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• Physical Assessment is a systematic, comprehensive, and continuous collection, validation, and communication of a client's data using a variety of methods.
• Be a patient advocate.
• Respect patient’s rights.
• Assure confidentiality of information/patient’s data.
• Remember to be responsible and accountable for your practice.
• Physical assessment is correlated with the patient's health history, including History of Present Illness (HPI) and Past Medical History.
• The examiner should follow a certain sequence in doing physical assessment, including only findings with medical significance and focusing on both symptoms that are present and pertinent negatives.
• In a case of dengue fever, having no abdominal pain/tenderness or epistaxis is significant.
• In a case of stroke, having no neurologic deficit is significant as well.
• The result of the physical examination should be objective and have no examiner variance.
• Neurologic exam is always a part of the physical exam.
• Ethico-legal considerations: Patient’s Rights include asking to see and get a copy of health records, having corrections added to health information, receiving a notice informing him how health information is used or shared, and getting a report on when and why health information is shared.
• Preparing the Environment: Make sure the room is quiet, private, warm, and well-lit.
• Approach to Patient During PA: Explain all procedures to avoid alarming the patient, and this encourages cooperation.
• Preparing the Client:Empty the bladder, determining if there is a need to void.
• Preparing the Client: Introduce yourself, explain what you are going to do and why, and explain what you are doing every step of the way.
• Preparing the Client: Consider the age of the patient, from neonate to older adult.
• Preparing the Client:Determine the status of the patient, whether pregnant or disabled.
• When examining a patient of the opposite sex, always have a companion of the same sex as the patient with you throughout the assessment.
• Always maintain patient privacy, remembering that the patient has the right to refuse to be examined, despite being an essential part of the history.
• Begin at the patient's right side, then moving to the opposite side of the patient, or foot of the bed as needed.
• Right JVP is more reliable (right) and Right kidney is more palpable.
• Gloves are used for protection during any part of the physical examination, especially for body fluids, open wounds, excreta, and contaminated items.
• A stethoscope is used for auscultation of body sounds, including Korotkoff sounds (BP), bowel sounds, heartbeats (adult/fetal), and pulsations.
• A sphygmomanometer is used for measuring blood pressure: systolic and diastolic.
• Thermometers are used for measuring body temperature through oral, axillary, otic, and rectal methods.
• A watch with a swift second hand is used for timing heart, pulse, respiratory rates, and the like.
• Skinfold calipers are used for measuring skinfold thickness of subcutaneous tissue.
• A flexible tape measure is used for measuring circumferences: mid-arm, abdominal girth, fundic height.
• A platform scale with height attachment is used for measurement of height and weight, and is used to derive factors in calculating body mass index (BMI).
• A ruler with centimeter markings is used for measuring the size of skin lesions, and occasionally, even surgical specimens.
• A magnifying glass is used for enlarging the visibility of lesions.
• A small cup of water is used for testing the swallow reflex during examination of the head and neck (or thyroid gland).
• A penlight is used for testing pupillary constriction (brain function).
• A Snellen Chart is used for measuring distance vision.
• An otoscope is used for viewing the ear canal and the tympanic membrane.
• An ophthalmoscope is used for viewing the red-orange reflex, and examination of the retina.
• A cover card is used for testing of strabismus.
• A Rosenbaum Pocket Screener is used for testing near vision.
• A tuning fork is used for comparison of air and bone conduction.