Physical Examination Of The HEENT Exam Assignment Paper

Physical Examination Of The HEENT Exam Assignment Paper

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Documenting an accurate history and physical examination is important to make an accurate diagnosis and also deliver safer and effective care to patients. This assignment focuses on the documentation of normal and abnormal findings of the HEENT exam.

Review the case study highlighted below and discuss pertinent subjective and objective findings of the neck exam that the nurse practitioner will be concerned about Physical Examination Of The HEENT Exam Assignment Paper.

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47 year old female presented today to the clinic with a c/o of ” I have a lump in my neck” x 1 month . She confirms dry cough, intermittent rhinorrhea, sore throat, and 15 lbs weight loss. She reports dime-sized lump and swelling on the right lateral side of her neck. She describes swelling as painless and immobile. She denies fever, chills, dysphagia, night sweats, nausea and vomitting. On examination, the nurse practitioner completes a detailed examination of the HEENT. The entire examination was unremarkable, except for an approximately 0.3cm lump noted on the right lateral aspect of the neck. On palpation the lump was immobile and painless. Further history revealed Nicotine dependence x 25 years, and 2PPD. Mother and Father are both dead. Father has a history of Oral Cancer while Mother passed away from Lewy body Dementia. What subjective and objective data will be concerning to you as the nurse practitioner? Explain?

Your written report must be in APA format (This includes the Title page, body of the paper, in-text citations, and the Reference page). Your paper should be between 300-500 words and should contain at least three scholarly articles Physical Examination Of The HEENT Exam Assignment Paper.

Introduction

The case presents a patient with a complaint of a lump in her neck and other associated symptoms. As a nurse practitioner, it is essential to evaluate both subjective and objective data. This evaluation may be imperative to identify any concerning findings that may indicate underlying health issues. This assessment is critical for making an accurate diagnosis and providing appropriate care.

Subjective Data

1. Duration of Neck Lump (1 month): The patient’s report of lumping her neck for one month is concerning. According to Linkhorn et al. (2019), the prolonged presence of a neck lump can indicate underlying pathologies. Linkhorn et al. (2019) also indicate that some benign causes may resolve spontaneously. It is crucial to investigate the cause of the lump, especially in the presence of other symptoms.
2. Significant Weight Loss (15 lbs): Unintentional weight loss of 15 pounds is alarming. Rapid, unexplained weight loss can be associated with serious underlying conditions (Kolb et al., 2020). Hendifar et al. (2019) assert that such weight loss can be associated with malignancies. It is important to determine if this weight loss is related to the patient’s symptoms or due to other factors like appetite changes.
3. Smoking History (Nicotine dependence for 25 years, 2 packs per day): The patient’s long history of nicotine dependence and heavy smoking is a major concern. According to Mori et al. (2020)Physical Examination Of The HEENT Exam Assignment Paper, smoking is a well-known risk factor for various cancers. Such cancers include those of the head and neck. This history increases the likelihood of malignancies. It also highlights the need for a thorough evaluation.
4. Family History of Oral Cancer (Father): The family history of oral cancer in the patient’s father is concerning, especially when combined with her smoking history and current symptoms. Family history can indicate genetic predisposition and shared environmental factors contributing to cancer risk.

Objective Data

1. Physical Examination of Neck Lump: The objective finding of a palpable lump on the right lateral aspect of the neck measuring approximately 0.3cm is concerning. While the lump is described as painless and immobile, these characteristics are not definitive indicators of a benign condition. Any neck lump, particularly associated with other symptoms, warrants further evaluation to rule out malignancies (Mody et al., 2021)Physical Examination Of The HEENT Exam Assignment Paper.
2. Unremarkable HEENT Examination (Except for Neck Lump): The fact that the rest of the HEENT examination is unremarkable except for the neck lump suggests that the lump is not associated with obvious localized symptoms in the head and neck region. This can raise concerns about its origin and potential systemic involvement.

Conclusion

This assessment reveals several concerning findings. The subjective data, including the duration of the neck lump, significant weight loss, a long history of heavy smoking, and a family history of oral cancer, collectively raise red flags regarding potential underlying health issues. These findings align with existing literature highlighting the importance of these factors as potential indicators of serious conditions, including malignancies. The objective data from the physical examination does not definitively rule out a more serious condition. Any neck lump, especially with other symptoms, necessitates further evaluation to exclude malignancies. The unremarkable findings in the rest of the HEENT examination, except for the neck lump, underscore the need for a comprehensive assessment to determine the lump’s origin and potential systemic implications. Given these concerns, the nurse practitioner must perform a detailed diagnostic workup. If necessary, refer the patient to specialists for further evaluation and timely intervention Physical Examination Of The HEENT Exam Assignment Paper

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References

Hendifar, A. E., Petzel, M. Q., Zimmers, T. A., Denlinger, C. S., Matrisian, L. M., Picozzi, V. J., … & Simeone, D. (2019). Pancreas cancer‐associated weight loss. The oncologist, 24(5), 691-701.

Kolb, L. J., Ellis, C., & Lafond, A. (2020). Nonuremic calciphylaxis triggered by rapid weight loss and hypotension. Cutis, 105(1), E11-E14.

Linkhorn, H., Pandya, H., Ramsaroop, R., Wade, M., & Smith, K. (2019). Neck lump clinic: a new initiative at North Shore Hospital. ANZ Journal of Surgery, 89(7-8), 853-857.

Mody, M. D., Rocco, J. W., Yom, S. S., Haddad, R. I., & Saba, N. F. (2021). Head and neck cancer. The Lancet, 398(10318), 2289-2299.

Mori, K., Mostafaei, H., Abufaraj, M., Yang, L., Egawa, S., & Shariat, S. F. (2020). Smoking and bladder cancer: review of the recent literature. Current opinion in urology, 30(5), 720-725 Physical Examination Of The HEENT Exam Assignment Paper