Chapter 13: Head, Face, And Neck Flashcards
Questions to ask about headaches
Ask pts if they have any unusually frequent or unusually severe headaches?
RED FLAG: a severe headache in an adult or child who has never had it before
When is it NORMAL for the thyroid gland to enlarge?
During the third trimester during pregnancy
Aging adults
facial bones? skin? teeth?
- Facial bones and orbits are more prominent
- Facial skin sags due to decreased elasticity, decreased sub Q fat, and decreased moisture in the skin
- teeth may be missing, too
Tension headaches
- Common; regular
- Tend to be occipital, frontal, or with band like tightness
- Viselike
- Associated with anxiety or stress
Migraine headaches
- Tend to be supra orbital, retro-orbital, or frontotemporal
- Throbbing
- Pain is often severe
- Migraines often occur about twice a month, lasting 1 to 3 days
- Aggravating factors: alcohol, letdown after stress,menstruation, eating chocolate, eating cheese
- Usually had nausea, vomiting, visual disturbances
- sometimes associated with family history
- people tend to lie down to ease the pain
Symptoms of meningitis and encephalitis.
Nuchal rigidity and fever
Cluster headaches
- sudden; more often in males; go to the ER
- (Vascular)
- Produce pain around the eye, temple, forehead, and cheek
- Pain is always unilateral and always on the same side of the head
- Excruciating
- occur once or twice per day, each lasting 1/2 to 2 hours for 1 to 2 months..remission may last months or yrs.
- Associated with daytime naping and alcohol ingestion
- Eye reddening, eye drooping, rhino rhea, and nasal congestion
People with cluster headaches feel the need to move around and not lie down.
The nurse is bathing an 80-year-old man and notices that his skin is wrinkled, thin, lax, and dry. This finding would be related to which factor?
A. An increased loss of elastin and a decrease in subcutaneous fat in the elderly
B. An increase in elastin and a decrease in subcutaneous fat in the elderly
C. Increased numbers of sweat and sebaceous glands in the elderly
D. Increased vascularity of the skin in the elderly
A
A 70-year-old woman tells the nurse that every time she gets up in the morning or after she’s been sitting she gets “really dizzy” and feels like she is going to fall over. The nurse’s best response would be:
A. “I’ll refer you for a complete neurologic examination.”
B. “Have you been extremely tired lately?”
C. “You need to get up slowly when you’ve been lying or sitting.”
D. “You probably just need to drink more liquids.”
C. You need to get up slowly when you’ve been sitting or lying down
The nurse has just completed a lymph node assessment on a 60-year-old healthy female patient. The nurse knows that most lymph nodes in healthy adults are normally:
A. shotty.
B. not palpable.
C. large, firm, and fixed to the tissue.
D. rubbery, discrete, and mobile.
B. Not palpable
The nurse is examining a patient who tells the nurse, “I sure sweat a lot, especially on my face and feet but it doesn’t have an odor.” The nurse knows that this could be related to:
A. the apocrine glands.
B. a disorder of the stratum germinativum.
C. a disorder of the stratum corneum.
D. the eccrine glands.
D. The eccrine glands
Inspecting the face
Note the symmetry of eyebrows, palpable fissures, nasolabial folds, and sides of the mouth
Note any abnormal facial features
A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The nurse suspects damage to cranial nerve (CN) _____ and proceeds with the examination by _____.
A. XII; assessing for a positive Romberg sign
B. XI; palpating the anterior and posterior triangles
C. XII; percussing the sternomastoid and submandibular neck muscles
D. XI; asking the patient to shrug her shoulders against resistance
D. XI; asking the patient to shrug her shoulders against resistance
When examining the eye, the nurse notices that the patient’s eyelid margins approximate completely. The nurse recognizes that this assessment finding:
A. may result in problems with tearing.
B. is expected.
C. may indicate a problem with extraocular muscles.
D. indicates increased intraocular pressure.
B. Is expected
Range of motion in the neck ( testing ROM)
Note any limited range of motion
Ask the person to touch chin to chest, touch each ear to shoulder without elevating shoulder, extend head back.
The neck should be supple, with smooth motion, and controlled
- if abnormal, may be arthritis
Range of motion in the neck ( testing muscle strenght)
Test the muscle strength of cranial nerve XI by having the patient shrug their shoulder while the examiner tries to resist
-as person moves the head, notice any enlargements of the salivary gland and lymph gland. should be no enlargements noticed.
Pulsations in the neck
Check for any Pulsations in the carotid artery, normally their are none while in a sitting position.
Abnormal findings of lymph nodes
Parotid is swollen with mumps
Parotid enlargement has been found with aids
Lymph nodes in the neck
Check the lymph nodes in the neck
Normally they are not palpable. and not tender
What is lymphadenopathy?
Enlargement of the lymph nodes (>1 cm) from infection, allergy, or neoplasm.
Cervical nodes
Cervical nodes are often palpable in a healthy person but lymph nodes are not supposed to be palpable
Normal nodes feel moveable, discrete, soft, and nontender
If nodes are palpable:note..
Note their location, size, shape, delimitation, mobility, consistency, and tenderness
Acute infection for nodes
Acute onset; < 14 days duration, nodes are bilateral,enlarged, warm, tender, and firm but freely moveable
Cancerous nodes
Are hard, >3 cm,unilateral, nontender, matted and fixed