The nurse assessment

The nurse evaluation begins with the health expert washing her hands prior to the assessment, a process that ensures the patient's safety. She then introduces herself and describes the nature and purpose of the tests being performed. She keeps the patient involved throughout by explaining what she is currently doing to address her health concerns. She ensures that she has a good channel of communication with the patient. The student followed the rules but did not interact as much as seen in the video assessment.

The nurse will then investigate the patient's integumentary system. While communicating this to the patient, she ensures the use of non-technical language stating that she wants to assess the overall body functioning instead of the integumentary system. Firstly, she explores the cranial nerves (CN). CN 1 is usually not involved within the testing process; however, the nurse performs a simple test to see if the patient has any deformity within the nose in her smelling. The student carried out these tests competently.

The test of CN 2 involves testing the patient’s eyesight on an eye chart. While this is not available, the nurse utilizes a book. Moreover, she wiggles her fingers to see if the patient recognizes the movement. While performing this, she clearly states limits of a general nurse and the responsibilities of an advanced practice nurse in checking the ophthalmic system. In the tests of CN3,CN4, and CN6, the nurse checked the responses from the patient’s pupils. While the use of eye charts was recommended standard practice, the student did not address all the outcomes of the CN2 – CN6 tests.

CN 5 involved the trigeminal nerve, where the corneal reflexes were investigated. The practitioner performed the standard test procedure that involved touching cotton wool on either side of the face, a sterile sharp object on the face as well as a repeat of the procedure with a dull object and several motor tests. She also assesses the CN7, which assesses the facial nerves. In this test, she asks the patient to make various expressions, shut eyes, frown, and puff out cheeks to investigate facial symmetry. The assessment of the student was relatively vague but still managed to achieve the relevant outcomes.

Thereafter, the nurse assesses the CN 8, the vestibulocochlear system that controls the hearing system. She tests for the patient’s hearing, ascertaining about her general hearing ability. The Cranial nerve 9 and 10 are then assessed together. These include the glossopharyngeal and vagus nerve. The nurse looks in the throat and checks her gag reflex. The test for CN11 involves shrugging the shoulders where the nurse determines if the accessory nerve is fully functional. Finally, the assessment procedure of the CN is wrapped up with the examination of the hypoglossal nerve where the tongue is inspected for fasciculation and wasting. While the investigation of the CN 8 –CN 9 was effective, the student failed to interactively explain the test’s functions.

A series of more specific tests is then carried out. She begins by asking the patient to tandem walk. Moreover, she tests the patient’s equilibrium. Fine motor skills are also investigated via fingertip touching and rapid alternating movement. She investigates coordination of her movement. Sensation is also tested through a sharp and dull tool. She also checks her tendon reflexes when the patient is relaxed and determines that her reactions are normal. Finally, the nurse carries out the falen’s test to check for any weakness. She then concludes the neurological assessment and asks the patient if she has any questions. For the student, the special tests progressed smoothly. Additionally, the patient seemed contented with the way in which the tests were carried out.

References

Man, R. (2013, October 23). Neurological Examination by Carolyn Merriman. Retrieved from Youtube.com: https://www.youtube.com/watch?v=JzgmyprutzQ