Question

For each assessment, please be sure to name the instruments that would be used in the process.

Discuss the assessment of cough in the older adult.

Discuss the assessment of the heart in a young child and include one usual abnormal finding

Discuss the assessment of the peripheral lymphatic nodes and include one usual abnormal finding

Answer 1

1- Cough- Cough is caused by the stimulation of irritant receptors in the central airways and stretch receptors in the distal airway or the lung interstetium.It may be a normal protective mechanism followed by general anasthesia,and it become abnormal if it is productive or painful.

Assessement includes history and examination

• Duration must be calculated such as days ,weeks or month
• course includes constant,intermittent or worsening.
• Triggers -It must be identified such as allergens,irritants or position.
• Dry or productive cough,nature and volume of sputum,it include hemoptysis.
• symptoms followed with cough-shortness of breath,wheezing,fever,
• Cough assosiated with weight loss or not.

Examination

Listen the type of cough,observe the signs,respiratory rate,

observe for breath sounds .

Diagnostic tests include

• Chest x-ray
• Sputum culture
• Pulmonary function test
• Bronchoscopy.,ECG

2-Cardiovascular assessment in children includes complete set of vitals including heart rate,respiratory rate,blood preassure,height,weight.

An ECHO can be performed.

ECG.

Premature or extar contraction can occur.

3-Lymph nodes are distributed throughout the body,evaluation includes examination of head and neck,breast and axilla,upper extrimities,genitalia and lower extrimities.

In Neck- Keep the patient neck flexed slightyly forward,inspect for lymphnode enlargement.

Plapate the neck with both hands on each side.

Palpate periauricular and mastoid nodes in frot of the ear and behind ear

Palpate occipital nodes.Palpate infraclavicular nodes.

Axilla and upper extrimity -Here evaluate brachial,subscapular and pectoral nodes.

Sits the patient in upright position,supporting patient left arm at the wrist or elbow.With hands palpate the nodes.

Lympadenopathy can occur due to infection .