HEENT

A HEENT assessment is not a tour of body parts. It is a rapid way to evaluate airway safety, sensory function, infection, trauma, hydration, nutrition, and neurological change. The same finding can have very different significance depending on its onset, symmetry, associated symptoms, and effect on function. An experienced nurse usually notices function before detail: Is the client breathing comfortably? Can the client speak clearly and swallow secretions? Is vision suddenly different on one side? Is the face symmetrical? Is there blood or clear fluid where it should not be? These observations determine whether a detailed examination is safe to continue. Time course often changes the priority more than the appearance of the structure. Gradual, bilateral nasal congestion with an itchy nose suggests a different problem from abrupt unilateral obstruction after facial trauma. A blocked ear may be cerumen, but new hearing loss with a normal-looking canal should not be dismissed as “just wax.” A mildly injected eye with preserved vision is not approached like sudden loss of vision in one eye. The assessment therefore has two simultaneous purposes: collect...