NURS 3110 Lecture 8: Wk 4: HEENT

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7 Feb 2017
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HEENT
HEENT Health History/Present
Have there been any changes to …
Eyes
Ears
Nose
Mouth/throat
Any chronic conditions of HEENT system
Current meds?
Visions issues (cataracts etc.…)
Migraines
Hearing loss
Thyroid dysfunction
Oral cancers?
Co-morbidities?
HTN
DM
General Health/Past Medical History
Any injuries to ears, eyes, mouth or neck?
If yes, what problems exist from injury?
Any surgeries?
What surgeries?
Do you smoke?
Are you interesting in quitting?
Any chronic infections of eyes, ears, sinus infections issues with
tonsils/adenoids?
Dental issues?
Own teeth or dentures? Eating issues? Regular dental care visits?
General Family History
H/O cancer in family?
Who? Kinds of cancer (illustration of squamous cell carcinoma)
Family members with vision/hearing or thyroid issues?
Patient/Client Problem Based History
Note the MOST COMMON problems R/T this system include
Headache/dizziness
Visional impairments
Hearing loss
Tinnitus/ringing in ears
Nasal infections
Sore throats
Dry mouth syndrome
Oral lesions
How long does issue last? What helps? Aggravates issue?
Headache Assessment
Headaches
Cluster headaches: occur more than 1x/day & last 1-2
hours. Are unilateral
Migraines: periodic intervals & last from a few hours
to 1-3 days. Also unilateral
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IDENTIFICATION of patterns and triggers important !
Foods/stress
Headache types
Sinus: cause tenderness
Tension: front/back of head
Cluster: pain over eye, temples, forehead & cheeks
Tension: throbbing pain, may have burning/stabbing
sensation behind eyes
Common problem: Headache
Most common reason for seeking medical attention
Chronic or primary = recurring headaches
Classification occurs based on S/S & history
Common problems: Migraines
2nd most common headache
May occur in any age group most frequently in young
women
Occurs due to vasospasm on intracranial arteries
Accompanied by depression, stress, light sensitivity
(photophobia), N&V
Can last from several hours to days
Common problems: Cluster Headaches
Most painful type
Seen mostly in teens to middle aged adults
Pain is usually intense, one-sided described as burning,
pounding
Duration less than 1 hour, reoccur
Common problems: Tension Headaches
Common in people B/T 20-40 years old
Usually bilateral
Confined to one location of head
Onset may be gradual, lasting for days
Tightness noted in face & jaw
Post Traumatic Headaches
Occur secondary to head injuries
Occur with concussions
Most commonly seen after a motor vehicle accident
S/S’s include …
Generalized/dull pain
Difficult to concentrate
Feelings of dizziness
Blurred vision
“staring off”
Hydrocephalus
Infants obstruction of CSF drainage. Increase in ICP with
bigger head, fontanels bulge & dilated scalp veins
Adults obstruction, increased production or decreased
absorption
Increased ICP in adults alterations in mental status,
unrelieved headaches.
Adult skulls cannot expand like newborns/toddlers
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