543 - Unintentional ASMR - Assessment / Exam / Head to Toe

[00:00:02]Hello. Hello.

[00:00:04]All right, I'm providing privacy for you. Hello, my name is Shelly. I'm going to be your nurse today.

[00:00:10]Um I'm here to do your physical assessment this afternoon.

[00:00:14]Is that okay with you? Yes. Okay. I'm going to go ahead and wash my hands here.

[00:00:19]Wash, wash, wash.

[00:00:24]Put on my gloves.

[00:00:28]You feeling okay today? I am.

[00:00:30]Do you know where you are at the moment?

[00:00:32]CCCT Hospital. Okay. Do you know what day of the week it is? Monday. Okay. And can you verify your name and your birth for me? Kelly Bolskay, July 11th, 1996.

[00:00:42]Perfect, thank you. Okay, so patient is awake, alert, and oriented. Um patient looks well-kempt. Her hair is washed clean, no pediculi.

[00:00:54]Um she's wearing a black tank top um and some shorts, appropriate for her physical assessment. Um she's answered some of my questions. Her speech is clear. Um her behavior is great for the situation. Um so now, Kelly, I'm going to go ahead and take your vital signs, okay? Okay. So, is it okay um if I use this arm for your blood pressure? Yes. Okay.

[00:01:18]Turn this on.

[00:01:26]All right.

[00:01:27]Can you straighten out your arm for me?

[00:01:31]Okay, good.

[00:01:33]Just make sure your legs are not crossed.

[00:01:36]I'm going to put Whoop.

[00:01:41]Put this on the opposite hand.

[00:01:43]There we go.

[00:01:45]Okay. I'm going to go ahead and start that. Have you had anything to eat or drink or smoked in the last 15 minutes?

[00:01:51]>> I haven't.

[00:01:52]Okay.

[00:01:57]Ooh.

[00:02:00]>> And then today We're going to put this under your tongue.

[00:02:16]Okay, good.

[00:02:30]All right. So, your blood pressure is 105 over 66. Looks great. Your pulse ox or your blood oxygen is 100% which is awesome.

[00:02:38]You're at 68 beats per minute and your temperature is 97.7. I'm going to go ahead and take these off for Okay, so we're going to kind of go from head to toe today. So, we're going to start out with your eyes.

[00:03:00]And I'm just going to touch your face, okay? So, I'm going to kind of pull down your lower lids here.

[00:03:06]Okay.

[00:03:07]So, your conjunctiva is pink and moist.

[00:03:09]Your sclera is nice and pretty white. Um I'm just going to have you um We're going to look through this light here, so just look ahead. Kind of up so I can see your pupils.

[00:03:22]Good.

[00:03:27]Good. So, pupils are round um and reactive to light um and I'm going to go ahead and do your cranial nerves now.

[00:03:38]So, I'm just going to have you follow the pin. You don't have to move your head, just your eyes, okay?

[00:03:42]Here.

[00:03:52]Good.

[00:03:54]Good. So, those eyes are accommodating.

[00:03:56]So, I'm going to move on to your nose here and inside membranes are pink and moist.

[00:04:03]Nothing obstructing. If you could open your mouth and say "Ah."

[00:04:07]Good. Mucous membranes are pink.

[00:04:10]And teeth are in good condition. I'm going to look at your ears.

[00:04:18]Good. Nothing obstructing.

[00:04:22]And nothing obstructing. Good.

[00:04:25]Okay.

[00:04:29]So, uh I'm going to bring the bed up um to assess the um JVD. So, if you wouldn't mind um moving that up. Here we go.

[00:04:41]And now, can you look away for me?

[00:04:45]Good. Now, look towards me.

[00:04:48]Perfect. No evidence of JVDs. So, I'm going to um just assess your skin turgor here. I'm just going to pull up on your skin.

[00:04:57]Good.

[00:04:58]So, no tenting. So, that's great. No dehydration. Um so, I'm going to move on to your heart sounds, okay?

[00:05:10]I'll get this thing.

[00:05:16]Okay.

[00:05:19]So, we're going to start with the aortic.

[00:05:28]Go over to the pulmonic.

[00:05:36]And down to Herb's point.

[00:05:45]Great. And if you could just lift your up for me.

[00:05:49]I'll listen to that tricuspid valve.

[00:05:57]Great.

[00:05:58]We're going to move over to the apical pulse.

[00:06:02]I'm going to listen to that for 1 minute, okay?

[00:07:01]All right.

[00:07:03]Apical pulse sounds good. 72 beats per minute.

[00:07:08]It's strong, regular.

[00:07:13]It's good for that. Okay, so we're going to move on to your lung sounds now, okay?

[00:07:17]>> Okay.

[00:07:22]Okay.

[00:07:31]Good.

[00:07:53]>> Thank you.

[00:08:04]Okay.

[00:08:05]Thank you for lifting up your shirt for me.

[00:08:32]All right.

[00:08:33]So, we'll have you just sit up so that I can go ahead and get those sounds from the backside.

[00:08:46]Thank you.

[00:08:50]Just breathe normal.

[00:09:26]I'm going to lift this up, okay?

[00:09:35]Other side.

[00:10:05]Good. All right.

[00:10:08]So your lungs sound great.

[00:10:11]There's no abnormal lung sounds, so all five lobes are clear there.

[00:10:16]Okay, so we're going to move on down to your tummy.

[00:10:21]So first, just going to lift up your shirt again.

[00:10:26]We're going to lower you down flat here.

[00:10:30]So first, I'm just looking to make sure that you don't have any kind of bruising, there's no distension.

[00:10:36]Everything looks normal. Um so, I'm going to go ahead and listen to your tummy first, um and then I'm going to kind of push into it a little bit, okay? So, um Sorry if this feels cold. I'm going to listen to each quadrant for 15 seconds, okay? Okay.

[00:10:54]We'll start in your right lower quadrant.

[00:10:58]Just listening for some bowel sounds.

[00:11:14]All right, there's four sounds there.

[00:11:16]Times four would be 16, so I'm moving up to your right upper quadrant.

[00:11:39]>> All right, there's five sounds there.

[00:11:41]So, five times four would be 20.

[00:11:43]Moving on to your left upper quadrant.

[00:12:04]Good. Six big sounds there. So, six times four would be 24. That's good. And moving on to the left lower quadrant.

[00:12:30]Good. We have seven sounds there.

[00:12:33]So, seven times four is 28.

[00:12:35]Good and hungry. There you go. We'll go ahead and put our um I'm going to go ahead and do my palpation. Uh palpitation.

[00:12:43]Um no, it's palpation. Okay. So, I'm just going to kind of move in this way.

[00:12:48]So, have you um have a bowel movement today? This morning. Okay. And have you urinated um within the last like hour or so? Yes.

[00:12:56]Okay. Good.

[00:12:57]So, I'm just going to kind of move some stuff around and please let me know if you feel any kind of pain or tenderness, okay? Okay.

[00:13:10]Okay. Any any kind of discomfort at all?

[00:13:13]Okay. I'm going to press down on your symphysis symphysis pubis.

[00:13:19]Okay.

[00:13:20]Any kind of pain or discomfort there?

[00:13:22]No. No. Okay. Good. So, we can go ahead and put your shirt down. Thank you so much for that.

[00:13:28]So, I'm going to uh start up with your limbs here. So, let me go ahead and put raise the bed.

[00:13:34]All right. Um so, we're going to start with your arms first.

[00:13:39]Um so, I'm just going to touch for any kind of edema. I'm noticing that your skin is warm and dry to touch.

[00:13:48]>> [snorts] >> No evidence of edema.

[00:13:52]Okay. And then, you can squeeze my hands for me. Okay. And if you can push down.

[00:13:58]Okay. And then, push away. Okay.

[00:14:02]Um and then, if you wouldn't mind, flip your hands over for me. And I'm just going to check your radial pulses to make sure that they're both going at the same time and equally.

[00:14:21]Okay.

[00:14:21]And your radial pulses are both equal um and regular.

[00:14:25]Um so, I'm going to check your capillary refill now.

[00:14:29]Now, fingernails are clean, intact, and pink. Capillary refill's good on that hand.

[00:14:42]Good. Capillary refill is less than two three seconds. So, that's great.

[00:14:47]Um Trying to think if I need to do anything else on here.

[00:14:56]I think that's it.

[00:14:58]Okay. So, oh, actually, I'm sorry.

[00:15:02]I have said to you, we need to do a little bit of range of motion. So, if you wouldn't mind, raise your hands up over your head and then roll down and back onto your lap. Did you have any kind of pain or anything in your shoulders or joints? No. Okay. So, I'm going to move on down to your lower extremities.

[00:15:16]I'm going to I'm going to put these blankets up here so I can expose the side.

[00:15:25]All right. So, I'm going to go ahead and start out with your capillary refill here since your toes are here and just noting that they are polished. So, I'm going to go ahead and do capillary refill on the toes.

[00:15:37]Okay.

[00:15:45]And noting that there is no necrotic tissue. Everything looks good. Capillary refill is less than 3 seconds.

[00:15:54]Um so, you would you mind push against me and then pull towards you? Good. Um and if you would bend your knees.

[00:16:05]Good. And then extend them back out towards me. And if you wouldn't mind move that laterally and then come back towards the center. Great. I'm going to go ahead and check your pedal pulses here.

[00:16:16]You have a very strong pedal pulse.

[00:16:18]It's good.

[00:16:20]Pedal pulses appear to be equal and regular.

[00:16:26]And then I'm just going to check you out for some edema. Does this hurt or anything? You feeling any discomfort?

[00:16:31]No.

[00:16:32]All right.

[00:16:33]All right, Ms. Kelly.

[00:16:35]I think that concludes our physical for you today. Do you have any questions?

[00:16:39]No. Okay.

[00:16:42]And scene.

[00:16:44]>> [laughter] >> Uh