RETURN DEMONSTRATION: MUSCULOSKELETAL

00:23:06
https://www.youtube.com/watch?v=SGKLRC9YZAY

Summary

TLDRCette vidéo illustre le processus d'évaluation du système musculo-squelettique d'un patient. L'infirmière commence par se présenter et vérifier l'identité du patient, suivie d'une explication de l'évaluation et de son importance. Elle évalue les muscles, les os et les articulations en inspectant la taille des muscles, la force musculaire, et en vérifiant la présence de douleur, de raideur ou d'autres anomalies. L'utilisation d'un goniomètre pour mesurer l'amplitude des mouvements des articulations est également démontrée. À la fin, les résultats sont documentés pour un suivi ultérieur par d'autres professionnels de la santé.

Takeaways

  • 👩‍⚕️ Présentation par une infirmière étudiante.
  • 📋 Établir des données de base pour l'évaluation.
  • 🧴 Importance de l'hygiène des mains.
  • ✅ Inspections musculaires et osseuses réalisées.
  • 💪 Mesure de la force musculaire bilatérale.
  • 📏 Utilisation d'un goniomètre pour l'amplitude des mouvements.
  • 🔍 Inspection des articulations pour des anomalies.
  • 📄 Documentation des résultats d'évaluation.
  • 🤝 Confidentialité assurée envers le patient.
  • 🔄 Suivi à effectuer selon les résultats.

Timeline

  • 00:00:00 - 00:05:00

    L'élève infirmier se présente et introduit son évaluation du système musculosquelettique, qui vise à établir des données de base pour une évaluation ultérieure. Il explique l'importance de cette évaluation et comment le patient peut participer. Le processus commence par la vérification de l'identité du patient, qui répond à des questions sur ses antécédents médicaux, y compris des douleurs et des limitations de mouvement.

  • 00:05:00 - 00:10:00

    L'évaluation physique commence par l'inspection des muscles, où la taille des muscles des bras, des cuisses et des mollets est comparée des deux côtés. Le graduateur et le ruban à mesurer sont utilisés pour vérifier les différences de taille, ainsi que pour évaluer la présence de contractures, de tremblements et de force musculaire. Chaque muscle est testé pour sa force et sa capacité de résistance, en vérifiant les muscles du cou, des épaules, des bras et des jambes.

  • 00:10:00 - 00:15:00

    Après l'évaluation des muscles, l'infirmier passe à l'évaluation des os, en inspectant le squelette pour détecter d'éventuelles déformations, puis en palpant les os pour détecter des zones de douleur ou de gonflement. Ensuite, les articulations sont examinées pour des signes de gonflement, de douleur et de mouvement, et la plage de mouvement des articulations est mesurée à l'aide d'un goniomètre.

  • 00:15:00 - 00:23:06

    Enfin, les résultats de l'évaluation sont documentés et un suivi détaillé est planifié en fonction des découvertes. Les écarts par rapport aux résultats normaux sont rapportés au fournisseur de soins primaires, et une évaluation plus approfondie des autres systèmes peut être souhaitable selon les résultats.

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Mind Map

Video Q&A

  • Quel est l'objectif de l'évaluation musculo-squelettique ?

    L'objectif est d'établir des données de base pour une évaluation ultérieure.

  • Quels équipements sont utilisés pour l'évaluation ?

    Un goniomètre et un mètre ruban sont utilisés.

  • Comment s'assurer de la confidentialité lors de l'évaluation ?

    En promettant que toutes les informations recueillies resteront confidentielles.

  • Quelles sont les étapes principales de l'évaluation ?

    Inspecter les muscles, les os et les articulations, et tester la force musculaire.

  • Que doit faire l'infirmière avant de commencer l'évaluation ?

    Elle doit se laver les mains et assurer la confidentialité.

  • Comment est mesurée la force musculaire ?

    En comparant la résistance musculaire de chaque côté du corps.

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  • 00:00:00
    [Music]
  • 00:00:02
    good day sir i'm your student nurse mara
  • 00:00:05
    mark vegas from bsn1c
  • 00:00:08
    and this is my video presentation the
  • 00:00:10
    third demonstration in assessing the
  • 00:00:12
    musculoskeletal system of my patient the
  • 00:00:16
    purpose of this assessment is to
  • 00:00:18
    establish baseline data for subsequent
  • 00:00:21
    evaluation for the equipment that we
  • 00:00:23
    will be using for the assessment we will
  • 00:00:26
    be using agoniometer and a tape measure
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    for the performance prior to performing
  • 00:00:32
    the procedure
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    introduce yourself and verify the
  • 00:00:35
    client's identity using the agency
  • 00:00:38
    protocol
  • 00:00:39
    explain to the client what you are going
  • 00:00:41
    to do why it is necessary and how he or
  • 00:00:45
    she can participate
  • 00:00:47
    discuss how the result will be used in
  • 00:00:49
    planning further care or treatments
  • 00:00:59
    okay good afternoon mom i am barbara
  • 00:01:01
    marquez and i will be your nurse for
  • 00:01:03
    today may i know about your full name
  • 00:01:05
    mom
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    my name
  • 00:01:08
    is your birthday
  • 00:01:12
    1968 your age i'm 52
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    okay so the procedure that i will be
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    doing mom is that i am going to check
  • 00:01:21
    and observe your muscles your bones and
  • 00:01:25
    your joints so this is done for us to
  • 00:01:27
    know if there is any abnormalities that
  • 00:01:29
    is present to your musculoskeletal
  • 00:01:32
    system would that be okay with you sure
  • 00:01:36
    perform hand hygiene and observe
  • 00:01:39
    appropriate infection control procedure
  • 00:01:42
    and provide for a client privacy
  • 00:01:47
    okay all the doors and all the parties
  • 00:01:50
    mom are now closed to ensure your
  • 00:01:52
    privacy okay
  • 00:01:55
    inquire if the client has any history of
  • 00:01:58
    the following such as a muscle pain
  • 00:02:01
    the onset
  • 00:02:03
    the location the character the
  • 00:02:06
    associated phenomena for example the
  • 00:02:09
    redness and the swelling of joints
  • 00:02:12
    the aggravating and elevating factors
  • 00:02:14
    the limitations of movement or inability
  • 00:02:17
    to perform activities of a daily living
  • 00:02:20
    previous sports injuries and loss of
  • 00:02:22
    function without pain came on so i'm
  • 00:02:25
    going to ask you questions and i promise
  • 00:02:28
    that all information that i've gotten
  • 00:02:29
    from you will remain confidential okay
  • 00:02:32
    sure okay so do you feel pain or
  • 00:02:35
    stiffness into your arms into your back
  • 00:02:38
    and to your thighs
  • 00:02:39
    no
  • 00:02:40
    okay so can you walk up and down stairs
  • 00:02:43
    without any difficulties
  • 00:02:45
    yes
  • 00:02:46
    okay so can you dress yourself in
  • 00:02:48
    everyday clothes without any
  • 00:02:50
    difficulties mom yes
  • 00:02:52
    okay
  • 00:02:53
    so in a few minutes now we're going to
  • 00:02:55
    start okay sure
  • 00:02:57
    so let's now proceed to assessing the
  • 00:02:59
    muscles of my patient
  • 00:03:01
    so first we need to inspect for the
  • 00:03:04
    muscle size
  • 00:03:05
    compare the muscles on the other side of
  • 00:03:08
    the body
  • 00:03:09
    the arms thighs and calf to the same
  • 00:03:13
    muscles on the other side okay so i'm
  • 00:03:16
    going to inspect your muscles for size
  • 00:03:20
    [Music]
  • 00:03:23
    can you stand up for me mom
  • 00:03:29
    [Music]
  • 00:03:34
    okay so you have an equal size on both
  • 00:03:37
    sides of your body which is actually
  • 00:03:40
    normal
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    for any discrepancies measure the
  • 00:03:43
    muscles with the tape inspect the
  • 00:03:46
    muscles and tendons for contractures
  • 00:03:49
    okay mom next i am going to inspect the
  • 00:03:51
    muscles for contractors
  • 00:03:55
    [Music]
  • 00:04:00
    [Music]
  • 00:04:05
    okay so i don't see any contracture
  • 00:04:08
    small
  • 00:04:09
    okay inspect the muscles for tremors for
  • 00:04:12
    example by having the client to hold the
  • 00:04:15
    arms out in front of the body okay mom
  • 00:04:18
    so i'm going to inspect the muscles for
  • 00:04:21
    tremors so i want you to do this
  • 00:04:26
    [Music]
  • 00:04:28
    so
  • 00:04:29
    there is no shaking
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    no concentrations
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    and
  • 00:04:35
    no tremors
  • 00:04:37
    okay test muscle strength compare the
  • 00:04:40
    right side with the left side for this
  • 00:04:42
    sternocleidomastoid
  • 00:04:44
    the client turns the head onto one side
  • 00:04:47
    against the resistance of your hand
  • 00:04:50
    repeat with the other side okay mom the
  • 00:04:53
    next that i am going to do is that i am
  • 00:04:55
    going to test your muscle strength so
  • 00:04:58
    the muscle strength should be equal
  • 00:05:00
    bilaterally and fully resist your
  • 00:05:03
    opposing force okay
  • 00:05:05
    okay so can you sit for me mom
  • 00:05:07
    [Music]
  • 00:05:09
    okay thank you okay mom so the first
  • 00:05:11
    that i am going to check is your stereo
  • 00:05:14
    play domastoid so i want you to look at
  • 00:05:16
    your right
  • 00:05:18
    look at your left
  • 00:05:21
    move up
  • 00:05:23
    and look down
  • 00:05:25
    okay so we can also have them to do that
  • 00:05:28
    against resistance
  • 00:05:33
    [Music]
  • 00:05:40
    okay very good
  • 00:05:42
    for the trophies use the client shrugs
  • 00:05:45
    the shoulders against the resistance of
  • 00:05:48
    your hands pokemon for your trapezius
  • 00:05:51
    can you shrug your shoulder for me
  • 00:05:55
    okay
  • 00:05:55
    [Music]
  • 00:06:00
    okay thank you
  • 00:06:02
    for the deltoid the client holds arm up
  • 00:06:06
    and dresses while you try to push it
  • 00:06:08
    down okay mom can you please raise your
  • 00:06:12
    arms
  • 00:06:14
    okay
  • 00:06:18
    [Music]
  • 00:06:20
    for the biceps the client fully extend
  • 00:06:24
    each arms and tries to flex it while you
  • 00:06:27
    attempt to hold arms in extension okay
  • 00:06:31
    mom next i am going to check for your
  • 00:06:33
    biceps so can you stand up for me
  • 00:06:36
    okay so i am going to attempt to hold
  • 00:06:39
    your arms in extension okay so then you
  • 00:06:42
    watch your arm
  • 00:06:48
    [Music]
  • 00:06:50
    okay i'll go over the other side
  • 00:07:00
    for the triceps the client flexes each
  • 00:07:04
    arm and then tries to extend it
  • 00:07:07
    against your attempt to keep arm in
  • 00:07:09
    flexion
  • 00:07:11
    okay next mom is for your triceps so i'm
  • 00:07:14
    going to keep your arm in flexion so can
  • 00:07:17
    you flex your arm again for me mom
  • 00:07:20
    okay
  • 00:07:28
    yeah i go over the other side lecture
  • 00:07:30
    arm
  • 00:07:34
    [Music]
  • 00:07:38
    okay
  • 00:07:41
    for the wrist and finger muscles the
  • 00:07:44
    client spreads the fingers
  • 00:07:46
    and resists as you attempt to push your
  • 00:07:49
    fingers together
  • 00:07:51
    okay next mom is for your wrist and your
  • 00:07:53
    finger muscles so can you spread your
  • 00:07:55
    fingers for me
  • 00:07:59
    e
  • 00:08:05
    for your mom
  • 00:08:09
    [Music]
  • 00:08:12
    okay very good for the grip strength the
  • 00:08:14
    client grasp your index and your middle
  • 00:08:17
    finger
  • 00:08:18
    while you try to pull the fingers out
  • 00:08:21
    okay mom you may now see it
  • 00:08:25
    okay so for your grip strength mom i
  • 00:08:27
    want you to grasp my index and my middle
  • 00:08:30
    finger while i'm trying to pull the
  • 00:08:32
    fingers out okay
  • 00:08:37
    [Music]
  • 00:08:44
    okay the other side
  • 00:08:50
    [Music]
  • 00:08:54
    for the hip muscles
  • 00:08:56
    the client is supine
  • 00:08:58
    both legs extended
  • 00:09:00
    the client raises one leg at a time
  • 00:09:03
    while you attempt to hold it down okay
  • 00:09:06
    mom next is for your hip muscles so i
  • 00:09:08
    want you to lay down for me
  • 00:09:14
    okay mom can you raise your one leg and
  • 00:09:17
    i'm going to attempt to hold it down
  • 00:09:19
    okay
  • 00:09:26
    [Music]
  • 00:09:31
    i'll go over the other side
  • 00:09:33
    can you raise your leg
  • 00:09:45
    for the hip abduction the client is
  • 00:09:48
    supine
  • 00:09:49
    both legs extend them
  • 00:09:51
    place your hands on the lateral surface
  • 00:09:54
    of each knee and then decline express
  • 00:09:57
    the legs apart against your resistance
  • 00:10:00
    okay mom next is for your hip abduction
  • 00:10:03
    so i'm going to place my hands
  • 00:10:06
    on the lateral surface of each knee and
  • 00:10:09
    you're going to spread your legs against
  • 00:10:12
    my resistance okay
  • 00:10:17
    so try to spread your legs mom
  • 00:10:20
    [Music]
  • 00:10:23
    okay at the other side
  • 00:10:26
    try to spread
  • 00:10:29
    [Music]
  • 00:10:33
    for the hip abduction the client is in
  • 00:10:36
    the same position as for the hip
  • 00:10:38
    abduction
  • 00:10:39
    place your hands between the knees and
  • 00:10:42
    then the client bring the legs together
  • 00:10:45
    against your resistance
  • 00:10:47
    okay next mom is for your hip adduction
  • 00:10:50
    so i'm going to place my hands between
  • 00:10:53
    your knees
  • 00:10:54
    and you're going to bring your legs
  • 00:10:56
    together against my resistance okay okay
  • 00:11:03
    okay try to bring it together
  • 00:11:08
    [Music]
  • 00:11:11
    here the other side
  • 00:11:21
    for the hamstring the client is supine
  • 00:11:25
    both knees bent
  • 00:11:27
    the client resist while you attempt to
  • 00:11:29
    straighten the legs
  • 00:11:31
    okay mom next is for your hamstring so
  • 00:11:34
    can you bend your knees for me
  • 00:11:38
    okay so i'm going to attempt to
  • 00:11:40
    straighten your legs okay okay
  • 00:11:43
    [Music]
  • 00:11:49
    for the quad triceps the client is
  • 00:11:51
    supine
  • 00:11:52
    knee partially extended and the client
  • 00:11:55
    will resist while you attempt to flex
  • 00:11:58
    the knees okay mom so for your
  • 00:12:00
    quadriceps i want you to extend your
  • 00:12:02
    knees for me
  • 00:12:05
    okay so i am going to attempt to flex
  • 00:12:08
    your knees okay
  • 00:12:10
    [Music]
  • 00:12:16
    okay
  • 00:12:17
    for the muscles of ankles and foot
  • 00:12:20
    the client resists when you attempt to
  • 00:12:23
    dorsiflex the foot
  • 00:12:25
    and again resist when you attempt to
  • 00:12:27
    flex the foot
  • 00:12:29
    okay next mom is for the muscles of your
  • 00:12:32
    ankles and feet
  • 00:12:35
    okay
  • 00:12:43
    the other side
  • 00:12:51
    okay
  • 00:12:54
    [Music]
  • 00:13:01
    okay
  • 00:13:10
    so let's reproceed in assessing the
  • 00:13:13
    bones of my patient so first we need to
  • 00:13:16
    inspect this skeleton for structure
  • 00:13:19
    okay mom next is that i'm going to
  • 00:13:21
    inspect your skeletons for structures so
  • 00:13:25
    can you sit for me mom
  • 00:13:26
    [Music]
  • 00:13:33
    okay
  • 00:13:34
    [Music]
  • 00:13:44
    okay so can you stand up for me
  • 00:13:57
    okay so i can't see any deformities mom
  • 00:14:01
    which is nice
  • 00:14:03
    next is we have to palpate the bones to
  • 00:14:06
    locate any areas of edema or tenderness
  • 00:14:09
    okay mom next i am going to call picture
  • 00:14:13
    bowls to locate any areas of edema or
  • 00:14:16
    tenderness okay so i'm going to
  • 00:14:18
    calculate and tell me if you feel
  • 00:14:21
    anything okay
  • 00:14:22
    okay
  • 00:14:27
    [Music]
  • 00:14:30
    do you feel pain or any tenderness
  • 00:14:32
    [Music]
  • 00:14:45
    [Music]
  • 00:14:48
    okay so there's no swallowing and no
  • 00:14:51
    tenderness
  • 00:14:52
    okay mom next i am going to palpate to
  • 00:14:55
    locate any areas of the edema okay
  • 00:14:59
    okay
  • 00:15:00
    so i'm going to calculate it
  • 00:15:03
    [Music]
  • 00:15:16
    okay and the other side
  • 00:15:21
    [Music]
  • 00:15:31
    [Music]
  • 00:15:34
    let's now proceed in assessing the
  • 00:15:36
    joints
  • 00:15:37
    inspect the joints for swelling
  • 00:15:40
    how to palpate each joint for tenderness
  • 00:15:44
    smoothness of movement swelling
  • 00:15:47
    gravitation and the presence of no juice
  • 00:15:50
    okay next i am going to inspect and
  • 00:15:53
    palpate your joists for any swelling
  • 00:15:55
    tenderness proper taping or
  • 00:15:58
    no juice okay
  • 00:16:02
    [Music]
  • 00:16:05
    so i can see any swelling your upper
  • 00:16:08
    extremities
  • 00:16:10
    and going down to your lower extremities
  • 00:16:13
    okay
  • 00:16:15
    no tenderness
  • 00:16:19
    and no noodles
  • 00:16:21
    and your joints move smoothly
  • 00:16:24
    [Music]
  • 00:16:26
    assess joint range of motion
  • 00:16:29
    as declined to move
  • 00:16:31
    selected body parts the amount of joint
  • 00:16:34
    movement can be measured by a goniometer
  • 00:16:38
    a device that can measure the angle of
  • 00:16:40
    the joint in degrees okay mom next i am
  • 00:16:44
    going to assess your joint ratio of
  • 00:16:46
    motion so first your next range of
  • 00:16:50
    motion so i want you to move your head
  • 00:16:52
    at your right
  • 00:16:57
    at your left
  • 00:17:00
    loop up
  • 00:17:02
    and down
  • 00:17:04
    okay so can you move your head laterally
  • 00:17:07
    on your left and to your right shoulders
  • 00:17:12
    [Music]
  • 00:17:14
    okay so for your rotation mom
  • 00:17:17
    can you move your head as far as
  • 00:17:19
    possible to your left and to your right
  • 00:17:27
    [Music]
  • 00:17:30
    okay mom so next is for your arm range
  • 00:17:33
    of motion so what i want you to do mommy
  • 00:17:36
    is follow what i do okay
  • 00:17:39
    okay so can you stand up for me
  • 00:17:42
    okay so can you lift your arms over your
  • 00:17:45
    head
  • 00:17:48
    and down
  • 00:17:49
    [Music]
  • 00:17:50
    at your side
  • 00:17:53
    and put them behind your head
  • 00:17:57
    and at your back
  • 00:18:00
    at your shoulder
  • 00:18:04
    same shoulder
  • 00:18:06
    and bring your arms at your side
  • 00:18:09
    bring your elbows back
  • 00:18:10
    [Music]
  • 00:18:12
    and keep your arms straight
  • 00:18:15
    and back okay
  • 00:18:17
    palms down
  • 00:18:19
    palms up
  • 00:18:21
    grease up
  • 00:18:23
    wrist down
  • 00:18:24
    spread your fingers
  • 00:18:26
    and make a feast
  • 00:18:28
    okay very good okay mom next is for your
  • 00:18:31
    trunk range of motion so can you bend
  • 00:18:34
    forward for me mom
  • 00:18:39
    okay
  • 00:18:40
    bend back
  • 00:18:43
    okay very good so can you bend at your
  • 00:18:45
    side
  • 00:18:48
    okay the other side
  • 00:18:53
    so for your trunk rotation mom can you
  • 00:18:55
    move the upper part of your body to the
  • 00:18:57
    other side
  • 00:18:59
    [Music]
  • 00:19:02
    okay very good okay mom so the first
  • 00:19:05
    thing that i am going to do is that i am
  • 00:19:07
    going to lift your leg up
  • 00:19:10
    and your knees towards your chest
  • 00:19:14
    and bring back again to the bed
  • 00:19:18
    okay so i'm going to do this three times
  • 00:19:21
    okay
  • 00:19:22
    okay one
  • 00:19:24
    [Music]
  • 00:19:27
    two
  • 00:19:28
    three
  • 00:19:30
    four
  • 00:19:31
    three
  • 00:19:32
    okay i'll go on the other side
  • 00:19:35
    i'm going to
  • 00:19:36
    leave and your knees towards your chest
  • 00:19:41
    one
  • 00:19:44
    two
  • 00:19:45
    three
  • 00:19:48
    three
  • 00:19:49
    okay
  • 00:19:50
    okay mom for the next one i am going to
  • 00:19:53
    bring your leg out to the side and back
  • 00:19:55
    in okay
  • 00:19:57
    okay okay mom so i am going to do this
  • 00:20:00
    three times okay
  • 00:20:02
    okay
  • 00:20:08
    two do you feel pain
  • 00:20:12
    three
  • 00:20:12
    okay i'll go over the other side
  • 00:20:16
    one
  • 00:20:17
    [Music]
  • 00:20:24
    okay mom next i am going to roll your
  • 00:20:26
    leg in and out okay
  • 00:20:29
    okay i'm going to do this three times
  • 00:20:31
    also
  • 00:20:32
    okay so one
  • 00:20:36
    two
  • 00:20:37
    [Music]
  • 00:20:39
    three
  • 00:20:43
    okay the other side
  • 00:20:46
    one
  • 00:20:49
    two
  • 00:20:52
    three
  • 00:20:54
    okay mom
  • 00:20:57
    next month for your uncle i am going to
  • 00:21:01
    move your ankle
  • 00:21:04
    up
  • 00:21:05
    and down okay so i'm going to do this
  • 00:21:08
    three times okay okay
  • 00:21:11
    one
  • 00:21:12
    [Music]
  • 00:21:14
    two
  • 00:21:16
    three
  • 00:21:18
    okay the other side
  • 00:21:21
    one
  • 00:21:23
    two
  • 00:21:26
    three
  • 00:21:27
    okay
  • 00:21:28
    okay mom for the next one i am going to
  • 00:21:31
    turn your foot in and out okay
  • 00:21:34
    so i'm going to do this three times
  • 00:21:36
    okay
  • 00:21:39
    okay
  • 00:21:40
    one
  • 00:21:41
    little bit
  • 00:21:45
    three
  • 00:21:47
    okay i'll go with the other side
  • 00:21:50
    one
  • 00:21:52
    two
  • 00:21:54
    three
  • 00:21:56
    okay okay mom for the last one i am
  • 00:22:00
    going to twirl your ankle okay okay
  • 00:22:04
    okay so i'm going to troll it three
  • 00:22:06
    times
  • 00:22:07
    one
  • 00:22:09
    two
  • 00:22:11
    [Music]
  • 00:22:12
    three
  • 00:22:15
    okay on the other side
  • 00:22:18
    one
  • 00:22:21
    two
  • 00:22:23
    [Music]
  • 00:22:24
    three
  • 00:22:26
    okay
  • 00:22:28
    now we can now document the findings of
  • 00:22:31
    the client's record using a form or
  • 00:22:34
    checklist supplemented by a narrative
  • 00:22:36
    report if appropriate for the evaluation
  • 00:22:40
    perform a detailed follow-up examination
  • 00:22:43
    on the other systems based on the
  • 00:22:46
    findings debated from the expected or
  • 00:22:49
    the normal to the client the late
  • 00:22:51
    defined based on the previous assessment
  • 00:22:53
    data if available
  • 00:22:55
    and last report the divisions from the
  • 00:22:58
    expected or the normal findings to the
  • 00:23:01
    primary care provider
Tags
  • système musculo-squelettique
  • évaluation
  • forces musculaires
  • inspecter
  • goniomètre
  • soins infirmiers
  • muscles
  • articulations
  • os
  • confidentialité