EMILIO AGUINALDO COLLEGE

School of Nursing and Midwifery

PERFORMANCE EVALUATION TOOL

PHYSICAL ASSESSMENT

Procedure 28-???: Assessing the Nose and Sinuses

NAME OF STUDENT:
SECTION/GROUP: Date:

LEGEND:
4 Very Satisfactorily Performed
(Student performs consistently in an effective and efficient manner)
3 Satisfactorily Performed
(Performance is usually effective and efficient but not always)
2 Fairly performed
(Progress in performance is too slow to judge satisfactorily; task performance is not properly for majority of the
time)
1 Poorly performed
(No progress in performance has been demonstrated, and or performance is consistently inefficient)

Procedure 28-: Assessing the Nose and sinuses

Procedure 4 3 2 1 REMARKS
1. Introduce yourself; explain to the
client what you are going to do,
why it is necessary, and how she
can cooperate.
2. Wash hands and observe other
appropriate infection control
procedures.
3. Provide for client privacy.
4. Determine client history of the
following:
 Allergies
 Difficulty breathing through the
nose
 Sinus infections
 Injuries to nose or face
 Nosebleeds
 Medication taken changes in
sense of smell
5. Position the client
Assessment: Nose
6. Inspect the external nose for any
deviations in shape, size, or color
and flaring or discharge from the
nares.
7. Lightly palpate the external nose to
determine any areas of tenderness,
masses, displacements of bone and
cartilage.
8. Determine patency of both nasal
cavities. Ask the client to close the
mouth, exert pressure on one naris,
and breath through the opposite
naris. Repeat the procedure to
assess patency of the opposite naris.
9. Observe for the presence of
redness, swelling, growths, and
 discharge.
10. Inspect the nasal septum between
the nasal chambers.
Assessment: Sinuses
11. Palpate the maxillary and frontal
sinuses for tenderness.
12. Document findings in the client
record using printed or electronic
form or checklists supplemented by
narrative notes when appropriate
TOTAL

GRADING SYSTEM

Performance Score _________ x 90% = ______

Punctuality and Grooming _________ x 10% = ______

Total = ______

Evaluated by: Conformed by:

____________________________ ______________________________
Signature over printed name Signature over printed name