Reply separately to two of your peer’s posts (See attached peer’s posts, post#1 and post#2). 

INSTRUCTIONS:

Your responses should be in a well-developed paragraph (300-350 words) to each peer. Integrating an evidence-based resource!!

Note: DO NOT CRITIQUE THEIR POSTS, DO NOT AGREE OR DISAGREE, just add informative content regarding to their topic that is validated via citations. 

• Insight on a solution to an identified peer challenge.
• Resources that may be helpful related to your peers’ post. 

Utilize at least two scholarly references per peer post. 

Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the second one is the reply to my other peer Post #2.

– Minimum of 300 words per peer reply.

I also attached my “INITIAL POST” for you to use it as a point of reference.

Background: I live in South Florida, I am currently enrolled in the Psych Mental Health Practitioner Program, I am a Registered Nurse, I work in a Psychiatric Hospital.

Reply Posts

Respond to your peers’ post and include the following:

· Insight on a solution to an identified peer challenge.

· Resources that may be helpful related to your peers’ post.

POST # 1 AYME

(Ayme’s initial Post)

Reflect on the focus area or system(s) for the week.

· What challenges might you anticipate in completing this assessment?

· What differences might you anticipate when assessing patients across the lifespan?

· Share findings from scholarly resources that help in the performance of this assessment.

The assessment of the HEENT is one of the routine nursing physical examinations. For instance, many hospital visits are due to respiratory infections as well as injuries affecting the HEENT. This makes this area of assessment quite common in daily practice. The regularity of HEENT assessments/ examinations does not however make this is an easy area of clinical examination. For instance, one of the challenges that one may anticipate relates to the patient’s lack of cooperation due to a myriad of factors including pain or impaired cognitive capabilities. As Bickley (2017), even though HEENT examination is objective, the assessment findings are usually based on the patient’s subjective account such as hearing and vision patterns or even taste patterns. Therefore, the subjective aspect of HEENT physical examination makes it particularly challenging since the responses provided by a patient may be inaccurate. On the other hand, this assessment area houses multiple organ systems that work both independently and dependently. These compounds the challenge in HEENT assessment since one finding may translate to multiple possible physiological and diagnostic implications. As such, as Harding, Kwong, Roberts, Reinisch & Hagler (2019), the propensity to misdiagnose in HEENT is high especially when one lacks sound knowledge about the possible systemic symptoms that manifest via HEENT.

   Besides, assessing patients across the lifespan poses additional and unique challenges. For instance, one of the challenges touches on the patient’s inability to cooperate due to underlying cognitive and perception weaknesses. For example, young children and older adults have poor cognitive and perception capabilities, thus making it hard to rely on their perceived stimuli for assessment. Besides, elderly persons may have underlying conditions such as dementia that makes it hard to fully win their cooperation in the physical examination of HEENT.

   Despite these challenges, various evidence-based strategies can be used to enhance diagnostic accuracy. According to Dains, Baumann & Scheibel (2016), it is always important to engage a high level of intuition and keen observation to collect additional clues from the patients’ behavioral effects when subjected to certain stimuli such as smell or sound among other stimuli used in HEENT assessment. As Jarvis (2018) asserts, it is also important to use assessment aids such as the ophthalmoscope among others when conducting HEENT assessments to ensure that all the clues are collected. When dealing with children who have impaired self-expression skills, it is important to enroll the assistance of the parent in terms of interpreting a child’s reaction to certain stimuli or assessment technique as well as use children-friendly methods of winning their cooperation such as offering rewards and other extrinsic motivation aspects (Perry, Hockenberry, Alden, Lowdermilk, Cashion & Wilson, 2017).

References

Bickley, L. (2017). Bates’ guide to physical examination and history taking (12th ed.). New York: Lippincott,Williams & Wilkins.

Dains, J.E., Baumann, L.C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). Boston: Elsevier.

Harding, M. M., Kwong, J., Roberts, D., Reinisch, C., & Hagler, D. (2019). Lewis’s medical-surgical nursing: Assessment and management of clinical problems, single volume. Mosby.

Jarvis, C. (2018). Physical Examination and Health Assessment-Canadian E-Book. Elsevier Health Sciences.

Perry, S. E., Hockenberry, M. J., Alden, K. R., Lowdermilk, D. L., Cashion, M. C., & Wilson, D. (2017). Maternal Child Nursing Care-E-Book. Mosby.

Reply Posts

Respond to your peers’ post and include the following:

· Insight on a solution to an identified peer challenge.

· Resources that may be helpful related to your peers’ post.

POST # 2 JAVONN

(Javonn’s initial Post)

Reflect on the focus area or system(s) for the week.

· What challenges might you anticipate in completing this assessment?

· What differences might you anticipate when assessing patients across the lifespan?

· Share findings from scholarly resources that help in the performance of this assessment.

 After checking a patient’s vital signs as the first part of a general physical examination, nurses may perform a HEENT (head, eyes, ears, nose, and throat) exam. This assessment requires the use of specific devices, such as an otoscope or tongue depressor, which help nurse practitioners gather important information about the patient’s state of health. This can eventually lay the foundation for the initial development of a patient’s care strategy. As Bickley (2017), even though a HEENT examination is formulated by objective findings, the subjective statements from the patient are the important building blocks in making those objective findings connect. 
     Some challenges I might anticipate in completing this assessment is the lack of confidence I may exude when performing this assessment on my patients and the patient will be able to pick up my energy vibes. Another challenge is the heavy reliance on technology and not on manual skills when the diagnostic tools become defective or inoperable. Another challenge faced is the lack of nurse leaders or role models that encourages the use of good assessment on patients. 
    One difference I might anticipate when assessing patients across the lifespan is the difference in the amount of time for each unique patient age group. For example, the time spent on assessment with a teenager it will vary when compared to a toddler, child, adult or a geriatric patient. Some scholarly articles to refer to help in the performance for this assessment is from researchers Alamri & Almazan (2018) noted that continuous exposure to practice assessing patients, with enhancing the quality of planning and promotion of the provider could develop necessary skills. In addition, increasing self-confidence is vital to assess the patient’s health status effectively and minimize the barriers to performing the physical assessment (Douglas,Windsor,Lewis, 2015). 

Reference

Alamri, M. S., & Almazan, J. U. (2018). Barriers of physical assessment skills among nursing students in Arab Peninsula. International journal of health sciences, 12(3), 58–66.
Bickley, L. (2017). Bates’ guide to physical examination and history taking (12th ed.). New York: Lippincott,Williams & Wilkins.
Douglas, C., Windsor, C., & Lewis, P. (2015). Too much knowledge for a nurse? Use of physical assessment by final-semester nursing students. Nursing & health sciences, 17(4), 492–499. 

https://doi.org/10.1111/nhs.12223

(My initial Post)

Reflect on the focus area or system(s) for the week.

· What challenges might you anticipate in completing this assessment?

· What differences might you anticipate when assessing patients across the lifespan?

· Share findings from scholarly resources that help in the performance of this assessment.

What challenges might you anticipate in completing this assessment?
HEENT/Neck areas of physical examination can be termed as major sources of assessment and diagnostic information for conditions affecting a broad array of systems. For example, diabetes usually manifests through blurry vision, while infections may manifest through headaches, watery eyes, and even loss of smell. This shows the importance of HEENT in diagnosing a myriad of conditions. One of the common challenges that can be anticipated in HEENT examination is deeply rooted in the fact that assessment information from this section usually infers to health conditions in other areas. For example, loss of smell or taste may signal neurological problems as well as infections affecting the oral and respiratory surfaces/structures. As such, a single finding can translate into many possibilities; an aspect that complicates the HEENT assessment. The other challenge comes from the fact that HEENT assessment requires effective communication skills from the patient (Dains, Baumann, & Scheibel, 2016). In some circumstances, patients may have impaired communication skills, therefore, resulting in increased difficulty in carrying out a sound HEENT physical examination.
What differences might you anticipate when assessing patients across the lifespan?
Age-specific features have different implications when it comes to undertaking HEENT assessment. A typical example touches on the pediatric population such as children below the age of 12 months with under-developed sensory and communication capabilities. Equally, across the lifespan, people usually develop conditions that can affect HEENT assessment. For example, age-related alterations, as well as mental disorders, affect perceptual and sensory capabilities, as such; taking away the vital aspect of patients’ cooperation as far as carrying out a physical assessment on these areas is concerned.
Share findings from scholarly resources that help in the performance of this assessment.
Indubitably, these challenges cannot interfere with an effective HEENT assessment, if there is a deliberate use of the evidence-based practice. For example, according to Bickley (2017) one should approach such a complex assessment area with an open mind, and ready to consider multiple possibilities. It is also important to rely on additional assessment approaches such as subjective assessment (Review of Systems) to supplement the information gained from the HEENT’s and neck physical examination. This can help in eliminating any assessment challenges and doubts.
References
Bickley, L. (2017). Bates’ Guide to Physical Examination and History Taking (12th ed.). New York: Lippincott, Williams & Wilkins.
Dains, J.E., Baumann, L.C., & Scheibel, P. (2016). Advanced Health Assessment and Clinical Diagnosis in Primary Care (5th ed.) Boston: Elsevier.