00:01
Hello, I'm Professor Rhonda Lawes.
00:03
And in this webinar,
we're going to talk about an issue
that's important
to nurse practitioners.
00:09
Nurse Practitioners
are often involved
in the ones who complete the
examinations of sports physicals.
00:14
Now, sometimes you'll hear them
called preparticipation physicals
because that's what the goal is.
00:20
Your job is to determine
if this athlete
is physically, mentally, ready to go
to be safe on the field
to participate in sports.
00:30
So, we're going to hit these
four learning objectives.
00:34
I want you to understand
the recommended
five main components
of a sports physical.
00:38
We'll will show you key assessment
cues for you to watch for
with a pediatric or an adolescent
preparticipation athlete.
00:45
I want you to understand
the clinical risks of cardiomyopathy
that is a big one
with sports physicals
and understand the application
of physical examination skills
in the sports physical
outpatient setting.
00:58
So, well, I won't be demonstrating
how to do the assessment.
01:02
we're going to talk about
the key components
of all the assessments.
01:06
So, moving on to the five components
of the sports physical.
01:11
One is a medical and family history.
01:14
Two is a physical examination,
which has several parts.
01:18
Three is a nutritional assessment.
01:21
Four, heat and hydration
related risk factors,
which you know is a big deal
when your students,
or your athletes
are in a very warm climate
and exercising outside.
01:32
And the fifth one is a
mental health assessment.
01:36
So first,
we're going to kind of talk about
the key considerations overall
for sports physical exams.
01:43
Now be sure that the environment
where you perform these,
it should allow the patient privacy,
and it should allow you to perform
a thorough examination.
01:52
Now, this means
if you're in a large room
with lots of people,
and lots of noises
can be very difficult for you to do
an appropriate physical.
02:00
So, you want to make sure
that before you go and do
the sports exams of physicals
that you know what the environment
is going to look like.
02:08
Now, part of these exams
could involve
examining the testicles.
02:12
So this is something that
you want to make sure
you've provided for privacy.
02:17
Next, the length of your
appointment time.
02:20
You want to make sure that you have
adequate time for these assessments
that you don't have to be
rushed through anything.
02:26
Remember, you could likely be
the only health care practitioner,
this student athlete
sees during the year.
02:34
So you want to make
sure that you can catch
anything in your assessment
that needs to be referred.
02:41
Lastly, the appropriate referrals
are the key here.
02:45
If you recognize anything
that requires more
detailed assessment and follow up,
you need to make that referral
and make sure
that it gets communicated
to the parent.
02:55
So let's start with the first of
the five components in this webinar.
02:58
We're looking for
medical and family history.
03:01
Now, I know you've had
lots of practice
in your nurse practitioner program,
taking histories.
03:06
But this is where
we really get to drill down
and see if we can recognize anything
that is concerning.
03:13
So let's start with some
general key history questions.
03:16
First of all, you need a
complete medication history
for the student athlete.
03:21
You're also going to have
to ask them about
things that they don't
consider medications.
03:26
So, you want to know
if they're on
any prescription medications,
of course.
03:29
you'd also like to know which
physician has prescribed that.
03:32
Then the other questions
are things that
aren't involving
prescription medications.
03:37
So you can ask them things like,
do you take any supplements?
Do you take any vitamins?
Do you take pre-workout?
Have you taken a supplement
to help you gain muscle
or enhance your performance?
You're going to have
to be really specific,
because the students may not be
meaning to hide this from you.
03:53
But they may not think
of those things
that they can take
from a health food store or GNC
as things that they need
to talk to you about
or make you aware
that they're taking.
04:03
Kids can overdo pre workout,
just like they do energy drinks.
04:07
So you want to make sure
that you use all that wording
so that you can help them
to think about
all the things that
they may be exposing to.
04:15
So, the fourth one is have
you taken a supplement
to help you lose weight?
This can particularly be
challenging for females, athletes,
or any sport that causes the
athlete to have to cut weight.
04:30
Now the last one,
that's kind of a unusual term.
04:33
Have you ever taken
anabolic steroids?
You're going to have to,
they may not understand
anabolic steroids,
they most likely will
recognize the word steroids.
04:45
So just make sure that you're always
doing an assessment
that's age appropriate,
and appropriate
to the developmental stage
and the language that you use
to ask the questions.
04:55
Now, here's some history questions
I'd like to go over.
04:58
And remember again,
I know we keep reminding you,
but it's really important that
you want to adjust your language
to the developmental age
of your client,
to be sure that they understand
what you're asking them.
05:10
So these may seem really odd,
especially to
a younger student athlete,
but ask them
if they've ever had chest pain.
05:17
Have they ever passed out?
Have they felt fatigued
or really tired?
Have they been diagnosed
with a heart murmur?
And have they ever been
diagnosed with a heart condition?
Now we have this in the
medical and family history.
05:30
So this is focused on the student.
05:33
Now we're going to focus on
the family members.
05:36
But remember,
ventricular dysrhythmias,
and sudden cardiac death
is a concern with student athletes.
05:43
But now, we're going to talk about
their family history
of cardiac issues.
05:47
So ask them if anyone
in their family
has had a heart condition.
05:50
Has anyone in their family
had a heart attack?
And how old were they?
Now, if you can ask in a
way that is appropriate,
you might also ask what was
the outcome of that heart attack,
to know if the
family members survived,
or if it was a significant
life ending event.
06:09
So that wraps up
medical and family history.