Ch. 8 - Answer-Assessment Techniques and Safety in the Clinical Setting
Health history provides - Answer-Subjective data for health assessment
Objective data (the signs perceived by examiner through physical examination)
Skills performed one at a time, in this order: - Answer-Inspection
Palpation
Percussion
Auscultation
Inspection - Answer-Close, careful scrutiny, first of individual as a whole and then of each body system
Begins when you first meet person with a general survey
,As you proceed through examination, start assessment of each body system with inspection
Inspection always comes first
Inspection requires
Good lighting
Adequate exposure
Occasional use of instruments, including otoscope, ophthalmoscope, penlight, or nasal and vaginal
specula, to enlarge your view
Palpation - Answer-Palpation applies sense of touch to assess the following:
Texture
Temperature
Moisture
Organ location and size
Swelling, vibration, or pulsation
Rigidity or spasticity
Crepitation
Presence of lumps or masses
Presence of tenderness or pain
Palpation Techniques - Answer-Different parts of hands are best suited for assessing different factors
Fingertips: best for fine tactile discrimination of skin texture, swelling, pulsation, determining presence
of lumps
, Fingers and thumb: detection of position, shape, and consistency of an organ or mass
Dorsa of hands and fingers: best for determining temperature because skin here is thinner than on
palms
Base of fingers or ulnar surface of hand: best for vibration
Bimanual Palpation - Answer-requires use of both hands to envelop or capture certain body parts or
organs, such as kidneys, uterus, or adnexa, for more precise delimitation
Percussion - Answer-Tapping person's skin with short, sharp strokes to assess underlying structures
Percussion has following uses:
Mapping location and size of organs
Signaling density of a structure by a characteristic note
Detecting a superficial abnormal mass
Percussion vibrations penetrate about 5 cm deep
Deeper mass would give no change in percussion
Eliciting pain if underlying structure is inflamed
Eliciting deep tendon reflex using percussion hammer
2 Methods of Percussion can be done - Answer-Direct, sometimes called immediate, the striking hand
directly contacts body wall
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