Nursing Nursing essay



Part C

Various techniques can be employed when it comes to the assessment ofMr. Hernandez’s skin. Skin aspects that would be analyzed includeits color, the temperature, moisture, turgor and the skin lesions.The techniques that can be employed when assessing the skin arevaried. Dermatologists identify the need to look out for the lesions(Ogai et al., 2015). Issues to be checked include identification ofareas that have friction or pressure. Equipment to be employed forassessment include the swabs that would be used in the virology andbacteriology department. Skin scrapings can also be used to check forthe fungal infections (Richardson &amp Warnock, 2012).

Stepsfor assessment:

  • Take a first look to determine whether the patient is sick or ill.

  • Remove all creams from the skin.

  • Determine areas that may be having friction or pressure.

A physical examination that includes observation can be done forHEENT. Lymph nodes are assessed in a sequential order. It follows thesequences epitrochlear, cervical, supraclavicular, the axillary,periumbilical, the inguinal and the femoral (Seevaratnam et al.,2012).


Mr. Hernandez needs to understand the significance of skin care. Heneeds to practice the highest level of hygiene as a way of protectinghimself from contracting the disease.


A variety of factors may have contributed the development ofpneumonia. Considering the medical examination that was conducted,Mr. Hernandez may have gotten infected because of chronic obstructivepulmonary disease. Also, he takes medication such as Zantac 150mgthat increased the likelihood of development of the condition. Aprevious history of the disease has a causal effect on theprobability of development of the condition (Fletcher, Fletcher &ampFletcher, 2012).


Mr. Hernandez needs to ensure he keeps warm at any given moment. Itis evident that during the cold periods, he encounters significantrespiratory problems. Mr. Hernandez should take caution and ensurethat he keeps warm. Further, he needs to understand to keep checkinghimself to ascertain or refute the existence of a particular disease,for example, the flu. It should be possible to address the ailments.


In conducting the assessment, the nurse could ask about the medicalhistory of Ms. Esposito with the aim of identifying the conditionsshe may have been predisposed. Questions about the heart conditionare vital such as congenital heart disease, heart murmurs, andhypertension (Fletcher et al., 2013). Also, it could be essential toask about relevant conditions such as diabetes.

The increase in the lipid levels could be attributed to the increasein consumption of fats that are saturated (Lamont, Waters &ampAndrikpoulos, 2016). The psychosocial issues that come into playregarding her poor social life where she does not have people aroundher. Environmental aspect depicted includes her lifestyle where herdiet is affecting her state. Cultural considerations entail her fearfor drugs that could help her regain her normal lipid levels.

Ms. Esposito could be suffering from hyperlipidemia and highcholesterol. The appropriate intervention is engaging in intensephysical exercises and a reduction in the overall intake of foodsrich in saturated fat (Michas, Micha &amp Zampelas, 2014).


The typical findings regard the concept of her blood pressure. Ms.Esposito could be having reasonable figures on blood pressure becauseof the way she lives. She is depicted as an individual who lives alife that is not defined by stress. She does not smoke and drinksresponsibly only taking wines on occasions. It is a reflection of thefact she is not exposed to conditions that are likely to affect hercondition.

The abnormal levels of lipids detected could be attributed to hereating habits and nature of lifestyle. She admits to the consumptionof foods that are rich in saturated fats indicating the increase insuch levels in her blood system. Further, she does not engage in muchphysical exercise. The effect is an increase in the level of fats.Her cardiac assessment could be documented as an individual who needsto conduct much exercise to reduce fat levels (Lamont, Waters &ampAndrikpoulos, 2016).


Day 1

  • Inspection of the chest. No scars are detected. Patient lacks the cardiac heaves and lifts. Blood pressure not entirely normal. Experiences episodes of high blood pressure.

  • Complains of pain and short breath.

Day Two


  • Facial expression appropriate to the situation

  • Has a clear speech and with a firm handshake

  • The patient is indicating recovery to normalcy.

Day Three

  • The patient is not having much complain. Responds positively to questions asked. Pain intensity not as high as was in the previous checkup.

  • Associated symptoms presented by the patient not evident. Looks healthy and steady. Physical appearance normal and has not complained about anything.

Day Four

  • Lipid levels assessed. The patient shows normalcy in other tests but indicates an abnormally high level of lipids. Values way beyond or below recommended values.


  • Rate, rhythm, and the depth appear normal.


The health assessment has brought out significant concepts when itcomes to the need of understanding a particular patient based onphysical examination and the tests they are required to undergo. Thephysical examinations may indicate that a patient is healthy whenthat is not the case. Proceeding to conduct laboratory tests mayserve as an appropriate channel to point out the primary diseasesthat could have caused the patient to experience particular symptoms(Lamont, Waters &amp Andrikpoulos, 2016). The case studies furtheridentify the significance of understanding various conditions and howthey affect patients from different perspectives.

The first concept regards the importance of conducting a physicalassessment to get an overview of the conditions patient is suffering.Secondly is the need to come up with a teaching plan to help thepatient recover from the condition they are facing. The accuracy ofthe teaching plans crucial to recovery.


Fletcher, R. H., Fletcher, S. W., &amp Fletcher, G. S. (2012).Clinical epidemiology: the essentials. Lippincott Williams &ampWilkins.

Fletcher, G. F., Ades, P. A., Kligfield, P., Arena, R., Balady, G.J., Bittner, V. A., … &amp Gulati, M. (2013). on behalf of theAmerican Heart Association Exercise, Cardiac Rehabilitation, andPrevention Committee of the Council on Clinical Cardiology, Councilon Nutrition, Physical Activity and Metabolism, Council onCardiovascular and Stroke Nursing, and Council on Epidemiology andPrevention. Exercise standards for testing and training: a scientificstatement from the American Heart Association. Circulation,128(8), 873-934.

Lamont, B. J., Waters, M. F., &amp Andrikopoulos, S. (2016). Alow-carbohydrate high-fat diet increases weight gain and does notimprove glucose tolerance, insulin secretion or β-cell mass in NZOmice. Nutrition &amp diabetes, 6(2), e194.

Michas, G., Micha, R., &amp Zampelas, A. (2014). Dietary fats andcardiovascular disease: Putting together the pieces of a complicatedpuzzle. Atherosclerosis, 234(2), 320-328.

Ogai, K., Matsumoto, M., Minematsu, T., Kitamura, K., Kobayashi, M.,Sugama, J., &amp Sanada, H. (2015). Development of an improvedmethod for quantitative analysis of skin blotting: increasingreliability and applicability for skin assessment. Internationaljournal of cosmetic science, 37(4), 425-432.

Richardson, M. D., &amp Warnock, D. W. (2012). Fungal infection:diagnosis and management. John Wiley &amp Sons.

Seevaratnam, R.,Bocicariu, A., Cardoso, R., Yohanathan, L., Dixon, M., Law, C., … &ampCoburn, N. G. (2012). How many lymph nodes should be assessed inpatients with gastric cancer? A systematic review. Gastric Cancer,15(1), 70-88.