How to do a head to toe assessment on a larger person?

[megaroo22475]

Hi everyone :)

2 months left till the end of the first year and the pressure is on. I am having a little bit of a problem right now in my health assessment course. I have read my chapters and have a fairly good understanding of what I am supposed to do and I even practice on my friends outside of class. I really don't want to be mean to my partner because they are a pretty good friend but they are on the larger side and certain assessments are difficult for me to do for example chest and neck. The final assessment is coming up and it is going to be difficult for me because I have to do a head to toe assessment and it is very hard for me to see or feel for certain things. I cannot switch partners so that is out of the question. Does anyone have any recommendations for me in this situation? I would be very grateful if I could get some.

[Esme12, ASN, BSN, RN]

I don't mean this to sound condescending...you do the assessment the same way you do it on anyone else.

Your patient population will NOT be ideal BMI so you need to learn and adapt.

Exactly what do you find difficult about the chest and neck?

[KelRN215, BSN, RN]

I don't mean this to sound condescending...you do the assessment the same way you do it on anyone else.

Your patient population will NOT be ideal BMI so you need to learn and adapt.

Exactly what do you find difficult about the chest and neck?

This. You assess the client the same way you assess a small or medium sized client.

[cheezwizz90]

Fire up the Hoyer lift and call for extra help when assessing the undercarriage. Use an electronic, higher-powered stethoscope to auscultate heart and lung sounds through the adipose layers. Put the patient in a Barimaxx bed for extra room when you turn them. Don't forget to assess for yeast under the numerous skin folds and beneath the pannus.

Proverbs 17:22

A merry heart doeth good like a medicine:

but a broken spirit drieth the bones.

[Wave Watcher]

Know your landmarks and you know every single patient. All the same. Don't let size make you think you would assess differently or it would be harder. Take your time as you would with any patient.

[Wave Watcher]

Fire up the Hoyer lift and call for extra help when assessing the undercarriage. Use an electronic, higher-powered stethoscope to auscultate heart and lung sounds through the adipose layers. Put the patient in a Barimaxx bed for extra room when you turn them. Don't forget to assess for yeast under the numerous skin folds and beneath the pannus.

Proverbs 17:22

A merry heart doeth good like a medicine:

but a broken spirit drieth the bones.

My Hoyer hasn't been fired up in years! You made me chuckle. lol

[KelRN215, BSN, RN]

Fire up the Hoyer lift and call for extra help when assessing the undercarriage. Use an electronic, higher-powered stethoscope to auscultate heart and lung sounds through the adipose layers. Put the patient in a Barimaxx bed for extra room when you turn them. Don't forget to assess for yeast under the numerous skin folds and beneath the pannus.

Proverbs 17:22

A merry heart doeth good like a medicine:

but a broken spirit drieth the bones.

It sounds like OP is a student doing her health assessment course and her friend is the "larger person" she needs to assess. I doubt there will be any hoyer lift involved, since the person to be assessed is a nursing student and therefore can probably transfer herself. I also can't imagine it would be appropriate to do such an in depth skin assessment on a classmate. It would be horrifying for all involved.