ed.). New York: Lippincott,Williams & Wilkins.

Dains, J.E., Baumann, L.C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). Boston: Elsevier.

Harding, M. M., Kwong, J., Roberts, D., Reinisch, C., & Hagler, D. (2019). Lewis's medical-surgical nursing: Assessment and management of clinical problems, single volume. Mosby.

Jarvis, C. (2018). Physical Examination and Health Assessment-Canadian E-Book. Elsevier Health Sciences.

Perry, S. E., Hockenberry, M. J., Alden, K. R., Lowdermilk, D. L., Cashion, M. C., & Wilson, D. (2017). Maternal Child Nursing Care-E-Book. Mosby.