7/28/2019 Approach to the Physical Assessment

1/24

7/28/2019 Approach to the Physical Assessment

2/24

Discuss the purpose of the physicalassessment.

Differentiate a complete from a focused

physical assessment. Differentiate nursing physical assessment

from medical physical assessment.

Identify the tools used during a physical

assessment.

7/28/2019 Approach to the Physical Assessment

3/24

Define physical assessment techniques. Demonstrate physical assessment

techniques.

Discuss variations in approaches fordifferent age groups.

Define the components of the physicalassessment.

7/28/2019 Approach to the Physical Assessment

4/24

Provides an objective data base Identifies actual/potential health problems

Identifies patients strengths

Validates history data

7/28/2019 Approach to the Physical Assessment

5/24

Complete Focused

Which type do you do?

Reason for performing examination Patients condition

Amount of time

7/28/2019 Approach to the Physical Assessment

6/24

General survey Measurements

Vital signs

Height

Weight

Head-to-toe, including all systems

7/28/2019 Approach to the Physical Assessment

7/24

Thermometer Doppler

Pen light

Otoscope

Stethoscope Visual acuity charts

Ophthalmoscope

Nasoscope

7/28/2019 Approach to the Physical Assessment

8/24

Transilluminator Tape measure

Goniometer

Triceps skinfoldcalipers

Ruler Scale

Tongue depressor

7/28/2019 Approach to the Physical Assessment

9/24

Cotton balls Cup of water

Safety pins or

toothpicks Substances for

smell and taste

Test tubes Coin

Gloves

7/28/2019 Approach to the Physical Assessment

10/24

Lubricant Specula

Cytology brush and scraper

Slides Hemoccult test

7/28/2019 Approach to the Physical Assessment

11/24

Inspection Palpation

Percussion

Auscultation

7/28/2019 Approach to the Physical Assessment

12/24

Types Direct, indirect

Senses Sight, smell

What can inspection tell you? Surface characteristics

Symmetry Gross abnormalities or signs of distress

Unusual odors

7/28/2019 Approach to the Physical Assessment

13/24

Types Single-handed, bimanual

Senses Touch Light: < 1/2 inch

Deep: > 1/2 inch

Ballottement: used to assess partially free-floating objects

7/28/2019 Approach to the Physical Assessment

14/24

Dorsal aspectBest for temperature

Balls & ulnar surface of handBest for vibrations

FingertipsBest for fine sensations

7/28/2019 Approach to the Physical Assessment

15/24

What can palpation tell you?

LightSurface characteristicsDeepOrgans, masses, tendernessBallottementSize, shape of free-floating objects

7/28/2019 Approach to the Physical Assessment

16/24

Types Direct (immediate) Indirect (mediate)

Fist or bluntSenses Touch

Hearing

7/28/2019 Approach to the Physical Assessment

17/24

What can percussion tell you?

Direct or indirect Density (air, fluid, solid)

Size and shape

Tenderness

Deep tendon reflexesFist or blunt Tenderness

7/28/2019 Approach to the Physical Assessment

18/24

Types Direct, indirect: stethoscope

Senses Hearing

What can auscultation tell you? Heart sounds

Lung sounds Bowel sounds

Vascular sounds

7/28/2019 Approach to the Physical Assessment

19/24

System or region Be systematic.

Minimize position change.

Expose only the area being assessed.

7/28/2019 Approach to the Physical Assessment

20/24

Explain as you go. Share findings with patient and teach.

Ensure privacy and confidentiality.

Consider developmental level of patient. Consider cultural background of patient.

7/28/2019 Approach to the Physical Assessment

21/24

Age: actual andapparent

Race

Level ofconsciousness

Obviousabnormalities or

signs of distress

Gender Affect

Dress

Speech Posture

7/28/2019 Approach to the Physical Assessment

22/24

Temperature Respirations

Height

Pulse Blood pressure

Weight

7/28/2019 Approach to the Physical Assessment

23/24

Integumentary Breast

Cardiovascular

Musculoskeletal Genitourinary/repro

ductive

HEENT Respiratory

Gastrointestinal

Neurological

7/28/2019 Approach to the Physical Assessment

24/24

Accurately Concisely

Objectively

Record by systems Chart pertinent negatives