To assess the movement of a clients thyroid gland, the nurse should ask the client to

Last updated: March 23, 2022

Inhaltsverzeichnis Show

Examination of the head
Examination of the ears
Screening assessments
Tuning fork tests
Additional tests
Focused examination of the eyes
Inspection and palpation
Visual acuity
Visual field testing
Examination of extraocular muscles
Examination of the neck
Examination of the thyroid
Examination of the nose and throat
Signs and differential diagnosis
Red flag symptoms of the head and neck
Which technique would the nurse use to assess the patient's thyroid gland?
What action by the patient helps the nurse to palpate the thyroid gland?
Which technique would the nurse use to assess the patient's thyroid gland quizlet?
What is the correct procedure for palpation of a client's thyroid gland?

Summary

Examination of the head and neck is a fundamental part of the standard physical examination. It is typically one of the first parts of the physical examination and is performed with the patient in a seated position. Because the complete head and neck examination is lengthy, it is usually tailored to the patient's history and presenting complaint. In adult patients, the parts of the examination dealing with the ears and nose are generally not required unless there is a pertinent complaint.

Examination of the head

Inspect the skull and face.
Inspect the skin and scalp.
Palpate skull (especially if patient complains of tenderness or recent trauma).
Assess facial sensation and motor function.
- Trigeminal nerve function: Lightly touch the forehead of the patient on both sides and the upper and lower areas of the cheek with the index finger. Ask the patient whether this feels the same on both sides of the face.
- Facial nerve function: Ask the patient to furrow their forehead, close their eyes, show their teeth, and inflate their cheeks.
- See examination of cranial nerves and cranial nerve palsies.

[1][2]

Examination of the ears

Otoscopy is an integral part of all pediatric examinations. It is usually only performed in adults if they have mentioned ear discomfort.

Screening assessments

Tuning fork tests

Performed in order to distinguish between conductive hearing loss and sensorineural hearing loss. See also hearing loss.
Weber test: tests for lateralization (sound is heard louder in one ear than the other)
- Place the base of a vibrating tuning fork on the middle of the forehead and ask the patient from which ear the sound is louder.
- The sound is normally heard equally in both ears.
- Interpretation
  - Lateralization → asymmetric hearing loss
  - No lateralization → normal hearing or bilateral hearing loss
Rinne test: tests for air conduction vs bone conduction in the examined ear
- Place the base of a vibrating tuning fork on the mastoid process of the ear. Once the patient no longer hears a tone, immediately hold the “U” part of the fork over the outer ear and ask the patient if they can still hear it.
- Air conduction is normally greater than bone conduction, so the patient should still be able to hear the tuning fork next to the outer ear after they can no longer hear it when placed on the mastoid process.
- Interpretation
  - Unable to hear the tuning fork; → there is conductive hearing loss (bone conduction > air conduction) in the examined ear (Rinne test is negative)
  - Still able to hear tuning fork over the outer ear; → there is no conductive hearing loss (Rinne test is positive); possible sensorineural hearing loss (air conduction > bone conduction) if there is diminished hearing in the examined ear

Overview of possible findings

Gelle test

Additional tests

Audiogram, speech audiometry, impedance audiometry
See hearing loss.

When screening for hearing loss, examine each ear individually in a quiet room.

References:[1][2]

Focused examination of the eyes

Inspection and palpation

Inspect for symmetry of the eyes and eyelids.
Note any swelling or redness around the eyelids, and assess whether the eyelids can fully close.
Inspection of the sclera (normal sclerae are white) and inspection of the conjunctivae
- Ask the patient to look up while you hold lower lids with your thumb.
- Inspect for color, vascular pattern, and whether there is any swelling.

Pupils

Assess the pupillary size, location, shape, and reactivity to light (indirect and direct pupillary light reflex)
For further information, see “Pupillary examination” in “Examination of the eye.”

Visual acuity

Determine the clarity or sharpness of central vision at various distances by using an ophthalmological chart (e.g., Snellen chart).
For further information, see “Visual acuity” in “Examination of the eye.”

Visual field testing

Assess light sensitivity and identify patterns of vision loss using a finger or pen.
For further information, see “Visual field examination” “Examination of the eye.”

Examination of extraocular muscles

Assess the movement and alignment of the eyes using a finger or a pen.
For further information, see “Extraocular movements” and “Examination of extraocular muscles.”

References:[1][2]

Examination of the neck

Examination of the thyroid

Inspection
- The thyroid gland is located below the thyroid cartilage and is normally not visible.
- Enlargement should prompt further evaluation.
Palpation
- Stand behind the patient.
- Place your finger pads below the thyroid cartilage and assesses the size and consistency of the thyroid.
- Ask the patient to swallow.
  - The thyroid should slide beneath the fingers.
  - The normal thyroid is usually not palpable.
- Note any asymmetry or enlargement.

References:[1][2]

Examination of the nose and throat

Signs and differential diagnosis

Red flag symptoms of the head and neck

References:[1][2]

References

Bickley L. Bates' Guide to Physical Examination and History-Taking. Lippincott Williams & Wilkins ; 2012
A Practical Guide to Clinical Medicine. https://meded.ucsd.edu/clinicalmed/. Updated: September 1, 2004. Accessed: January 10, 2018.

Which technique would the nurse use to assess the patient's thyroid gland?

Health care professionals use a thyroid scan to look at the size, shape, and position of the thyroid gland. This test uses a small amount of radioactive iodine to help find the cause of hyperthyroidism and check for thyroid nodules.

What action by the patient helps the nurse to palpate the thyroid gland?

Use one hand to slightly retract the sternocleidomastoid muscle while using the other to palpate the thyroid. Have the patient swallow a sip of water as you palpate, feeling for the upward movement of the thyroid gland.

Which technique would the nurse use to assess the patient's thyroid gland quizlet?

To palpate the thyroid, use a posterior approach. Stand behind the client and ask the client to lower the chin to the chest and turn the neck slightly to the right. The nurse is assessing a client complaining of swelling in the neck. While palpating the neck, the nurse finds a 2-cm lump that is fixed and hard.

What is the correct procedure for palpation of a client's thyroid gland?

Place first two digits of both hands just below cricoid cartilage so that left and right fingers meet on the patient's midline. Place thumbs posterior to patient's neck and flatten all fingers against the neck. Use finger pads, not tips, to palpate.