Physical Assessment: Head, Face and Neck

Why is it important to do physical assessment?

Before any intervention can be done, it is vital to do physical assessment because this will serve as the basis for giving the right implementation. Physical assessment is like collecting the data that you have gathered and once done, you then now ready to formulate your intervention based on the data you have collected as you then formulate your goals as well.

Head, face and neck physical assessment is important. This will help you assess on possible causes, signs or symptoms that the patient feels or manifested to show so that you can provide the right process of giving quality care to your patient.

Part of Janet Weber, Jane Kelley and Ann Sprengel's contribution in their book, Health Assessment in Nursing Laboratory Manual, 3rd Edition (pages 73-74) reveals the physical assessment on head, face and neck. This, I will share it with you.

Assessment Skill
1. Gather equipment (gloves, penlight or flashlight, small glass of water, stethoscope).
2. Explain the procedure to the client.

Head and Face
1. Inspect head for size, shape and configuration.
2. Palpate head for consistency while wearing gloves.
3. Inspect face for symmetry, features, movement, expression and skin condition.
4. Palpate temporal artery for tenderness and elasticity.
5. Palpate temporomandibular joint for range of motion, swelling, tenderness, or crepitation by placing index finger over the front of each and asking client to open mouth. Ask if client has history of frequent headaches.

Neck
1. Inspect neck while it is in a slightly extended position (and using a light) for position, symmetry and presence of lumps and masses.
2. Inspect movement of thyroid and cricoid cartilage and thyroid gland by having client swallow a small sip of water.
3. Inspect cervical vertebrae by having client flex neck.
4. Inspect neck range of motion by having client turn chin to right and left shoulder, touch each ear to the shoulder, touch chin to chest, and lift chin to ceiling.
5. Palpate trachea by placing your finger in the sternal notch, feeling to each side, and palpating the tracheal rings. 
6. Palpate the thyroid gland.
7. Auscultate thyroid gland for bruits if the gland is enlarged (use bell of stethoscope).
8. Palpate lymph nodes for size/shape, delimination, mobility, consistency and tenderness (refer to display on characteristics of lymph nodes).
a. Preauricular nodes (front of ears)
b. Postauricular nodes (behind of ears)
c. Occipital nodes (posterior base of skull)
d. Tonsillar nodes (angle of the mandible, on the anterior edge of the sternocleidomastoid muscle)
e. Submadibular nodes (medial border of the mandible); don't confuse with the lobulated submandibular gland
f. Submental nodes (a few centimeters behind the tip of the mandible); use one hand
g. Superficial cervical nodes (superficial to the sternomastoid muscle)
h. Posterior cervical nodes (posterior to the sternocleidomastoid and anterior to the trapezius in the posterior triangle)
i. Deep cervical chain nodes (deep within and around the sternomastoid muscle)
j. Superclavicular nodes (hook fingers over clavicles and feel deeply between the clavicles and the sternomastoid muscles)

Analysis of Data
1. Formulate nursing diagnoses (weakness, risk, actual).
2.Formulate collaborative problems.
3. Make necessary referrals.

Why do people need to be impatient?...In fact, they don't have to.

Attitudes. This matters most in any field.

It is apparently not a match when someone does the right way and shows the right attitude and then for all of a sudden being that right in actions may turn out to be bad, being an impatient person.

Wait. To wait. To wait even more. To wait much harder than what one thinks. To wait for more years until the grass dries up. To wait for even a lifetime of many lives build and rebuild. To wait for the right time.

This kind of "waiting" is like mustering to have patient. One can't be impatient if he knows how to wait. To wait one's turn when falling in line no matter how long the line is. To wait for more years in order to taste the happiness of life through satisfied decisions due to waiting patiently.

Well, I don't know if you agree with me that oftentimes wrong path leads to a person all the time if he doesn't know how to wait. Just like, if you want to be loved by a person, you need to wait and be patient for you will not find that person that you love if you don't make "patient" your leader. Thus, if you force yourself to strike to the point while it is hot, then you will end up paying what you deserve.

I don't say here that you need to grow old and be old in waiting. At the very most part, that is not my point. All can be done in prayer that, that waiting will soon or probably take place now. That is for sure, you need to pray, pray and even pray more while you hope and be patient.

As what Celine Dion says in a song, "When you want it the most, there is no easy way out." How? Be patient, pray, hope and don't be impatient.  

Point of View: The 4th Element of a Story

In order to understand a certain story, it is essential to learn the elements of the story. Aside from the plot, characters, settings and theme, I would like to stress more emphasis on the Point of View for this part seems so queer or hard to identify when analyzing a story.

Point of View presents the stance or shall we say the personality of a story. It implies the kind of attitude of the narrator towards the theme, plot and most especially to the characters of the story respectively.

When we say Third Person Point of View, the narrator does not do something or does not show any participation in the action of the story. It is like the outside voice that only allows the readers to exactly know each individual character on how each one feels.

When we speak about First Person Point of View, the narrator lives in the character/s in the story. It leads the audience or the readers to have the "feel" that they are the scene itself in the time the narrator tells the story.

On the other hand, Omniscient Point of View shares that the narrator is like having the ultimate power to know everything about the characters - what they do and how they behave or display their attitudes in the story. In this, the narrator knows. That is why, he can tell perfectly the feelings, actions and plans of each character.

Limited Omniscient Point of View obviously has only limited knowledge of the characters of the story. It is quite hard to predict the nature of the character, but it can only be noticeable through the characters conversations and/or thoughts as the story unfolds.

I hope you find delight on what point of view you are looking into while talking the time to fully involve yourself to feed your mind in reading stories.

Word Associations: Forming Links

Writing is a whole lot of fun just as a poet loves to make poems everyday. The art in writing needs an expert and humorous sense of using and even playing with worlds to form meaning. That is where, word associations set in.

Word associations are ways for you to form links as you think of the word/s. It simply drives you to recall the words that you have learned way pass before. It is classified as: 1. Characteristics or property (example: teacher - brilliant, strict, witty); 2. Assonance (example: night - knight, flight - plight); 3. Completion or compounding (example: black + board = blackboard); 4. Contrast or antonym (example: beautiful - ugly, fat - thin); 5. Predication (example: dog - bark, eat, bite); 6. Similarity or synonyms (example: beautiful - wonderful, pretty); 7. Derivation (example: invite - invitation, talk - talkative); 8. Subordination (example: flower - rose, daisy); 9. Coordination (example: guitar - violin, harp) and 10. Superordination (example: Chevrolet - car, Celine Dion - singer)

Word associations help form ideas and it simply ignites memory. It is also a way of creating meaning and associating them to unlock sophisticated writings.

Ballpen: Perfect stroke

I am the kind of person who never stop writing. In a day, I can't rest my hands without leaving the day without making marks and marking strokes. My secret, the kind of point that my pen gives.

I am particular in choosing the perfect points in pen. I want them tiny. Just like this kind of points, they are my type in a ballpen. 

These pens are not expensive. What is best of them is that they provide me with the kind of mark that I really want. With them, I have a perfect day. I can accomplish all the things that I have done. And my notetaking, answering on textbooks, etc. are all done.

Worst, on the other hand, what hates me about some ball pens is when they give me this...

Sending a messsage of "Thanks" this Christmas

I always make sure that I could say my "Thanks" to everyone especially on Christmas time.

Yesterday, I made a letter for my friend who I thank her for sharing me how it is to live, making my dreams do come true. I will not forget what she shares to me. She help me with my education. I know that it is not easy to pay all those fees in school, but her spirit helps me in ways that I do appreciate them all.

All my life, I longed for taking the kind of course in college that I really wanted, being a Nursing student. And so, with the kind of help that my friend shares to me, I am able to be in school.

She works as an accountant and she has a family. Seeing that kind of sacrifice of helping me gladdens my heart in ways that as soon as I will finish my schooling and as soon as I land a job, I will surely help her in return. I always think of that.

I have realized that it is not easy to send me to school while she has also her family to attend to. I could not imagine how she does all of it. But with great love, thanks that she carried me helping in paying for my school fees. I will never waste any dollar that she has helped me. I do my part to study and make the most out of schooling.

Now, I always thank her. I have already sent the letter. I do hope that she will not get tired of helping me. 

Why you should need loan?

In this world where everything wants to meet the daily needs in order to survive, it talks all the must to work. And when salary is not enough to augmently share a portion for something, then it is best that you should secure to enjoy loans.

Loans are important in some ways. It is reasonable to enjoy the benefits out from loans. In fact, when one is in need of extra cash, the right option to consider is to loan.

In supplying the demands of everyday life, the basic needs are the most of the top priority. Cutting cost, cutting expenses are wise ideas in order to save, but not all do really find out that when one does all the "cuttings", it is also a clear aspect to ask loans to work for you.

How? Simply, you just need to click here for more info in terms of loans so that you will have a clear view on the kind of process that will benefit you and not just you and the rest of your family's daily demands and basic needs.

For more information, always rely on loans!