QUIZ

• The first step to creating an effective marketing plan is conducting market research.
• A complete or partial physical examination is conducted following a careful comprehensive or problem related history
• Examination is conducted in a quiet well-lit room with consideration for patient privacy and comfort
• Begin with the patient in a sitting position when possible to examine both the front and back
• Conduct the examination systematically from head to foot (cephalocaudal) to observe all systems or body parts
• Compare findings on one side of the body with those on the other side
• Explain all procedures to the patient during the examination to avoid alarming or worrying them and to encourage cooperation
• Objective data includes information directly observed by the midwife during interaction with the client and information elicited through physical assessment techniques
• Types of equipment needed for the examination include: penlight, sphygmomanometer, otoscope, tuning fork, and stethoscope
• Preparation for the physical assessment involves setting up equipment, oneself, and the client, and performing inspection, palpation, percussion, and auscultation
• Gloves and gowns are used to protect the examiner when there may be contact with blood, body fluids, or contaminated items
• Equipment for vital signs includes a sphygmomanometer, thermometer, watch with a second hand, and a pain rating scale
• Equipment for an eye examination includes a penlight, Snellen chart, ophthalmoscope, cover card, and newspaper
• Physical examination settings can vary and should provide a comfortable, private, quiet, and well-lit environment
• The examination setting should include a firm examination table or bed at a height that prevents stooping and a bedside table/tray for equipment
• Wash hands before and after the examination, after contact with blood or body fluids, and after removing gloves
• Wear gloves if there is an open cut or skin abrasion, when handling body fluids, or when examining the mouth, genitalia, vagina, or rectum
• Discard sharp objects after use and wear a mask and protective eye goggles if there is a risk of splashes with blood or body fluid droplets
• Establish the midwife-client relationship before the physical examination, explain the examination to the client, and respect their desires and requests
• Begin the examination with less intrusive procedures like measuring temperature, pulse, blood pressure, height, and weight to help the client feel more comfortable
• Continuously explain procedures during the examination to ease the client's anxiety and integrate health teachings and promotions
• Approach the client from the right side of the examination table and prepare them for position changes during the examination
• Physical examination techniques include IPPA (Inspection, Palpation, Percussion, and Auscultation) and IAPP for assessing the bowel
• During inspection, use good lighting, observe before touching, and note characteristics like color, patterns, size, and symmetry
• Palpation involves using parts of the hand to feel characteristics like texture, temperature, mobility, and tenderness
• Three parts of the hand are used during palpation: finger pads, ulnar/palmar surface, and dorsal surface
• Four types of palpation include light palpation, moderate palpation, and deep palpation, following standard precautions
• Light palpation involves gently placing the dominant hand on the surface of the structure with very little pressure
• • Feel very deep organs or structures covered by thick muscle
  • Bimanual Palpation:
  • Use two hands on each side of the body part being palpated
  • One hand applies pressure, the other feels the structure
  • Note size, shape, consistency, and mobility of structures
• Types of Palpation:

  • Light Palpation:
  • Place dominant hand lightly on the structure surface
  • Very little or no depression (less than 1 cm)
  • Circular motion to feel for pulses, tenderness, texture, temperature, and moisture
  • Moderate Palpation:
  • Depress skin surface 1 to 2 cm with dominant hand
  • Circular motion to feel for body organs and masses
  • Note size, consistency, and mobility of structures
  • Deep Palpation:
  • Place dominant hand on skin surface
  • Nondominant hand on top to apply pressure
  • Results in a surface depression between 2.5 and 5 cm
• • Solid tissues produce a soft tone, fluid produces a louder tone
• Percussion:

  • Involves tapping body parts to produce sound waves
  • Enables assessment of underlying structures
  • Blunt Percussion:
  • Detects abnormal masses
  • Vibrations penetrate approximately 5 centimeters deep
  • Deep masses do not change normal percussion vibrations
  • Elicits deep tendon reflexes
  • 3 Types of Percussion:
  • Direct percussion: tapping body part with fingertips
  • Blunt percussion: detects tenderness over organs
  • Indirect or Mediate Percussion:
  • Most commonly used method
  • Tone varies with density of underlying structure
• Auscultation:

  • Requires stethoscope to listen for body sounds
  • Not audible to human ear
  • Classified by intensity, pitch, duration, and quality of sound
  • Guidelines:
  • Eliminate distracting noises
  • Expose body part being auscultated
  • Use diaphragm for high-pitched sounds, bell for low-pitched sounds
• Positioning the Client:

  • Sitting Position:
  • Good for evaluating various body parts
  • Supine Position:
  • Legs together, head may have a pillow
  • Dorsal Recumbent Position:
  • Knees bent, feet flat
  • Sims' Position:
  • Useful for assessing rectal and vaginal areas
  • Standing Position:
  • Assesses posture, balance, gait
  • Prone Position:
  • Used to assess hip joint
  • Knee Chest Position:
  • Useful for examining the rectum
  • Lithotomy Position:
  • Used to examine female genitalia, reproductive tracts, and rectum