Head to Toe Assessment on a Female Patient | 71 | Unintentional ASMR

Added: 2026-05-19

[00:00:00]Knocks on door, performs hand hygiene.

[00:00:03]Hi, my name is Cindy Matamoros. I'm a Regis College student nurse. Can you please provide me your name and date of birth? My name is Xena Matamoros and my birthday is August 22nd, 2006. Okay, perfect. All right. Patient is alert, sitting upright, no signs of distress, no overt skin color changes, grooming and hygiene is intact.

[00:00:21]Great. Next, I'm going to be doing your heart rate.

[00:00:25]Okay.

[00:00:26]So, I'd be listening to her heart rate for about 30 seconds and then I'd go into her respiratory for another 30 seconds and times those both by two.

[00:00:35]For the sake of this video, I will not be doing that, but that's what you would do.

[00:00:40]Okay. And uh from a scale of zero to 10, zero being no pain at all and 10 being the worst pain you can imagine, um are you experiencing any pain today?

[00:00:48]>> No. Perfect. Denies pain, reports zero out of 10 pain, expected heart rate 60 to 100 beats per minute, and expected respiratory 12 to 20 beats per minute.

[00:00:57]Let's say that her uh heartbeat was at 80 and her respiratory rate was at 16.

[00:01:03]Great. How uh before we get started, how is your appetite? Any nausea? Any frequency or urgency with urinating? Are your bowel movements regular? And um when was your last bowel movement?

[00:01:15]This morning and everything is normal.

[00:01:17]Okay, perfect.

[00:01:19]Okay.

[00:01:21]Skin is a match Oh, first lie down, please.

[00:01:27]Lift and lower your hands a little bit for me, please.

[00:01:30]Perfect.

[00:01:31]Okay. Skin is a match in coloring, no lesions, skin is intact without striae.

[00:01:37]No hernias, contour flat, no pulsations.

[00:01:41]Okay.

[00:01:42]Next, I'm going to auscultate.

[00:01:44]There are four quadrants and we're going to start with the right lower quadrant and we're going to listen twice for 15 seconds. And then we're going to move our way to the right upper quadrant, listen twice for 15 seconds, same thing with the left upper quadrant and then left lower quadrant. We're going to be going in a clockwise motion.

[00:02:05]Okay, for the sake of the video, I won't be listening for the full 15 seconds, but that's what you would do.

[00:02:13]Okay.

[00:02:27]Perfect.

[00:02:32]Active bowel sounds times four quadrants.

[00:02:35]Okay, [snorts] and then next I'll be percussing in the exact same quadrants in the exact same order. Can you lower it down again, please?

[00:02:42]Okay.

[00:03:01]Perfect.

[00:03:03]Did you experience any pain when I did that? Okay.

[00:03:07]Tympany times four quadrants, and then next I'm going to be palpating. First, I'm going to palpate lightly in the exact same quadrants.

[00:03:18]And then I'm going to go deeply.

[00:03:35]Did you experience any pain when I did that? No, perfect.

[00:03:38]Okay, no pain or rebound tenderness.

[00:03:41]Okay, and then next I'm going to need you to sit up and then turn your back towards me.

[00:03:49]Perfect.

[00:03:51]Next I'm going to be palpating for assessing pain in the kidneys.

[00:03:55]Just going to move your bra a little bit up.

[00:03:57]Okay.

[00:04:03]Did you experience any pain when I did that?

[00:04:04]>> No.

[00:04:05]Perfect.

[00:04:07]No CVA tenderness bilateral. No flank or pain bilaterally. Okay, that's the video. Thank you for watching.