Question

Case Study Chapter 14 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 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? Where is your headache located? When did it start? Does anything make it better or worse? Is it dull, sharp, or throbbing? Do you have nausea and vomiting along with the headache? Did you hit your head before the headache? How often do you have headaches? The nurse proceeds to palpate the lymph nodes. Which lymph nodes are located in the neck? Cervical lymph nodes. The superficial cervical nodes are on the neck but below the ear. The deep cervical nodes are under the muscle along the neck. Posterior nodes are on the neck but towards the posterior side. 3. When performing the physical examination, what objective data should the nurse inspect and palpate for the head and neck? 4. How might the physical examination vary given the patient's age?

Answer 1

1. To know the cause of headache ,the questions to be asked to the patient are :-

- What is the location of the headache ?

- When does in the day it starts ?

- Does any precipating factor you feel that is causing the pain?

- How is the pain - dull ,sharp , excruciating etc

- Do you have any other symptoms associated with headache ?

- How many times a day do you have headache ?

2. The lymph nodes which are located in the neck are Cervical.

Cervical Lymph nodes located in the neck. The function is to drain head and neck. May be enlarged during an upper respiratory infections.

3. Objective data that should be assessed by the nurse for the head and neck are :-

- does the patient has stuffy nose , rhinnohorea etc

- is there swelling of the lymph nodes in the neck

- see for any inflamation in the portion of the head where headache is present

- is there swelling or puffiness in the face

4. The physiacl examination pattern remians the same for all age groups , in older adults some of the sensory and cranial nerve functions might be diminished .