Head and Neck Mass Evaluation

Documenting an accurate history and physical examination is important to make an accurate diagnosis and also deliver safer and effective care to patients. This assignment focuses on the documentation of normal and abnormal findings of the HEENT exam.

Review the case study highlighted below and discuss pertinent subjective and objective findings of the neck exam that the nurse practitioner will be concerned about.

47 year old female presented today to the clinic with a c/o of ” I have a lump in my neck” x 1 month . She confirms dry cough, intermittent rhinorrhea, sore throat, and 15 lbs weight loss. She reports dime-sized lump and swelling on the right lateral side of her neck. She describes swelling as painless and immobile. She denies fever, chills, dysphagia, night sweats, nausea and vomitting. On examination, the nurse practitioner completes a detailed examination of the HEENT. The entire examination was unremarkable, except for an approximately 0.3cm lump noted on the right lateral aspect of the neck. On palpation the lump was immobile and painless. Further history revealed Nicotine dependence x 25 years, and 2PPD. Mother and Father are both dead. Father has a history of Oral Cancer while Mother passed away from Lewy body Dementia. What subjective and objective data will be concerning to you as the nurse practitioner? Explain?