Kelsey Hill Chamberlain University Week 7: Case Studies Professor Smith
18 October 2022
1. IN-CLASS/ONLINE CASE STUDY
P.A. is a 72-year-old female who presents to the family practice with her 40-year-old daughter. The daughter states that her mother has been confused lately and is complain...
, 1. IN-CLASS/ONLINE CASE STUDY
P.A. is a 72-year-old female who presents to the family practice with her 40-year-old daughter. The
daughter states that her mother has been confused lately and is complaining of a headache, shortness
of breath, and a cough. The cough has been persistent for 6 days, and a fever developed 2 days ago. The
patient states that she is bringing up yellow-green mucus and has a cough, which gets worse at night.
Vital signs are T 100.5, P 88, R 16, and BP 110/55. Lungs are positive bilaterally for wheezing, positive
egophony. A chest x-ray reveals consolidation indicative of bacterial pneumonia. Labs and culture are
pending for specific antigen. The nurse proceeds with the physical exam of the head, face, neck, and
associated lymphatic system.
1. When performing a review of systems, the nurse obtains subjective data concerning the patient’s
headache. What specific questions will assist the nurse in determining the cause of the
headache?
Where is the headache located? When did it start? Does anything make it better or worse? Is it
dull, sharp, or throbbing? Do you have nausea and vomiting along with the headache? Did you
hit your head before the headache? How often do you have headaches? Where is the location of
the headache?
2. The nurse proceeds to palpate the lymph nodes. Which lymph nodes are located in the neck?
Cervical lymph nodes. The superficial cervical nodes are located on the neck and below the ear. The
deep cervical nodes are under the muscle along the neck. Posterior nodes are on the neck towards the
posterior side.
3. When performing the physical examination, what objective data should the nurse inspect
and palpate for the head and neck?
Does the patient complain of a stuffy nose? Is there any swelling of the lymph nodes in the neck? Notice
any inflammation in the portion of the head where the headache is present? Is there swelling or
puffiness in the face?
4. How might the physical examination vary given the patient’s age?
The physical examination will remain the same for all age groups. In older adults, some of the sensory
and cranial nerve functions might be diminished.
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