Question

head to toe assessment of 13 years old female with polycystic ovarian syndrome

Answer 1

ANS :

HEAD TO FOOT ASSESSMENT

GENERAL STATUS -

*Age - 13years

* Sex - Female

*BMI - >25 kg/m2

*Wrist circumference - > 35cm witch is abnormal

* Apperanace - Depressed

* Grooming - well groomed

MENTAL STATUS -

* Consciousness - conscious and oriented

VITALS SIGNS -

Temp. - 98०F

Pulse - 98/min

Resp. - 22/min

Spo2- 99%

BP - 100/60 mmofhg

PHYSICAL ASSESSMENT -

HEAD -

* HAIR - Black in colour , well nurished

*Scalp - clean, dandruff not present

*Injury - no any injury or troma seen

EYES -

* Vison - 6/6 ,good

*Sclera - white

* Conjunctiva - pale in colour, light pink

*Pupils - reacted to lights

*Eyelids - present, no any infection seen

NOSE -

*Watch for symmetry

*Deviated nasal septum

*Secretion present or not

* Watch for any infection or deformities

EARS -

*Watch for symmetry

* Ear cannal

* Cleanliness and presence of wax in ear

*Any discharge or smell from ear

*Watch for infections of ears and deformities

MOUTH -

*Lips - watch for colour , moisture and texture of lips

*Teeth - watch for cleanliness, colour , and no. Of teeth,

*Gums - watch for colour, infection and inflammation of gums.

*Tongue - watch for colour, infection and inflammation

*Watch mouth for bad odours, any infection to mouth and mucosal membrane.

FACE AND SKIN -

*Skin colour - fair

*Type of skin -oily

*Hair present on face

* Acne present over face

* Excessive hair growth present all over body

NECK -

* Watch for lymph nodes swelling

* Apperanace of thyroid gland

THORAX -

*Respiratory examination -

*Watch for symmetry

* Listen breathing sound

*Air entry in both lungs

*Watch for any injury

BREAST EXAMINATION -

*Symetrical growth of both breast

* Watch for development according to age

* Watch for presences of lump, secretions or inflammation of breast

ABDOMEN-

*Palpation - presence of lump or swelling of internal organ

* Auscultation - listening of peristaltic movement

* Percussion - watch for presences of peritoneal fluids or gases

BACK -

*Watch for symmetry

*Any injury or deformities

PELVIC EXAMINATION -

* Palpation - Ovaries palpable witch is abnormal

GENITAL EXAMINATION -

* Watch genitalia for any infection, discharge, odour , any deformities .

* Menstrual cycle - seen abnormal in this condition

* Any discharge - white discharge present

*Rectum - watch for any infection, or hemmoroids

EXTREMITIES -

*UPPER AND LOWER EXTREMITIES-

*Watch for movement

*Range of motion

* Any injury or deformities

* Nails for colour

Abnormal findings in polysistic ovarian syndrome is -

* Irregular menses

*Client in depression

*Complaint with sleep disturbance,

* Blood pressure - increase

* Risk of cardiac disease

* Body mass index - incresed

- > 25 , obesity present

* Excessive Acne present on face, and excessive hair growth due to excessive synthesis of androgen hormone.

* Insulin intolerance cause for type 2 daibetes

* Thyroid dysfunction

* Stigma of cushings syndrome ( moon face , striae, etc.)