NUR 634 Topic 9 DQ 2

Discussion: Practice the physical exam techniques outlined in the topic’s assigned Bates’ Physical Examination Videos and write a reflection on the following:

NUR 634 Topic 9 DQ 2 Assessment Description

Practice the physical exam techniques outlined in the topic’s assigned Bates’ Physical Examination Videos and write a reflection on the following:

Identify three techniques that you learned from the videos.

What aspects of the assigned physical examination are you doing well?

What are you going to focus on for improvement as you practice for the skills check off?

Scholarly resources are not required.

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Objectives:

Identify clinical characteristics and pathophysiology of neurological conditions. NUR 634 Topic 9 DQ 2

Apply subjective (symptoms) and objective (physical exam) findings associated with the neurological system to the diagnostic process.

Apply diagnostic or screening tools to the diagnostic process for the neurological system.

Create a list of differential diagnoses for chief complaints related to conditions of the neurological system.

Practice physical exam techniques for evaluating the neurological system.

Resources

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Bates’ Guide to Physical Examination and History Taking

Required

Read Chapters 9 and 24 in Bates’ Guide to Physical Examination and History Taking.

View Resource

Bates’ Visual Guide: 12-Month Access Card to BatesVisualGuide.com With OSCE Clinical Skills Videos

Optional

View and complete video segments 17.1-17.6 in “Volume 17: Nervous System: Cranial Nerves and Motor System” and 18.1-18.5 in ”

… Read More

https://batesvisualguide.com/

CareOnPoint

Optional

Read “Neurologic Disorders,” located in the CareOnPoint? application.

http://app.careonpoint.com

NUR 634 Topic 9 DQ 2 Sample

My experience in the neurology rotation has been very fulfilling. I have learned and gained some skills that will be very helpful in my future practice. During this rotation, I learned how to perform a systematic nervous system examination encompassing all aspects. I have learned to evaluate for higher cognitive functions such as speech, memory, and orientation (Zakaria et al., 2020). I have also learned how to assess for cerebellar and cranial nerve function examination and how to identify any abnormality and its relation to several lesions. I have also learned the importance of assessing the motor and sensory functions while examining the nervous system.

I have noted that I am quite confident performing various aspects of the nervous system examination. NUR 634 Topic 9 DQ 2 This includes assessment of the different cranial nerve functions starting from the 1^st to 12^th cranial nerves. I can identify different cranial lesions, the most significant being Bell’s Palsy, where the facial nerve is most affected. The common findings include ipsilateral loss of wrinkles, drooping of the eyelid and mouth, asymmetrical smile, and inability to puff the cheek on the side of facial nerve paralysis (Singh et al., 2022). I can also identify different lesions affected by paralysis of extraocular muscles, including the oculomotor, abducens, and trochlear nerve. In addition, I can perform a motor examination and include all aspects such as muscle power, tone, and bulk, as well as test for reflexes. I can identify different muscle tones, including spasticity, hyporeflexia, and hyperreflexia, and identify clinical conditions associated with tone abnormalities. NUR 634 Topic 9 DQ 2

However, I have challenges performing a sensory examination and utilizing the ASIA chart to assess the level of spinal cord injury. I am having difficulties identifying different levels of nerve injury, especially in the upper and lower limbs (Rupp et al., 2020). I am also having difficulties identifying gaits, such as waddling and steppage gait, associated with different levels of motor control dysfunction, including the cerebellum and cerebrum.

NUR 634 Topic 9 DQ 2 References

Rupp, R., Biering-Sørensen, F., Burns, S. P., Graves, D. E., Guest, J., Jones, L., Read, M. S., Rodriguez, G. M., Schuld, C., Tansey-MD, K. E., Walden, K., & Kirshblum, S. (2020). International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019. Topics in Spinal Cord Injury Rehabilitation, 27(2), 1-22. https://doi.org/10.46292/sci2702-1

Singh, A., & Deshmukh, P. (2022). Bell’s Palsy: A Review. Cureus, 14(10). https://doi.org/10.7759/cureus.30186

Zakaria, Z., Abdullah, M. M., Halim, S. A., Izaini Ghani, A. R., Idris, Z., & Abdullah, J. M. (2020). The Neurological Exam of a Comatose Patient: An Essential Practical Guide. The Malaysian Journal of Medical Sciences: MJMS, 27(5), 108-123. https://doi.org/10.21315/mjms2020.27.5.11 NUR 634 Topic 9 DQ 2