Physical Assessment

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  1. What is inspection ?
    • Use of sight to gather data
    • Movement, gait, hygiene, behavior...
  2. palpation
    • Use of touch to gather date
    • Temperature, skin texture, edema, anatomical landmarks, areas of tenderness, masses
    • Fingertips for swelling, pulsation and masses
    • dorsum of hand for temperature
    • Palomar of hand for locating general area of pulsation
    • Grasping with fingers and thumb for position, shape, consistency of mass
  3. percussion
    • Tapping fingers on skin (short strokes)
    • For ovation, size, density
    • Abdomen, lungs
    • Direct percussion : with fingers on skin
    • Indirect percussion with 2 hands
  4. ausculation
    • Hearing to gather data
    • Direct auscultation : ear
    • Indirect auscultation : stethoscope
    • Diaphragm high pitched heart, lungs, abdomen
    • Bell low pitched heart murmurs, turbulent blood flow (bruits)
  5. olfaction
    • smell
    • Alcohol, urine, fruity or acetone -> ketoacidosis (reduced alkalinity in blood accom. With diabetes) assess urine for ketones, diet: high-protein, high fat and low carbohydrate could cause build up of ketones
  6. How treat infants
    • Patent can hold during examination
    • Otherwise on padded examination table (no fall)
  7. How treat toddlers ?
    • Can be on parent's lap
    • Exam ear and mouth last
    • Let them make choices, show their skills, have parents help and watch interaction, praise toddler for abilities and coordination
  8. How treat preschoolers ?
    • Demonstrate procedure if kid fearful on doll ...
    • Let child help with exam, can hold equipment, let them remember height and weight, praises, and reassurance "your lungs sound very healthy :-)
  9. How treat school age children ?
    Demonstrate equipment and communicate, opportunity to teach kid something new
  10. How treat adolescents ?
    • Is self-conscious and introspective, may wish to be examined in privacy (offer choice),
    • Often worry if they are normal
    • Discuss normal physiological changes
    • Teach about diet, alcohol, a..a.screen for depression and suicide risk (third leading cause of death)
  11. How to treat young and middle adults ?
    Mostly able to cooperate, do not need a modified approach. Modification may be required if patient has chronic or acute illness or cannot understand or follow instructions
  12. How treat older adults
    • Adjusting to changes in physical abilities and health
    • observe abilities, energy levels, provide rest
    • Be aware of stiff muscles, impaired vision and hearing, obtain feedback
    • SPICES sleep disorders, Problems with eating or feeding, incontinence, confusion, evidence of falls, skin breakdown
Card Set:
Physical Assessment
2014-01-25 20:42:24
Assessment physical examination

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