1 8.5 Objective Assessment

A comprehensive assessment of the eyes and ears by registered nurses in both inpatient and outpatient settings involves a thorough inspection of external structures for signs of issues such as infections, inflammation, or abnormalities. This includes checking for redness, swelling, discharge, and deformities that might indicate underlying problems.

In addition to visual inspection, the assessment includes screening for vision and hearing issues. For vision, nurses often conduct visual acuity tests and evaluate pupillary responses to detect abnormalities. Hearing assessments may include a whispered voice test or other auditory evaluations to identify potential hearing problems. These early screenings are essential for identifying issues promptly, ensuring timely diagnostic or therapeutic interventions.^[1] Additional assessments may be performed if the patient’s status warrants assessment of the cranial nerves.

Your subjective assessment should segue into into your objective assessment of the eyes and ears. Typically, you will identify priority areas based on your conversation with the client. For instance, if the client mentions difficulty seeing or hearing, you might conduct a focused assessment of those areas. Depending on the health care context and purpose, you may also perform a general assessment to establish a baseline or detect any additional issues not revealed during the subjective assessment.

Prepare before conducting your objective assessment. For example:

• Prepare both the client and the environment. Inform the client about what the assessment will involve, including the duration, areas to be touched, and any clothing removal required, ensuring they feel comfortable and prepared.
• Prepare the environment by ensuring the room is well-lit, at a comfortable temperature, and private, with curtains drawn or the door closed. Gather necessary equipment like an otoscope, ophthalmoscope, penlight, gloves, and any other equipment in advance to avoid distractions. This preparation not only facilitates a smooth assessment but also helps maintain the client’s comfort and dignity throughout the process.