Overview of Physical Assessment Chapter 13 PNU 145
- Slides: 31
Overview of Physical Assessment Chapter 13 PNU 145 Bethann Davis RNC/NP MSN
Learning Objectives • List the four purposes of a physical assessment. • Name and define four assessment techniques. Inspection Percussion Palpation Auscultation
Learning Objectives (cont) • Identify a head-to-toe approach to physical assessment. • Define Accommodation Capillary refill Edema
Learning Objectives (cont) • Describe the sequence of a lung assessment. • Define Adventitious sounds Crackles Gurgles Wheezes • Describe appropriate way to assess the abdomen.
Overview of Assessment Purposes 1. Evaluate current physical condition 2. Detect early health problems 3. Establish a baseline 4. Evaluate client’s responses to interventions
Overview of Assessment • Assessment techniques • Inspection • Percussion • Palpation • Auscultation
Overview of Assessment • Inspection: Systematic observation
Overview of Assessment • Percussion: striking one object against another to produce vibration and sounds – usually fingers are used
Overview of Assessment • Palpation: light touch using hands and fingers
Overview of Assessment • Auscultation: listening to sounds - with a stethoscope
Overview of Assessment • General areas of assessment head & neck chest extremities abdomen genitalia anus/rectum
Overview of Assessment • “Head-to-toe” Assessment Ht/Wt vital signs
Overview of Assessment • Mental status assessment • Determine if client alert & oriented • Does client remember what you say to them
Overview of Assessment • Neurological Assessment level of consciousness (LOC) alert lethargic
Overview of Assessment level of consciousness (cont) stuporous comatose
Overview of Assessment • Orientation document: alert & oriented x’s 3 person, place, time
Overview of Assessment • Pupil response size equality response to light accommodation
Overview of Assessment • Lung assessment inspect: palpate:
Overview of Assessment • Lung assessment (cont) percuss: auscultate:
Overview of Assessment • Abnormal lung sounds • Crackles (rales): high pitched popping sounds heard primarily during inspiration Gurgles (rhonchi): low pitched continuous bubbling sounds heard during expiration.
Overview of Assessment • Wheezing: whistling or squeaking sounds, during inspiration or expiration may be heard without a stethoscope
Overview of Assessment • Extremities assessment: Muscle strength Motor Responses • Hand grasps, feet pushes Equal, unequal, strong, weak
Overview of Assessment • Extremities assessment (cont) Nails capillary refill
Overview of Assessment • Extremities assessment (cont) Edema: pitting dependent
Overview of Assessment • Extremities assessment (cont) Sensory responses: touch, pinch skin deep response – pinch mid chest or achillis tendon
Overview of Assessment • Abdominal Assessment 4 quadrants: RUQ, RLQ, LUQ Inspect: auscultate:
Overview of Assessment • Abdominal Assessment (cont) palpation: percussion:
Overview of Assessment • Abdominal Assessment (cont) Abdominal girth: measure abdomen, same site, same time of day
Overview of Assessment • Genitalia, anal, rectal assessments
General Considerations Make sure client has glasses/hearing aid in place if needed Explain everything you are going to do. Make sure client understands your terminology.
General Considerations When positioning client, be aware of any physical limitations. Set a time limit with your client for the examination.