a. Is used to assess most of the other structures of the
body
b. For moderate palpation, the nurse uses moderate
pressure, places the palmar surface of the fingers of
the dominant hand over the structure to be assessed,
and presses downward approximately 1 to 2 cm
(0.25 to 0.5 in.), rotating the fingers in a circular
motion
c. Now the nurse can determine the depth, size, shape,
consistency, and mobility of organs as well as any
pain, tenderness, or pulsations that might be present
3. Deep palpation
a. Is used to palpate an organ that lies deep within a
body cavity such as the kidney, liver, or spleen, or
when overlying musculature is thick, tense, or rigid
such as in obesity or with abdominal guarding
b. The nurse should use more than moderate pressure
by placing the palmar surface of the fingers of the
dominant hand on the skin surface. The extended
fingers of the nondominant hand are placed over the
, fingers of the dominant hand, pressing and guiding
the fingers downward
c. This technique provides extra support and pressure
and allows the nurse to palpate at a deeper level
from 2 to 4 cm (0.75 to 1.5 in.). All palpation must
be used with caution; however, greatest caution
must be used with deep palpation
b. Direct and indirect percussion
i. Three methods of percussion can be used: direct percussion, blunt
percussion, and indirect percussion. The part of the body to be
percussed indicates the method to be used
ii. Direct percussion
1. Is the technique of tapping the body with the fingertips of
the dominant hand. It is used to examine the thorax of an
infant and to assess the sinuses of an adult
iii. Indirect percussion
1. Is the technique most commonly used because it produces
sounds that are clearer and more easily interpreted
2. To perform indirect percussion, the hyperextended middle
finger of the nondominant hand is placed firmly over the
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