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What is inspection ?
- Use of sight to gather data
- Movement, gait, hygiene, behavior...
- 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
- Tapping fingers on skin (short strokes)
- For ovation, size, density
- Abdomen, lungs
- Direct percussion : with fingers on skin
- Indirect percussion with 2 hands
- 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)
- 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
How treat infants
- Patent can hold during examination
- Otherwise on padded examination table (no fall)
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
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 :-)
How treat school age children ?
Demonstrate equipment and communicate, opportunity to teach kid something new
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)
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
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