Health assessment

• Sitting Position

  This position is good for evaluating the head, neck, lungs, chest, back, breasts, axillae, heart, vital signs, and upper extremities.
• Supine Position

  This position allows the abdominal muscles to relax and provides easy access to peripheral pulse sites.

  Areas assessed with the client in this position may include head, neck, chest, breasts, axillae, abdomen, heart, lungs, and all extremities.
• Dorsal Recumbent Position

  This position may be more comfortable than the supine position for clients with pain in the back or abdomen.

  Areas that may be assessed with the client in this position include head, neck, chest, axillae, lungs, heart, extremities, breasts, and peripheral pulses.
• SIMS’ Position

  This position is useful for assessing the rectal and vaginal areas.
• Standing Position

  This position allows the examiner to assess posture, balance, and gait.

  This position is also used for examining the male genitalia.
• Prone Position

  The prone position is used primarily to assess the hip joint.

  The back can also be assessed with the client in this position.
• Knee–Chest Position

  useful for examining the rectum.
• Lithotomy Position

  used to examine the female genitalia, reproductive tracts, and the rectum.
• methods of examining

  • inspection
  • palpation
  • percussion
  • auscultation
• 1. INSPECTION

   involves using the senses of vision, smell, and hearing to observe and detect any normal or abnormal findings

  -Moisture

  -Color

  -Texture

  -Shape

  -Position

  -Size

  -Symmetry of the body
• 1. PALPATION

  using parts of the hand to touch and feel for the following characteristics

  texture(rough/smooth)

  temperature (warm/cold),

  moisture (dry/wet),

  Mobility (fixed/movable/still/ vibrating)

  consistency (soft/hard/fluid filled),

  strength of pulses (strong/weak/thready/bounding),

  size(small/medium/large)

  shape (well defined/irregular),

  degree of tenderness.
• LIGHT PALPATION

  To perform this, place your dominant hand lightly on the surface of the structure. Use this technique to feel for pulses, tenderness, surface skin texture, temperature, and moisture
• MODERATE PALPATION

  Depress the skin surface 1 to 2 cm (0.5 to 0.75 inch) with your dominant hand, and use a circular motion to feel for easily palpable body organs and masses.
• DEEP PALPATION

  Place your dominant hand on the skin surface and your nondominant hand on top of your dominant hand to apply pressure

  This allows you to feel very deep organs or structures that are covered by thick muscle.
• BIMANUAL PALPATION

  Use two hands, placing one on each side of the body part (e.g., uterus, breasts, spleen) being palpated

  Use one hand to apply pressure and the other hand to feel the structure.
• PERCUSSION

  Act of striking the body surface to elicit sounds that can be heard or vibrations that can be felt
• Direct percussion

  is the direct tapping of a body part with one or two fingertips to elicit possible tenderness (e.g., tenderness over the sinuses).
• Blunt percussion

  is used to detect tenderness over organs (e.g., kidneys) by placing one hand flat on the body surface and using the fist of the other hand to strike the back of the hand flat on the body surface.
• Indirect percussion

  is the most commonly used method of percussion. The tapping done with this type of percussion produces a sound or tone that varies with the density of underlying structures
• PLEXIMETER

  Middle finger of the non-dominant hand
• PLEXOR

  Tip of the flexed middle finger of the other hand and will strike the pleximeter
• Flatness sound

  Extremely dull sound or very dense (muscle/ bone)
• Dullness sound

  Thudlike sound (liver, spleen, heart)
• Resonance sound

  Hollow sound (lungs filled with air-normal sound)
• Hyperresonance sound

  Not normal-booming sound (emphysematous lungs)
• Tympany sound

  Drumlike sound (airfilled stomach)
• AUSCULTATION

  Listening to sounds produced within the body
• PITCH

  Frequency of vibrations
•  INTENSITY

  Loudness/softness of a sound
• DURATION

  length
• QUALITY

  Subjective description (whistling, gurgling, snapping)
• PALLOR

  Absence of underlying red tones

  Most evident in conjunctiva, oral mucous membranes, nail beds, palm of the hands and soles of the feet. Indicates anemia, illness, emotional shock/stress
• CYANOSIS

  Bluish tinge

  Most evident in nail beds, lips, buccal mucosa

  Indicates low oxygen levels in RBC
• JAUNDICE

  Yellowish-tinge

  Most evident in sclera, mucous membranes, skin

  Increase amount of bilirubin in the blood
• ERYTHEMA

  Redness associated with variety of rashes
• HYPERPIGMENTATION

  increase melanin (birthmark)
• HYPOPIGMENTATION-VITILIGO

  Patches of hypopigmented skin

   Destruction of melanocytes
• ALBINISM

  Complete/partial lack of melanin
• Striae (sometimes called stretch marks)
• Seborrheic keratosis, a warty or crusty pigmented lesion