HEENT and Skin

HEENT and skin findings often reveal changes in airway patency, oxygenation, perfusion, hydration, infection, neurological status, and tissue integrity before the client can describe a clear problem. A useful assessment does more than identify an abnormal appearance. It establishes what is normal for this client, connects findings to likely clinical meaning, and shows which change requires action first. The head, eyes, ears, nose, throat, mouth, and neck should be assessed as connected structures. Facial swelling may threaten the airway. A new hoarse voice may be the first visible clue to upper-airway narrowing. Dry oral mucosa may support, but does not prove, dehydration. Unequal pupils may be benign for one client and a new neurological emergency for another. The skin is both a barrier and a record of perfusion, pressure, inflammation, moisture, nutrition, and systemic illness. A complete assessment includes intact skin as well as wounds, rashes, pressure points, hair, and nails. Trends matter more than one isolated description: a small area of redness that is becoming warmer, more painful, and larger has a different priority from a stable, longstanding mark....