Discussion: Thumb and Index Finger

NOW F OR AN ORIGINAL PAPER ASSIGNMENT:Discussion: Thumb and Index Finger

An easy-to-perform test for higher-pitched sounds is to rub the tips of your thumb and index finger together, 2 – 3 inches from the patient’s ear—D. Furr

6. Perform the whisper test by having the client place a finger on the tragus of one ear. Whisper a two-syllable word (1–2 ft) behind the client. Repeat on the other

9 ear.

7.Perform the Weber test by using a tuning fork placed on the center of the head or forehead and asking whether the client hears the sound better in one ear or the same in both ears.

8. Perform the Rinne test by using a tuning fork and placing the base on the client’s mastoid process. When the client no longer hears the sound, note the time interval, and move it in front of the external ear. When the client no longer hears a sound, note the time interval.

9. Perform the Romberg test to evaluate equilibrium. With feet together and arms at the side, close eyes for 20 seconds. Observe for swaying. (Refer to textbook, Chapters 16 and 26.)

Mouth, nose throat and sinuses: Objective data

Adapted from Weber, Kelly & Sprengel, 2014: Lippincott, with permission.

Questions Findings

Current Status

Mouth

1. Note any distinctive odors.

2. Inspect and palpate lips, buccal mucosa, gums, and tongue for color

10 variations (pallor, redness, white patches, bluish hue), moisture, tissue consistency, or lesions (induration, roughness, vesicles, crusts, plaques, nodules, ulcers, cracking, patches, bleeding, Koplik spots, cancer sores), Stensen and Wharton ducts.

3. Inspect gums for hyperplasia, blue-black line.

4. Inspect teeth for number and shape, color (white, brown, yellow, chalky white areas), occlusion.

5. Inspect and palpate tongue for color, texture, and consistency (black, hairy, white patches, smooth, reddish, shiny without papillae), moisture, and size (enlarged or very small).

Throat

1. Inspect the throat for color, consistency, torus palatinus, uvula (singular).

2. Inspect the tonsils for color and consistency; grading scale (1, 2, 3, or 4).

Nose

1. Inspect and palpate the external nose for color, shape, consistency, tenderness, and patency

of airflow.

2. Inspect the internal nose for color, swelling, exudate, bleeding, ulcers, perforated septum, or polyps.

Sinuses

1. Palpate the sinuses for tenderness.

2. Percuss and transilluminate (if possible) the sinuses for air versus fluid or pus.