Nursing – Physical assessment

This is for a USA based (need American English) intro nursing class – Physical Assessment – do not need references but answers need to be correct.

Question 1

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Document a detailed and complete assessment of the wound pictured below. Measurements can be approximated and depth can be fabricated.

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Question 2

First identify what skin assessment tool would be used to assesses this skin lesion below. Next, use that skin assessment tool to document a detailed and complete assessment of the skin lesion.

(image is attached) – image 2

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Question 3

The home care nurse is seeing a 68-year-old Hispanic woman for the first time. The patient speaks very little English. However, the home care nurse does speak and understand some Spanish, as well as, the patient daughter is present to assist with interpretation. The patient was discharged from the hospital with a diagnosis of congestive heart failure (CHF) and was given prescriptions for a diuretic (water pill) and beta-blocker (BP medication). The nurse completes a full health history and physical on the patient. During the health history the daughter states that the mother does not like taking medications and prefers to use herbal remedies instead. The physical assessment reveals that the patient’s vitals are: Temp – 98.6; Pulse – 72; BP – 160/90; Respirations – 14; and pulse ox – 94%. The nurse also notes the patient’s lungs have scattered rhonchi (rattling noise) that clears when she coughs. She also has bilateral lower extremity edema (swelling).

  • Based on the information above, what is wrong with the patient and what is causing it?
  • What disease causation theory does this patient believe in? Explain.
  • What culturally appropriate interventions could the nurse incorporate into the plan of care for this patient? What does the nurse need to assess and do to get the patient to be compliant with her medications?
  • What does the nurse need to do before caring for this patient who is from a culture different from hers? How would she do this?
  • What level of cultural competence is the nurse displaying? Explain.

Question 4

M.C. is a 40-year-old man who comes into the emergency department with an ankle injury. He states that he was working on his house and fell off the latter. He rates his pain at a 10 on a scale of 1 to 10. Upon assessment the nurse notes that M.C.’s ankles are asymmetrical, he has a large ecchymotic (bruise) area on left upper ankle and foot, and has noticeable swelling. M.C. left ankle is tender to the touch and there is increased pain with movement. X

  • What subjective data does the nurse need to collect from M.C. regarding his shoulder pain and injury?
  • What objective data did the nurse already assess regarding M.C. shoulder pain and injury? What assessment techniques did the nurse use to collect the objective data? Explain.
  • What range of motion (ROM) can you do with M.C. to assess his movement? Explain how you would do these movements.
  • Identify two other assessment tests that need to be performed and how you would do these assessments.

Question 5

N.T. is a 79-year-old woman who had a stroke 5 days ago. N.T. was just transferred to the inpatient rehabilitation unit and the nurse has just finished her initial assessment of N.T.

Mental Status – Appears alert with appropriate eye contact and is listening intently. Dressed appropriately and is sitting in a wheelchair. Speech is slow, requires a lot of effort, can give one or two word answers only. Appears to understand all words spoken to her and follows requests within limits of motor weakness.

Cranial nerves – Normal visual acuity with loss of left field of vision. Able to track movement with just eyes, left pupil is slightly dilated, and eyes accommodate. Weak jaw strength on left side. Able to wrinkle forehead bilaterally but unable to smile, show teeth, or puff out cheek on left side. Hearing intact. Difficulty swallowing. Shoulder shrug and head movement weak on left side. Tongue protrudes midline.

Sensory – Unable to distinguish between sharp and dull on left side of face, arm or leg.

Motor – Left hand grip is weak, left arm drifts, left leg is weak, unable to support weight. Spasticity in left arm and leg muscles. Limited range of motion on passive motion. Unable to stand up and walk unassisted.

  • Identify four cranial nerves that you would assess on N.T. and how would you perform the test. Based on the information above what would you document for N.T. assessment results for these six cranial nerves? (Note: Can only use one of the eye cranial nerves in your answer).
  • Identify three coordination and skilled movement tests you would perform on N.T. and how would you perform the tests. Based on the information above what would you document for N.T. test results?
  • Identify two balance test you would perform on N.T. and how would you do those tests. Based on the information above what would you document for N.T. results?
  • What stroke acronym would you teach N.T. and her husband about to help identify if N.T. were to have another stroke?Explain what that acronym means as if you were educating N.T. and her husband.

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