Upper & Lower Extremities Script

Good Morning po, I’m Chloe Anne Maniego from BSN 1B and today I will be performing a
return demonstration on the assessment of the upper and lower extremities.
So prior to starting the assessment, I will perform hand washing first. Then, I will also wear a
face mask in order to avoid cross contamination.

INTRODUCTION

Good day, I’m Chloe Maniego your assigned student nurse for today.
So I will be conducting an abdominal assessment po as a part of your monthly health check up.

Now for verification purposes, may you please state your full name along with your age &
birthday po?

I’m also asking for your permission po if ok lang po sa inyo? kasi there will be physical
contact/touches po throughout the process?

I’m also hoping for your cooperation and patience po during this assessment, and if you have
further questions or concerns, please don’t hesitate to tell me po.

And to ensure my client’s privacy and comfort, I’m going to close all curtains and windows.

Also, all of your personal information and findings will be strictly confidential between me and
the physician that I will be referring you to.

Now, for a moment po. I'll just prepare the equipments po…

PREPARE THE MATERIALS NEEDED:

✔Facemask ✔Gloves ✔ Reflex Hammer

So I will be assessing the upper extremities first

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Okay Ma’am may i check and inspect your arms po? (dorsal pataas for d temp)
- Okay the arms are equal in size bilaterally. There’s no color variations. No obvious masses,
no bulging, no nodules and no prominent venous pattern.

Now I will palpate…

- So, both arms are equally warm to touch. I didn’t feel any masses or nodules.
- For the palms, both palms are dry and warm.

Now i will assess for the peripheral pulses wherein i will palpate two pulses together.
- Both radial pulses are equal bilaterally, 3+ strong but not bounding.
- Now for the Ulnar pulses, both ulnar pulses are difficult to palpate but its present equally.
So, I will grade this as 2+.
- And for the Brachial pulses, both brachial pulses are equal bilaterally, 3+.

Now im going to assess for the capillary refill time, (all fingers)
- In this case, my patient's refill time was observed to be around 1-2 seconds, indicating a good
blood circulation and adequate oxygenation levels. This result is considered to be within the
normal range and is indicative of a healthy cardiovascular system.

Now im going to test for Allen Test.

- Ideally po both hands po ang ittest but since this is just a return demonstration I will only test
one hand po.
Clench your fist then open and close po. So I will do this until the palms becomes pale
Then, slowly I will release ulnar artery. So the color returned within 3-5 seconds. So, it indicates
normalcy.
Again po, pa clench ng fist, now i will release the radial artery.
So it turned pink right upon 3-5 secs. Which again, indicates normalcy.
So for the overall findings. There is contralateral circulation and the radial and ulnar arteries are both
patent.

Now I will test for the Phalen’s test, to test for carpal tunnel syndrome
can u flex your shoulder Ma’am then positon your elbows in a 90 degree angle (lije this) and maintain
this position for 60 seconds po and please refrain from moving. (so 60secs is up)

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Did you feel any pain, numbness or tingling sensations on your thumb, index and middle fingers po?
None, okay so she is negative po for the phalen’s test.
Now I for the other side naman po, maintain this position po again for 60 seconds and please refrain from
moving.
Did you feel any pain in your (thumb, index, middle finger) po?.
And with that being said, I conclude that my patient is negative for phalen’s test.

Next will be the range of motion, we’ll start off with the shoulder.
Can u put your shoulder forwards as far as it goes then just follow my lead up (flexion) and then go down
(extension) go backwards (hyperextension).
For the abduction, put your shoulders sideward as far as it goes until the top of your head.
Now adduction, you will put your shoulders in front of your body.

Now we’ll proceed with Pronation and Supination (ELBOW)

Next is the wrist range of motion

Mam follow my lead again: Flexion, Extension, Hyperextension, Rotation, Ulnar Deviation

Now can u put your shoulder in a 90 degree angle into the side, then rotate shoulders internally

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