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Capstone project progress report for money write for me capstone property management jobs the colbert report mckayla maroney vault three hi my name is Terry Dubrow and I'm a registered nurse this is my final examination physical examination for nursing 360 and my participant today is Jacob I just washed my hands and we are going to go ahead and start assessing his vital signs we have blood pressure 116 over 70 for heart rate 72 respirations 18 Jacob is 6 foot 1 weighs 195 pounds his BMI is 26 while I'm assessing Jacob I'm also going to be looking at general overall appearance behavior cognition and emotional well-being emotional health as well so we're going to start the examination from head to toe and we'll start with his head so as I'm looking at Jacob's head I'm looking for any bumps on any lesions anything abnormal this in the scalp as well as any hair loss and as I'm feeling his scalp I don't feel anything a scalp looks normal cephalic we're going to go ahead and press on Jacobs posterior posterior cervical trapezius and again mandibular mastoid area just to see if just checking muscle tone or rigidity normal now I'm going to look at Jacob's face as I look at Jacobs face I'm looking for symmetry and any abnormal signs I'm going to have Jacob open his mouth okay and then Jacob push down on my hand great um can you pump up your cheek puff out your cheeks for me make a frown okay smile and then go ahead and push take your tongue push it against your cheek push against my hand great another side wonderful okay I'm I'm looking for cranial nerves number five and seven here now I'm going to go ahead and do a little sensory test Jacob I'm going to touch your forehead and Ashley might touch your face and I'd like you to tell me when my finger touches your face please let me know by saying yes yes yes yes yes okay cranial nerve number five trigeminal sensory okay now I'm looking at Jacob's eye I browse lashes everything looks intact here I don't see any lesions or in any funny abnormalities and then Jacob could you look straight ahead for me okay I'm going to be looking at Jacob's pupils irises normal lenses are cleared and as I look at Jacobs pupils I'm going to look for reaction to light and accommodation so reactive reactive great Jacob I'm going to have you I'm going to cover one of your eyes okay and I just want you to look straight at me good okay great you know ms is great I'm going to go ahead and have you now put this paper over one eye you're going to hold this with your other hand and I'd like you to read this last line here okay four to six seven three nine okay we're gonna change sides and then I'd like you to read that backwards nine three seven six two four great alright now we're going to check the movement of Jacob's eyes so I'm going to stand - finally here Jacob in and I want you to keep your head towards me and I just want you to follow my finger okay great okay so checking cranial nerves number three four and six okay now we're going to go from Jacobs and actually I going to check little red light reflex here at an angle I'm looking at Jacob's eyes here now from here we're going to go to Jacobs ears and what I'm looking for a cemetry I'm going from the lateral canthus of Jacob's eyelid to his ear I'm going to be pulling on the pin at is there any pain or discomfort when I go okay I'm also going to be feeling another or the ear to see if there's any lumps bruises lumps or any adhesions looking around assessing I don't see anything here okay Jacob I'm going to whisper in your ear and what I'd like you to do is I'd like you to put your right hand over your of your right hand over your right ear and then as I whisper these words to you I want you to do them back to move over Monday orange football great okay I'm gonna go to the other side same thing I'm going to go ahead tug on the pinna any pain discomfort okay pressing and I don't feel me loves I get assessing any any lesions adhesions and Jacob want to do that brandy that tests on this side again and I would like you to put your left hand on your ear and I'm going to again three words Tuesday soccer go up great perfect okay from the ears we're going to I'm going to drink nose I'm going to go ahead and palpate his nose and feel funny again abnormalities okay and then Jacob I'm going to press on your left nostril and I want you blow your right okay good I'm going in sight okay do you feel any obstructions okay and I don't hear anything obstructive from the nose I'm going to Jacob some mouth and as I look up Jacobs mouth I'm going to start with his lips and then go into the oral cavity so I don't see anything abnormal Jacobs lips are full no sores redness adhesions okay so Jacob I'm going to go hook your mouth for me I'm looking at Jacobs dentin tation here he's got some cavities and a crown it looks like um hard palate normal no redness as sores or lesions tongue is normal okay can you go ahead Jacob and stick your tongue out go ah ah Villas midline and again race we're looking at cranial nerve number 10 okay now from here I'm going to go ahead and we're going to check some lymph adenopathy so I'm going to see if there's any lymph nodes that we can feel or assess let's start with this journals okay nothing here some mental okay and then I'm looking at Jacobs neck and I'm looking at his trachea midline and intact okay I'm also going to feel posterior and then again anterior and then I'm going to go up to the inch of scapular area and then impre and I don't feel anything abnormal and we pump some lymph nodes now I'm going to go ahead and we're going to assess Jacobs thorax so the first thing I look at is is just view Jacobs thorax and I don't see anything abnormal in presentation checking the anterior posterior and the shoulders and it looks like it's about one to two there's not nothing significant here I'm going to go ahead and assess his lung cells and Jacob what I'm going to have you do is I'm going to have you take a deep breath and then as you exhale just I want you to exhale you out of your mouth okay so what are you ready okay excellent your mouth good very good okay I don't hear anything lungs are clear to auscultation Jacob won't have you take a deep breath I know what I want you to know when should I exhale good normal chest expansion excuse me now I'm going to just do a little percussion on your back so good if you're a little bit of pounding on your back just checking for CVA okay any tenderness pain discomfort okay all right all right from here I'm going to check anteriorly when it was to drink it's lungs so once games I could take a deep breath okay again once again clear to auscultation alright from here I'm going to have Jacob go ahead and lie down now I'm going to also go pressing and just ticking for a father shunting so I'm I'm checking the aorta collision pulmonic the region tricuspid region mitral and also I'm checking for PMI Jacob I'm going to go ahead and press and then once you take a nice deep breath for me again no abnormalities I'm going to go ahead and listen now for shunting I'm going to start with the aortic region which is the second intercostal right they write a right sternal bass I'm starting with a diaphragm to hear for high pitched sounds going to pulmonic and again left the secondary costal left sternal bass herbs point third intercostal left sternal bass tricuspid fifth intercostal mid clavicular and then mitral fifth intercostal lateral I'm entering the bellover this is for deeper tones mitral tricuspid and again back to herbs point third intercostal left sternal base pulmonic and once again a or t'k the last thing I'm going to do before we stop the film is gonna check for trots checking for breweries negative and I'm also checking aorta and then last parties renals again checking for breweries and we're going to stop the tape at this point to take a break and then finish up the assessment you capstone settlement services llc order King's College, Financial District, Manhattan.