Question

Case Studies, Chapter 25, Health Assessment

1. You are a nurse caring for a 26-year-old mother of three who presents at your physician’s office with tachypnea, productive cough, hyperthermia, malaise, and insufficient fluid intake. Upon auscultation, you note coarse rhonchi in bilateral lung fields. (Learning Objectives #1, #3, & #4)
   1. Outline the rationale for performing a comprehensive physical assessment.
   2. Prioritize the symptoms to be assessed.
   3. Explain which system would have the highest priority for this assessment. Why?
   4. Describe the etiology of this patient’s adventitious lung sounds.
   5. List appropriate health history questions that could identify this patient’s risk factors for altered pulmonary health.

2. As a nurse in a clinic that is held weekly in the local senior center, you perform comprehensive physical assessments and prepare your patients for a general exam by the gerontologist, who offers free care to low-income seniors. The physician places great importance on detecting early neurologic changes in this population. (Learning Objectives #1 & #5)
   1. In a mental status assessment, what findings would be considered outside normal limits?
   2. In the early stages of neurological impairment, which orientation is typically lost first?
   3. How might you assess this orientation?
   4. Which inquiries could be used to assess a patient’s immediate memory?
   5. What might a patient’s inability to follow a simple command indicate?

Answer 1

Answer: Physical assessment reveals the any kind of sign and symptoms that the patient is suffering from. The healthcare professionals check the sign and symptoms which can be the result of the disease or any abnormality. Gathering information regarding the auscultation, palpitations etc provides information about the health condition of the patient.

In the above case, the symptoms that should be assessed are coarse rhonchi in bilateral lung fields, tachypnia as the abnormal breathing rates as well as sounds reveals that there is anykind of abnormality in lungs.

The symptom that would have the highest priority for this assessment is the rhonchi sounds. These sounds usually resembles to the snoring and it occurs due to any type of obstruction in the lungs where there is a pitch of sound while breathing.

Patient having symptoms of the rattled sound indicates that there is presence of fluid or the obstruction in the airways of the lungs. This occurs in the patient suffering from constructive pulmonary disease, pneumonia etc. This can be due to excessive smoking, lung infection etc.