Health Assessment LAB

• General Physical Survey- study of a whole person, covering the general health state and any obvious physical characteristics.
• 4 Areas To Be Considered:

  1. Physical Appearance
  2. Body Structure
  3. Mobility
  4. Behavior
• Physical Appearance - traits or features about your body. These are the aspects that are visually apparent, knowing nothing else about the person.
• Physical Appearance- include age, sex, level of consciousness, skin, facial features, ovearll
• Body Structure - include stature, nutrition, symmetry, posture, position and body build, contour.
• Mobility - Gait ( manner of walking) and Range of Motion
• Behavior - include Facial Expression, Mood and Affect, Speech, Dress, and Personal Hygiene
• B. Measurement

  Weight -use a standardized weighing scale. Best indicator of patient's nutritional status.
• B. Measurements

  Unexplained weight loss may be a sign of an illness.
• B. Measurements

  Obesity affect's a person's health and may increase risk for a certain chronic illness.
• B. Measurements

  Height - use a well- mounted device or the measuring pole on the balance scale.
• B. Measurements

  BMI - Body Mass Index
• B. Measurements

  Body Mass Index- practical marker of optimal weight for height and indicator of obesity or CHON- calorie malnutrition.
• BMI INTERPRETATION

  Below 18.5 = underweight

  18.5-24.9 = normal weight

  25.0-29.9 = overweight

  30.0- 39.9 = obesity

  40.0 and above = extreme obesity

  2-20 years: 85th to 95th percentile = risk for overweight
• B. Measurements

  Waist -to-hip Ratio - ratio assesses body fat distribution as an indicator of health risk.
• B. Measurements

  Vital Signs ( Cardinal Signs) - physical sign that indicate an individual is alive, such as heart beat, breathing rate, temperature, blood pressure, and recently oxygen saturation.
• Observation - before diving in, take a minute or so to look at the patient in their entirety.
• Four primary vital signs which are standard in most medical settings:

  1. Body temperature
  2. Heart Rate or Pulse
  3. Respiratory rate
  4. Blood pressure
• Physical Assessment - requires an organized and systematic approach using the techniques of inspection, palpation, percussion and auscultation.
• Comprehensive patient assessment yields both subjective and objective findings.
• Subjective findings - obtained from the health history and body systems review.
• Objective findings- collected from the physical examination.
• BASIC TECHNIQUES IN PERFORMING A PHYSICAL ASSESSMENT

  Inspection - visual examination of a person.
• BASIC TECHNIQUES IN PERFORMING A PHYSICAL ASSESSMENT

  Palpation - examination by touch.
• Types of Palpation

  Light Palpation - to determine the surface variations ( e.g. texture, tenderness, temperature, moisture, elasticity, pulsations, superficial organs, masses). Techniques are depress skin ½ inch to ¾ inch with finger pads
• Types of Palpation

  Deep Palpation - to feel internal organs and masses for size, shape, tenderness, symmetry, mobility. Technique are depress skin 1 ½ inches to 2 inches with firm, deep pressure. May use one hand on top of the other to exert firmer pressure
• Types of Palpation

  Bimanual Palpation ( use with caution as it may provoke internal injury) - to palpate breasts and deep abdominal organs. Technique are use two hands, one on each side of body or organs being felt. the upper hand is used to apply pressure while the lower hand is used to detect deep structures.
• BASIC TECHNIQUES IN PERFORMING A PHYSICAL ASSESSMENT

  Auscultation - examine by listening for sounds produced within the body. Using a stethoscope.
• USES OF DIAPRAGM AND BELL OF STETHOSCOPE

  DIAPRAGM - to detect high-pitched sounds. Technique are press firmly on body parts
• USES OF DIAPRAGM AND BELL OF STETHOSCOPE

  Bell- to detect low-pitched sound. Technique are press lightly over body parts
• BASIC TECHNIQUES IN PERFORMING A PHYSICAL ASSESSMENT

  Percussion - examination of the body by tapping it with the fingers.
• Two Types of Percussion

  Direct Percussion - to elicit tenderness or pain. Technique are directly tap body part with one or two fingertips
• Two Types of Percussion

  Indirect Percussion - to elicit one of the following sounds over the chest or abdomen, tympany, resonance, hyper resonance, dullness, flatness. Technique are press middle finger of nondominant hand firmly on the body part
• Pain- is a sensation of physical or mental hurt or suffering that causes distress or agony to the one experiencing it.
• Theories of Pain

  Pattern Theory - states that pain is perceived whenever the stimulus is intense enough
• Theories of Pain

  Specificity Theory - states that there are specific nerve receptors for particular stimuli
• Theories of Pain

  Gate Control Theory - conceptualize that there is a great in the spinal cord called SUBSTANTIA GELATINOSA
• Theories of Pain

  Affect Theory - it avers that the pain is emotional. Intensity of pain perceived depends on the value of the organ affected to the individual
• Theories of Pain

  Parallel Processing Model- believes that the physiologic or neurologic deciphering of the pain sensation and cognitive emotional properties occur along different nerve fibers
• Pain Threshold - amount of pain stimulation a person requires be fired feeling pain. ( Also pain sensation). Generally, fairly uniform among people