NUR 2220: HEENT ASSESSMENT
(Head, Eyes, Ears, Nose, Throat)
OBJECTIVES NOTES Student Responsibility
1. Demonstrate the 1. Review the difference between
assessment of the Head, Eyes, conductive hearing loss and auditory nerve Prior to Lab:
Ears, Nose and Throat using loss (sensorineural loss). 1. Complete all reading and
the assessment guideline. 2. When would you perform the Weber viewing assignments.
test? The Rinne test? 2. Support reading:
2. Demonstrate the
techniques of inspection, 3. Review anatomy and
palpation and percussion. 3. As you learn this examination, be sure to physiology of the head,
relate it to the cranial nerves. The eyes, ears, nose, and
3. Nursing tools: eyes, hands, examination of the HEENT tests the “gross” throat.
pen light, otoscope, tongue functioning of many Cranial Nerves.
blade, tuning fork.
4. Review cultural/ethnic
4. Remember, the most common cause of and age related
3. Document assessment
findings in appropriate nursing conductive hearing loss is a buildup of considerations.
language on the assessment cerumen!
guideline. Practice:
5. Always look under the tongue to identify 1. Psychomotor
4. Demonstrate the cancerous growths. assessment of HEENT using
integration of new techniques inspection, palpation, and
and learning with previous percussion as
6. Grade those tonsils! (p. 392)
learning. demonstrated by your
1+ visible
instructor.
2+ halfway between tonsillar pillar and
uvula
3+ touching the uvula Written Assignments:
4+ touching each other 1. Complete documentation
on the appropriate portion
7. Remember to note odor when examining of the Physical Assessment
nose and mouth. prior to leaving lab.
2. Complete VS check offs.
8. Lymph Nodes: (Jensen, p. 291)
Delimitation: discrete vs confluent
Mobility: move side to side & up and down
Size. Are they greater than 1mm?
Hard or soft?
HEAD INSPECTATION EXPECTED FINDINGS STUDENT FINDINGS
Head: Centered, size, Normocephalic – (skull is
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https://www.coursehero.com/file/21083598/HEENT/
, FACE symmetry, shape and round, symmetric, and size is
integrity, unusual appropriately related to body
movements. Neck size)
muscles hold the head Atraumatic – (no injury noted)
erect. No unusual movements noted.
Face: Facial movements bilaterally
Look at expression and symmetrical. CN VII grossly
symmetry. intact.
Observe for smooth,
purposeful movement.
Have person smile, frown,
and tightly close eyes to
test CN VII.
PALPATION EXPECTED FINDINGS STUDENT FINDINGS
Nodules, masses, No nodules, masses or
depressions, skin and depressions. Skin intact. Bony
bone integrity, pain structures intact. No complaint
of pain.
Temporal Arteries Smooth, equal and strong
bilaterally.
EYES INSPECTION EXPECTED FINDINGS STUDENT FINDINGS
a) Eyebrows a. Symmetrical, hair
evenly distributed.
b. Full, hair evenly
b) Eyelashes
distributed. Curl
upward or downward
away from the eye
c) Eyelids c. Open and close
completely. Lateral
canthus even with the
top of the ear.
Palpebral fissures are
equal bilaterally.
d) Eye shape
d. Eye shape varies. Note.
Should be Symmetrical
and parallel in
alignment.
This study source was downloaded by 100000844460766 from CourseHero.com on 05-23-2022 13:01:01 GMT -05:00
https://www.coursehero.com/file/21083598/HEENT/
(Head, Eyes, Ears, Nose, Throat)
OBJECTIVES NOTES Student Responsibility
1. Demonstrate the 1. Review the difference between
assessment of the Head, Eyes, conductive hearing loss and auditory nerve Prior to Lab:
Ears, Nose and Throat using loss (sensorineural loss). 1. Complete all reading and
the assessment guideline. 2. When would you perform the Weber viewing assignments.
test? The Rinne test? 2. Support reading:
2. Demonstrate the
techniques of inspection, 3. Review anatomy and
palpation and percussion. 3. As you learn this examination, be sure to physiology of the head,
relate it to the cranial nerves. The eyes, ears, nose, and
3. Nursing tools: eyes, hands, examination of the HEENT tests the “gross” throat.
pen light, otoscope, tongue functioning of many Cranial Nerves.
blade, tuning fork.
4. Review cultural/ethnic
4. Remember, the most common cause of and age related
3. Document assessment
findings in appropriate nursing conductive hearing loss is a buildup of considerations.
language on the assessment cerumen!
guideline. Practice:
5. Always look under the tongue to identify 1. Psychomotor
4. Demonstrate the cancerous growths. assessment of HEENT using
integration of new techniques inspection, palpation, and
and learning with previous percussion as
6. Grade those tonsils! (p. 392)
learning. demonstrated by your
1+ visible
instructor.
2+ halfway between tonsillar pillar and
uvula
3+ touching the uvula Written Assignments:
4+ touching each other 1. Complete documentation
on the appropriate portion
7. Remember to note odor when examining of the Physical Assessment
nose and mouth. prior to leaving lab.
2. Complete VS check offs.
8. Lymph Nodes: (Jensen, p. 291)
Delimitation: discrete vs confluent
Mobility: move side to side & up and down
Size. Are they greater than 1mm?
Hard or soft?
HEAD INSPECTATION EXPECTED FINDINGS STUDENT FINDINGS
Head: Centered, size, Normocephalic – (skull is
This study source was downloaded by 100000844460766 from CourseHero.com on 05-23-2022 13:01:01 GMT -05:00
https://www.coursehero.com/file/21083598/HEENT/
, FACE symmetry, shape and round, symmetric, and size is
integrity, unusual appropriately related to body
movements. Neck size)
muscles hold the head Atraumatic – (no injury noted)
erect. No unusual movements noted.
Face: Facial movements bilaterally
Look at expression and symmetrical. CN VII grossly
symmetry. intact.
Observe for smooth,
purposeful movement.
Have person smile, frown,
and tightly close eyes to
test CN VII.
PALPATION EXPECTED FINDINGS STUDENT FINDINGS
Nodules, masses, No nodules, masses or
depressions, skin and depressions. Skin intact. Bony
bone integrity, pain structures intact. No complaint
of pain.
Temporal Arteries Smooth, equal and strong
bilaterally.
EYES INSPECTION EXPECTED FINDINGS STUDENT FINDINGS
a) Eyebrows a. Symmetrical, hair
evenly distributed.
b. Full, hair evenly
b) Eyelashes
distributed. Curl
upward or downward
away from the eye
c) Eyelids c. Open and close
completely. Lateral
canthus even with the
top of the ear.
Palpebral fissures are
equal bilaterally.
d) Eye shape
d. Eye shape varies. Note.
Should be Symmetrical
and parallel in
alignment.
This study source was downloaded by 100000844460766 from CourseHero.com on 05-23-2022 13:01:01 GMT -05:00
https://www.coursehero.com/file/21083598/HEENT/
