HEENT
What is Arcus Senilis?
Gray circle around the eye due to aging
The nurse notes thrush on the palate of a patient. What should the nurse ask?
Have you been on antibiotics recently?
What is vital in maintaining vision and a healthy outlook for clients?
Health Education
What are the components of health promotion of the ear nose and throat?
Hearing Screening Ear protection Oral and dental screening Cancer Prevention
What does the Weber test test for?
Hearing lateralization
Past history of the ear would include what?
History of syphilis, rubella, meningitis Exposure to hazardous noise Swimmer's ear Removal of cerumen
What do palpitations and involuntary weight LOSS suggest?
HyPERthyroidism
What does intolerance to cold, preference for warm clothing, and decrease sweating suggest?
HyPOthyroidism
In adults, how do the tonsils usually look?
In adults, the tonsils are usually small or absent
How is tinnitus related to age?
Increases frequency with age
What do tender lymph nodes suggest?
Inflammation
How is the thyroid cartilage readily identified?
Its notch on the superior edge
What are signs of cancerous lymph nodes?
Large Irregular Nontender Cool Fixed
A patient complains of feeling like he is slowly losing his central vision. The nurse knows this symptom could represent what
Macular degeneration
What do hard or fixed nodes suggest?
Malignancy
What are the most frequent cause of headaches in practice?
Migraines
What are bleeding gums most often caused by?
Most often caused by gingivitis
During PE of the external ear, how might otitis externa present?
Movement of the pinna and tragus is painful
What kind of headaches raise concerns of tumor, abscess, or mass?
New and persisting, progressively severe headaches
What is Epistaxis?
Nose bleed
Discharge from the ear is termed what?
Otorrhea
What is the natural relate decrease in visual acuity called?
Presbyopia
What does the Consensual reaction to light test?
Pupil constricts when the other pupil has light
A patient tells the nurse that he is constantly congested in spite of using a decongestant at least twice daily. The nurse understands the patient might be experiencing what?
Rhinitis Medicamentosa
When using an ophtthalmoscope to examine a patients eyes, in what hand should it be held for each eye?
Right hand for right eye, left hand for left eye
Disorders of the inner ear cause what kind of hearing loss?
Sensorineural
What does the Sensorineural phase of hearing involve? People with sensorineural hearing loss experience what symptoms?
Sensorineural phase of hearing: involves cochlea and cochlear nerve People with sensorineural hearing loss have particular trouble understanding speech, have trouble in noisy environments
When assessing a patient with Graves disease, how would you expect the thyroid gland to be?
Soft
How do you assess the Corneal light reflex?
Standing 2 feet away from the patient, shine a light into the patient's eyes and ask patient to look at it, inspect the reflection in the corneas, they should be visible
What are crossed eyes called?
Strabismus
You can feel all lymph nodes with two hands except which?
Submental
What activities are known to aggravate a tension headache?
Sustained muscle tension (like driving or typing)
What does papilledema describe?
Swelling of the optic disc and anterior bulging of the physiologic cup
During the PE of the external ear, how might otitis media present?
Tenderness behind the ear
A headache that is pressing or tightening, non throbbing pain, and mild to moderate intensity is what kind of headache?
Tension Headache
What is the most common headache that most patients self treat?
Tension Headaches
When conducting the Rinne test, what are you testing? What is a normal finding?
Tests air conduction to bone conduction Normally, air conduction should be greater than bone conduction
What structure in the inner ear senses the position and movements of the head and helps to maintain balance?
The labyrinth
What are the most important attributes of a headache?
The most important attributes are severity and chronological patterns
What do the numbers mean when assessing a patients vision with a snellen chart?
The numerator, 20, is the distance away from the snellen chart. This should always be 20 unless the pt was moved. The denominator, bottom number, is the distance at which a normal eye can read the letters. The larger the second number, the worse the vision
Where in the mouth do most cancers of the mouth develop?
The sides and under surface of the tongue and floor of the mouth are where most cancer often develops
Vertigo points primarily to a problem in what part of the ear?
This points primarily to a problem in the inner ear
The nurse would expect to assess which symptoms in a patient complaining of migraine headaches?
Throbbinb Photophobia Recurrent
What is the primary purpose of the health history in relation to the eyes?
To identify changes
What is a prodrome?
Unusual feelings such as euphoria, craving for food, fatigue, dizziness
What are associated manifestations of a headache associated with TBI?
Vision changes Nausea or vomiting Attention span deficits drainage from the ears, nose, eyes, or mouth tremors seizures gait changes
If a patient has had a TBI, what should you ask next?
What happened to cause the TBI? Absence of protective equipment? Environmental? Symptoms prior to injury? Prevention of further injury?
What is Leukoplakia?
White spots on tongue
What is the difference between thyroid glands of men and women?
Women have more palpable thyroid glands than men
When assessing peripheral visual acuity and the patient has glasses or contacts, should they be worn during the exam?
YES
What is Xanthelasma?
Yellow spots on the eyelids due to high cholesterol
When inspecting the mouth of a patient with dentures, what should you ask?
ask them to remove them to inspect the mouth mucosa
As aging occurs, what eye diseases become more prevalent?
cataracts, macular degeneration, and glaucoma
When inspecting the size of the pupils, what is considered large? What is considered small?
large is bigger than 5mm, small is less than 3 mm
If the thyroid gland is enlarged, what should you do?
listen over the lateral lobes with the bell of the stethoscope to detect a bruit
What is Exostoses?
nontender nodular swellings covered by normal skin deep in the ear canal, nonmalignant, may obscure the ear drum
What does PERRLA stand for?
pupils equal round, and reactive to light and accommodation
What are the RED FLAGS of headaches?
recent onset (less than 6 months), onset after 50 years of age, acute onset "like a thunderclap", "worst headache of my life", elevated blood pressure, presence of rash or signs of infections , cancer, HIV, pregnancy, vomiting, recent head trauma, persistent neurological deficits
What peripheral field are most defects found in?
temporal fields
Excessive use of decongestants can have what affect on congestion?
worsen symptoms, causing rhinitis medicamentosa
What is Amblyopia?
"lazy eye", loss of vision in one eye
What is a Scotomas?
(area of lost or depressed vision within the visual field surrounded by an area of normal vision)
What is Hyperopia?
(farsightedness, difficulty seeing close)
What is Myopia ?
(nearsightedness, difficulty seeing far)
What is the grading scale for tonsils?
+1 Tonsils are visible +2 Tonsils are between the tonsillar pillars and the uvula +3 Tonsils are touching the uvula +4 Tonsils are touching each other
What drugs can cause stuffiness?
- Oral contraceptives - Reserpine - Guanethidine Alcohol
What are the 10 lymph nodes in the head and neck?
- Preauricular - Posterior auricular - Tonsilar - Occipital - Submandibular - Submental - Deep cervical Chain - Superficial Cervical - Posterior Cervical - Supraclavicular
Why does hoarseness usually arise? If a patient sounds hoarse, what should you ask about?
-Usually arises from inflammation or infection of the larynx buy may also develop as laryngeal lesions which press on the laryngeal nerves -Ask about smoking, inhaling irritants, acid reflux, allergies
When performing the Rinne Test, what steps are performed?
1. Place the base of a vibrating tuning fork on the mastoid bone until the patient says she cannot hear the sound 2. Place the tuning fork in front of the ear and ask the patient if she can hear the sound
What is legally blind?
20/200
The nurse examines the pharynx of a patient and records that the tonsils are touching the uvula. What would the nurse grade the tonsils as?
3+
Functionally, the mos important range for hearing is the range of human speech. What is the range for human speech?
500 Hz to 3000 Hz
When asking the patient to look at a far object and then a near objecting, observing for pupillary constriction, what are you testing for?
Accommodation
What is Halitosis? What might it be indicative of?
Bad breath, may be indicative of diabetic ketoacidosis, renal failure, or mouth, nose, or pharynx infection
What is Anisocoria?
Benign difference in pupil size less than 0.5mm or up to 1mm, make sure pupillary reactions are normal
If a patient complains of loss of hearing out of one ear. What ear should you test first during the whisper test?
Better Hearing ear
An alternate pathway that bypasses the external and middle ear is called what
Bone conduction
How is a near visual acuity test different from a peripheral visual acuity test?
Both eyes are tested at the SAME TIME WITHOUT corrective lenses
What is Exophthalmos?
Bulging of the eyes anteriorly out of the orbit
The patient complains of Clouding in lenses of eyes, blurred vision, inability to see in dim light, what is this suspicious of?
Cataracts
What kind of headache is less common, more common in men, unilateral, usually behind or around the eye or temple, sharper continuous, intense, severe in intensity?
Cluster headaches
Hearing disorders of the external and middle ear cause what kind of hearing loss?
Conductive
In what kind of hearing loss may noisy environments help?
Conductive phase of hearing: external ear to middle ear
What are you testing when you ask the patient to follow your finger as you move it in toward the bridge of the nose?
Convergence
What is Ptosis?
Drooping of an upper eye lid
What is otalgia?
Earache
What does the nurse assess the face for?
Edema Asymmetry Involuntary Movements
What is Miosis?
Excessive constriction of the pupil of the eye
What is a characteristic symptom of Graves hyperthyroidism?
Exopthalmos
When testing for the 6 cardinal fields of gaze, what are you testing?
Extra Ocular Movements