(My initial Post) Reflect on the focus area or system(s) for the week. · What challenges might you anticipate in completing this assessment? · What differences might you anticipate when assessing patients across the lifespan? · Share findings from scholarly resources that help in the performance of this assessment. The assessment of the abdomen is primarily regarded as one of the most common clinical roles. This notion is associated with the likelihood that a good number of conditions reported at the clinical level include the gastro-intestinal system or those that result in changes in abdominal status. Most healthcare practitioners will recognize that the four assessment techniques namely inspection, auscultation, percussion, palpation are applicable in the assessment of the abdomen than any other region (Zeng, 2020). However, in my time within clinical settings, I found applying these techniques quite complex. Notably, I found it difficult to apply the palpation technique as advised by my clinical preceptor. My clinical preceptor had an emphasis that when using the palpation technique, light and deep palpation should be performed. While I understood the theoretical aspect and necessity of it, the practical determination of the extent of light and deep requires some experience. For the other three techniques, I found them more applicable and without much complication as long as one recognizes the unique differences in texture, color, and general appearance for patients across the lifespan.  In the assessment of the skin, hair, and nails the inspection technique is the most utilized. In my view, comprehensive inspection of the skin, hair, and nails provides for the significant information that may be needed to inform clinical decisions. In skin inspection, there are three key attributes to check and they include skin integrity, color variations, and skin lesions. The biggest challenge in assessing the skin for these attributes is recognizing the differences across the lifespan. For instance, dry and cracked skin may not inform much in an elderly patient as it would inform in an infant (Jarvis, 2018). These age-related differences are critical in clinical decision making. However, I consider that knowing and applying those differences comes with clinical experience and sometimes new nurse practitioners may not find it easy identifying such differences or even considering them in the findings. References  Jarvis, C. (2018). Physical Examination and Health Assessment-Canadian E-Book. Elsevier Health Sciences. Zeng, R. (2020). Complete Physical Examination. In Handbook of Clinical Diagnostics (pp. 265-271). Springer, Singapore. Reply Posts Respond to your peers’ post and include the following: · Insight on a solution to an identified peer challenge. · Resources that may be helpful related to your peers’ post. POST # 2 WANDA (Wanda’s initial Post) Reflect on the focus area or system(s) for the week. · What challenges might you anticipate i ...

1. (My initial Post)
Reflect on the focus area or system(s) for the week.
· What challenges might you anticipate in completing this
assessment?
· What differences might you anticipate when assessing patients
across the lifespan?
· Share findings from scholarly resources that help in the
performance of this assessment.
The assessment of the abdomen is primarily regarded as one of
the most common clinical roles. This notion is associated with
the likelihood that a good number of conditions reported at the
clinical level include the gastro-intestinal system or those that
result in changes in abdominal status. Most healthcare
practitioners will recognize that the four assessment techniques
namely inspection, auscultation, percussion, palpation are
applicable in the assessment of the abdomen than any other
region (Zeng, 2020). However, in my time within clinical
settings, I found applying these techniques quite complex.
Notably, I found it difficult to apply the palpation technique as
advised by my clinical preceptor. My clinical preceptor had an
emphasis that when using the palpation technique, light and
deep palpation should be performed. While I understood the
theoretical aspect and necessity of it, the practical
determination of the extent of light and deep requires some
experience. For the other three techniques, I found them more
applicable and without much complication as long as one
recognizes the unique differences in texture, color, and general
appearance for patients across the lifespan.
In the assessment of the skin, hair, and nails the inspection
technique is the most utilized. In my view, comprehensive
inspection of the skin, hair, and nails provides for the
significant information that may be needed to inform clinical

2. decisions. In skin inspection, there are three key attributes to
check and they include skin integrity, color variations, and skin
lesions. The biggest challenge in assessing the skin for these
attributes is recognizing the differences across the lifespan. For
instance, dry and cracked skin may not inform much in an
elderly patient as it would inform in an infant (Jarvis, 2018).
These age-related differences are critical in clinical decision
making. However, I consider that knowing and applying those
differences comes with clinical experience and sometimes new
nurse practitioners may not find it easy identifying such
differences or even considering them in the findings.
References
Jarvis, C. (2018). Physical Examination and Health Assessment-
Canadian E-Book. Elsevier Health Sciences.
Zeng, R. (2020). Complete Physical Examination. In Handbook
of Clinical Diagnostics (pp. 265-271). Springer, Singapore.
Reply Posts
Respond to your peers’ post and include the following:
· Insight on a solution to an identified peer challenge.
· Resources that may be helpful related to your peers’ post.
POST # 2 WANDA
(Wanda’s initial Post)
Reflect on the focus area or system(s) for the week.
· What challenges might you anticipate in completing this
assessment?
· What differences might you anticipate when assessing patients
across the lifespan?
· Share findings from scholarly resources that help in the
performance of this assessment.
· What challenges might you anticipate in completing this

3. assessment? The challenges I may anticipate this week are
making sure I have enough information to accurately diagnose
my patient (meaning associated conditions and any relevant past
medical history) for other student postings. The last assignment
was a bit confusing for some, which could pose a problem this
week. However, skin problems and abdominal pain can be a
variety of things. As a healthcare provider, if you do not pay
close attention to what the patient is saying or ask the
appropriate questions, you can misdiagnose. Therefore, it is
imperative to fully assess your patient and refer to a specialist
when appropriate.
· What differences might you anticipate when assessing patients
across the lifespan? Differences that I may foresee this week
when assessing patients across the life span are children's
assessment. Children may be limited in their ability to provide
precise information or not recall certain things they have told
their parents. Therefore, making it difficult to diagnose and for
the parents to explain what is going on with the child. For
women of childbearing age complaining of abdominal pain, a
pregnancy test should be administered to rule out pregnancy.
Asking specifics about her sexual and menstrual history would
be a priority with women of childbearing age. When you think
about the elderly patients; some of them have dementia or
Alzheimer's and may complain of referred pain or may not
remember complaining of pain in the first place. Therefore,
dealing with patients across the lifespan can be difficult and
challenging, but performing a thorough physical examination
and extensive health history can make diagnosing a little
easier.
· Share findings from scholarly resources that help in the
performance of this assessment.
According to Apau (2010), the objective of assessing the patient
with abdominal pain is to create an early, efficient, and precise
diagnosis. Establishing a description of the onset, location,
intensity, character, aggravating or alleviating factors, other
symptoms, medical history, medication, and social history will

4. shed more light on the nature of the problem (Apau, 2010,
p.51).
Physical examination should consist of inspection, auscultation,
percussion, palpation, and other special maneuvers to aid
diagnosis. Good knowledge and ability to differentiate between
the different forms of visceral pain will get the healthcare
provider a step closer to establishing the underlying diagnosis
(Apau, 2010).
Reply Posts
Respond to your peers’ post and include the following:
· Insight on a solution to an identified peer challenge.
· Resources that may be helpful related to your peers’ post.
POST # 1 AYME
(Ayme’s initial Post)
Reflect on the focus area or system(s) for the week.
· What challenges might you anticipate in completing this
assessment?
· What differences might you anticipate when assessing patients
across the lifespan?
· Share findings from scholarly resources that help in the
performance of this assessment.
The focus areas of assessment over the week included the skin,
hair, and nails. These areas are seemingly too external that they
may be considered to have minimal information to inform the
diagnostic and care planning processes. However, the cardinal
rule in assessment is that every system and area is as important
as the other and may inform the point of separation especially in
differentia diagnosis where differences are too minimal but still
critical. Notably, the skin should be considered as a critical
organ considering that it is the largest organ occupying up to
16% of the entire body weight (Jensen, 2018). When assessing
the skin, inspection is usually the first-line procedure. The
inspection helps in identifying skin lesions and growth. Skin

5. coloration and skin integrity can be identified via observation.
However, the challenge with skin assessment is that the
variations in attributes from one age-matched group to the other
are extremely wide. In essence, the skin of a healthy infant is
significantly different from that of a healthy elderly adult. In
elderly adults, for instance, dry skin may be attributed to
reduced mobility, low fluid intake, and general drooping of the
skin due to age-related factors (Dains et al., 2020). The elderly
adult will still be considered healthy with no significant health
issues. However, dry and drooping skin in an infant is likely to
be interpreted as emergency dehydration and the infant may
require extensive monitoring.
Inspection of the hair focuses on identifying the overall
distribution of axillae, pubic hair, and scalp. In hair assessment,
the distribution of hair, scalp, and axilla tends to decline with
age with less hair, fewer axillae, and extended scalp (Jarvis,
2019). This interpretation of hair is less complex as compared
to nails and skin. In nail inspection, the shape, cleanliness, and
color are the informing factors. Nails are also critical in
informing peripheral blood circulation via refill patterns/rate.
The challenge with using nails as a primary determinant in
peripheral blood circulation is that it varies across the lifespan
and experience may be necessary for ensuring age-appropriate
interpretation (Bickley, 2017). Older adults while healthy may
display slower capillary refill and this may be considered
normal due to inevitable decline in the functional status of
muscles with age. However, a slower capillary rate in an infant
may be informative of poor or compromised blood circulation
(Harding, 2019).
References
Bickley, L. (2017). Bates' guide to physical examination and
history taking (12th ed.). New York: Lippincott, Williams &
Wilkins. ISBN-13: 978-1469893419
Dains, J.E., Baumann, L.C., & Scheibel, P. (2020). Advanced
health assessment and clinical diagnosis in primary care (6th
ed.). Boston: Elsevier.

6. Harding, M. M. (2019). Assessment: Integumentary
System. Lewis's Medical-Surgical Nursing E-Book: Assessment
and Management of Clinical Problems, Single Volume, 395.
Jarvis, C. (2019). Physical Examination and Health Assessment
E-Book. Elsevier Health Sciences.
Jensen, S. (2018). Nursing health assessment: A best practice
approach. Lippincott Williams & Wilkins.