HA

• Areas of basic knowledge required for physical examination skills

  • Types and operation of equipment needed for the particular examination
  • Preparation of the setting, oneself, and the client for the physical assessment
  • Performance of the four examination techniques: inspection, palpation, percussion, and auscultation
• How well you prepare the physical setting, yourself, and the client can affect the quality of the data you elicit
• Conditions for the examination setting

  • Comfortable warm room temperature
  • Private area free of interruptions from others
  • Quiet area free of distractions
  • Adequate lighting
  • Firm examination table or bed at a height that prevents stooping
  • A bedside table/tray to hold the equipment needed for the examination
• It is helpful to assess your own feelings and anxieties before examining the client
• Anxiety is easily conveyed to the client, who may already feel uneasy and self-conscious about the examination
• General principles to keep in mind while performing a physical assessment
• Wash your hands before beginning the examination, immediately after accidental direct contact with blood or other body fluids, and after completing the physical examination or after removing gloves
• Always wear gloves if there is a chance that you will come in direct contact with blood or other body fluids
• Wear a mask and protective eye goggles if you are performing an examination in which you are likely to be splashed with blood or other body fluid droplets
• Methods for cleaning hands

  • Hand washing
  • Antiseptic hand wash
  • Antiseptic hand rub
  • Surgical hand antisepsis
• Cleaning your hands reduces the spread of potentially deadly germs to clients, the risk of health care provider colonization or infection caused by germs acquired from the client
• Alcohol-based hand sanitizers are the most effective products for reducing the number of germs
• Benefits of cleaning hands

  • Reduces the spread of potentially deadly germs to clients
  • Reduces the risk of health care provider colonization or infection caused by germs acquired from the client
• Effectiveness of alcohol-based hand sanitizers

  • Most effective products for reducing the number of germs on the hands of health care providers
  • Preferred method for cleaning hands in most clinical situations
• Steps for cleaning hands with alcohol-based hand sanitizer


  Put product on hands and rub hands together; Cover all surfaces until hands feel dry; This should take around 20 seconds
• Times to wash hands with soap and water


  When hands are visibly dirty, before eating, after using the restroom
• Times to clean hands with soap and water

  Immediately before touching a client, Before performing an aseptic task, Before moving from work on a soiled body site to a clean body site, After touching a client or the client's immediate environment, After contact with blood, body fluids, or contaminated surfaces, Immediately after glove removal
• Steps for cleaning hands with soap and water

  Wet hands with water, apply the recommended amount of product, rub hands together vigorously for at least 15 seconds, cover all surfaces of the hands and fingers, rinse hands with water and dry, use a towel to turn off the faucet, avoid using hot water to prevent drying of skin
• Using an alcohol-based hand sanitizer
• Either 15 or 20 seconds is acceptable for cleaning hands with soap and water, the focus should be on cleaning hands at the right times
• Gloves are not a substitute for hand hygiene
• When to wear gloves and perform hand hygiene

  Prior to donning gloves, Before touching the client or the client environment, Immediately after removing gloves
• When to change gloves and perform hand hygiene

  If gloves become damaged, If gloves become visibly soiled with blood or body fluids, Moving from work on a soiled body site to a clean body site, or if another clinical indication for hand hygiene occurs
• Preventing hand contamination


  Change gloves and perform hand hygiene during client care, Never wear the same pair of gloves for more than one client, Carefully remove gloves to prevent hand contamination
• Lotions and creams can prevent and decrease skin dryness from cleaning hands
• Use only hand lotions approved by the health care facility to not interfere with hand-sanitizing products
• Health care providers are recommended not to wear artificial fingernails or extensions when having direct contact with high-risk clients
• Keep natural nail tips less than ¼ inch long
• Studies have shown that skin underneath rings contain more germs than comparable areas of skin on fingers without rings
• Measures to contain respiratory secretions for individuals with signs and symptoms of a respiratory infection
• Further studies are needed to determine whether wearing rings results in an increased spread of potentially deadly germs
• Recommended measures to contain respiratory secretions

  • Cover your mouth and nose with a tissue when coughing or sneezing
  • Use the nearest waste receptacle to dispose of the tissue after use
  • Perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic hand wash) after having contact with respiratory secretion & contaminated objects/materials
  • Health care facilities should ensure the availability of materials for adhering to respiratory hygiene/cough etiquette in waiting areas for clients and visitors
  • Provide tissues and no-touch receptacles for used tissue disposal
  • Provide conveniently located dispensers of alcohol-based hand rub; where sinks are available, ensure that supplies for hand washing (i.e., soap, disposable towels) are consistently available
• It establishes the nurse-client relationship


  During the client interview before physical examination takes place
• It helps alleviate any tension or anxiety that the client is experiencing
• Group 3 members


  • Balindan
  • Bueno
  • Cuba
  • Dimanarig
  • Manlapaz
  • Gonzaga
  • Nilayan
  • Paloyo
  • Suñas
  • Trillanes
• Preparing the client


  1. Consider the physiological and psychological needs of the patient

  2. Explain the process and importance of physical examination to the patient

  3. Explain the physical assessment

  4. Ask the client to sign a consent form before physical examination

  5. Answer patient questions directly and honestly

  6. Begin the examination with the less intrusive procedures such as measuring the client's temperature, pulse, blood pressure, height and weight

  7. Integrate health teaching and health promotion during the physical examination

  8. Ask the client to change positions frequently, depending on the part of the examination being performed
• Preparing the environment for physical assessment

  1. Agree upon a time for the assessment

  2. Patient should be as free of pain as possible

  3. Provide a gown and drape for the patient

  4. Gather the supplies and instruments needed for the assessment

  5. Provide a curtain or screen if the area is open to others

  6. The client should sit upright on the side of the examination table. In the home or office setting, the client can sit on the edge of a chair or bed

  7. Ask the client to lie down with the legs together on the examination table (or bed if in a home setting). A small pillow may be placed under the head to promote comfort. If the client has trouble breathing, the head of the bed may need to be raised

  8. The client lies down on the examination table or bed with the knees bent, the legs separated, and the feet flat on the table or the bed
• Comfortable positions for clients with pain in the back or abdomen


  May be more comfortable than the supine positions
• Areas that may be assessed in a specific position

  Head, neck, chest, axillae, lungs, heart, extremities, breasts, peripheral pulses
• The abdomen should not be assessed in a specific position because the abdominal muscles are contracted