PHYSICAL ASSESSMENT

• FOUR TECHNIQUES -

  • INSPECTION
  • PALPATION
  • PERCUSSION
  • AUSCULTATION
• INSPECTION - skill of observing the patient in a deliberate systematic manner, using the senses of vision, smell, and hearing to observe abnormal findings.
• PALPATION - is a skill assessing the client through the sense of touch determine the specific characteristics of the body.
• PALPATION -

  • FINGERPADS - pulses, texture, size, consistency, shape and crepitus.
• PALPATION -

  • DORSAL (BACK) SURFACE - temperature.
• 4 TYPES OF PALPATION -

  • LIGHT PALPATION - less than 1cm, uses this technique to feel the pulses, tenderness, surface skin texture, temperature and moisture.
• 4 TYPES OF PALPATION -

  • MODERATE PALPATION - 1 to 2cm, uses to assess most of the other structure of the body.
• 4 TYPES OF PALPATION -

  • DEEP PALPATION - 2 to 4cm, allows you to feel very deep organs or structures that are covered by thick muscle.
• 4 TYPES OF PALPATION -

  • BIMANUAL PALPATION - uses two hands, placing one on side of the body part to feel the structure, and another one hand to apply pressure.
• PERCUSSION - involves tapping body parts to produce sound waves. these sound waves enable the examiner to assess underlying structure.
• TYPES OF PERCUSSION -

  • DIRECT PERCUSSION - tapping the body with the fingertips of dominant hand, to elicit possible tenderness.
• TYPES OF PERCUSSION -

  • BLUNT PERCUSSION - used to detect tenderness over organs, by placing one hand flat on the body surface and using the fist of the other hand to strike to back of the hand.
• PERCUSSION SOUNDS -

  • TYMPANY - a loud, high pitched, drumlike tone. STOMACH.
• PERCUSSION SOUNDS -

  • RESONANCE - a loud, low-pitched, hollow tone. LUNGS.
• PERCUSSION SOUNDS -

  • HYPERRESONANCE - an abnormal loud, low tone, heard when the air is trapped.
• PERCUSSION SOUNDS -

  • DULLNESS - high pitched tone that is soft and short dullness. SOLID BODY ORGANS.
• PERCUSSION SOUNDS -

  • FLATNESS - high pitched tone, very soft and dullness. SOLID TISSUE SUCH AS MUSCLE AND BONE.
• AUSCULTATION - the skill of listening to the sound produced by the body, requires a quiet environment in which the nurse listen not just the presence or absence of sounds, but also for the characteristics of each sound.
• BELL SIDE - detect low-pitches sound.
• DIAPHRAGM SIDE - detect high-pitched sound.
• OBJECTIVE DATA - collecting this is essential for complete nursing assessment, nurse must have knowledge and skill in three basic areas to become proficient.