PERPETUAL HELP COLLEGE OF MANILA

1240 V., Concepcion St., Sampaloc Manila

COLLEGE OF NURSING

NCM101 Health Assessment

SKILLS LAB

Level Outcome:
At the end of this course, the First year NCM 101 nursing skills students will be able to
perform safe skills that deals with the priciples and technique, given simulated situations in
selected settings, rendering safe and appropriate care utilizing the nursing process.

Learning Outcome:
At the end of this course, the third year NCM 101 nursing skills students will be able to:
1. Discuss the mechanisms of conduction of sound waves to the fluid of the inner ear
[ossicular conduction; air conduction; bone conduction]
2. Describe the physical properties of sound
3. Differntiate Weber and Rinne test
Objectives:
During the performance of the activity on Assessing the Ears and Hearing, the nursing students
will be able to:
1. Inspect and palpate the external ear
2. Assess the client’s response to normal voice tones.
3. Perform the Weber and Rinne test
General Instructions:
1. Attend the scheduled skills laboratory class wearing a prescribed school uniform
2. Review the skill(s) to be practiced and demonstrated
3. Secure a copy of checklist provided for skills demonstration
4. Gather the equipment neede for skill performance
5. Students will follow safety measures at all times
6. No food or drink is allowed during the online clinical skills class
7. Secure a convenient place where you can perform the procedure to avoid distractions

Return demonstration on Assessing the Ears and Hearing will on Wednesday 7-11AM, 3-5PM
during our online/F2F class. Each student will be given a 2 to 5 minutes to perform the
procedure. Video recording during the return demonstration will be automatically saved to
google drive as basis of grading.
 PERPETUAL HELP COLLEGE OF MANILA
1240 V., Concepcion St., Sampaloc Manila
COLLEGE OF NURSING

CHECKLIST FOR ASSESSING THE ERAS AND HEARING

NAME:______________________
Year Level:____________________

PERFORMANCE DESCRIPTION
RATING SCALE
4 Consistently demonstrates ability to perform skill with no instructor
assistance of cueing
3 Demonstrates ability to perform skill. Requires instructors verbal cueing
2 Inconsistently demonstrates ability to perform skil. Requires instructor
assistance and cueing
1 Unable to perform skill. Demonstrated unsafe patient care

PREPARATION score REMARKS

1 Assemble equipment and supplies:
 Otoscope with several sizes or ear specula
PROCEDURE:
2 Explain to the client what you are going to do, why it is necessary,
and how he/she can cooperate
3 Wash hands and observe other appropriate infection control
procedures
4 Identify the patient
Provide privacy
5 Inquire if the client has any history of the following:
 Family history of hearing problems or loss
 Presence of any ear problems or pain
 Medication history, especially if there are complaints of
ringing ears
 Any hearing difficulty: its onset, factors contributing to it,
and how it interferes with activities of daily living
 Use of a corrective hearing device when and from whom it
was obtained
6 Position the client comfortably- seated, if possible
ASSESSMENT:
AURICLES
7 Inspect the auricles for color, symmetry of size, and position. To
inspect position, note the level at which the superior aspect of the
auricle attaches to the head with relation to the eyes
8 Palpate the auricles for texture, elasticity, and areas of tenderness
9 Gently pull the auricle upward, downward, and backward
1 Fold the pinna forward. (it should recoil.)
0
1 Push in on the tragus
1
1 Apply pressure to the mastoid process
2
EXTERNAL EAR CANAL ANF TYPANIC MEMBRANE
9 Using an otoscope, inspect the external ear canal for cerumen, skin
lessions, pus, and blood. Attach a speculum to the otoscope
1 Tilt the client’s head away from you and straighten the ear canal
0
1 Hold the otoscope either right side up, with your fingers between
1 the otoscope handle and the clients head or upside down, with your
fingers and the ulnar surface of your hand against the client’ head
1 Gently insert the tip of the otoscope into the ear canal, avoiding
2 pressure by the speculum against either side of the ear canal
1 Inspect the tympanic membrane for color and gloss
 PERPETUAL HELP COLLEGE OF MANILA
1240 V., Concepcion St., Sampaloc Manila
COLLEGE OF NURSING

3
GROSS HEARING ACUITY TEST
1 Assess the client’s response to normal voice tones. If the client has
4 difficulty hearing the normal voice, proceed with the following test.
1 Perform the watch tick test
5
1 Have the client occlude one ear. Out of the client’s sight, place a
6 ticking watch 2-3 cm (1-2 inches) from the unoccluded ear
1 Ask what the client can hear. Repeat with the other ear
7
Tuning fork test
1 Perform weber test
8  Hold the tuning fork at its base. Activate it by tapping the
fork gently against the back of your hand near the knuckles
or by stroking the fork between your thumb and index
fingers
 Place the base of the vibrating fork on top of the client’s
hand and ask whether the client hears the noise
Conduct Rinne Test
 Ask the client to block the hearing in one ear intermittently
by moving a fingertip in and out of the ear canal
 Hold the handle of the activated tuning fork on the mastoid
process of one ear until the client states that the vibration
can no longer be heard
 Immediately hold still the vibrating fork prongs in front of the
client’s ear canal. If necessary, push aside the client’s hair.
Ask whether the client now hears the sound
1 Document findings in the client record
9
TOTAL SCORE

COMPUTATION OF GRADE
Formula for Grading
Raw Score/Total Score x 60+40 = Grade

Clinical Instructor: Date: