Health & Physical Assessment in Nursing

First Edition

Donita DAmico
and

Colleen Barbarito

Chapter 6
Techniques and Equipment
Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Four Basic Techniques of Physical Assessment
Inspection Palpation Percussion Auscultation
2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

LEARNING OBJECTIVE ONE

Inspection

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.1

Inspection of client.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Palpation
Characteristics
Size Shape Location Mobility Position

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Palpation
Characteristics
Vibrations Temperature Texture Moisture Tenderness Edema

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.2

Sensitive areas of the hand.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Palpation
Light

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.3

Light palpation.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Palpation
Moderate

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.4

Moderate palpation.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Palpation
Deep

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.5

Deep palpation.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Percussion
Methods
Direct

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.6

Direct percussion.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Percussion
Methods
Blunt

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.7

Blunt percussion.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Percussion
Methods
Indirect

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.8

Indirect percussion.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Percussion Sounds
Tympany Resonance Hyperresonance Dullness Flatness
2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

LEARNING OBJECTIVE ONE

Characteristics of Percussion Sounds
Intensity or amplitude Pitch or frequency Duration Quality

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Auscultation
Sounds
Intensity Pitch Duration Quality
2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

LEARNING OBJECTIVE TWO

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE TWO

Equipment used During Physical Assessment
Stethoscope Doppler ultrasonic stethoscope Ophthalmoscope Otoscope
2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

Table 6.1

Equipment Used During the Physical Assessment

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Table 6.1 (continued)

Equipment Used During the Physical Assessment

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Table 6.1 (continued)

Equipment Used During the Physical Assessment

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Table 6.1 (continued)

Equipment Used During the Physical Assessment

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE TWO

Stethoscope
Bell Diaphragm

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.9 (right).

A. Stethoscope with both a bell-shaped and flat-disc amplifier. B. Close-up of a flat-disc amplifier (left) and a bell amplifier

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.9 (continued) bell amplifier (right).

A. Stethoscope with both a bell-shaped and flat-disc amplifier. B. Close-up of a flat-disc amplifier (left) and a

B
Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.10

Nurse using a stethoscope.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE TWO

Doppler Ultrasonic Stethoscope

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.11

Doppler ultrasonic stethoscope.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE TWO

Ophthalmoscope

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.12

Ophthalmoscope demonstrating aperture.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.13

Apertures of ophthalmoscope.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE TWO

Otoscope

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 6.14

Otoscope.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE THREE

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE THREE

Safe and Comfortable Environment for Physical Assessment
Comfort Warmth Privacy Standard precautions
2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

LEARNING OBJECTIVE THREE

Measures
Warm, private, distraction-free exam room Good overhead lighting with a portable lamp Clean, firm exam surface Knowledge of clients preferences for personal values and beliefs Decreasing clients anxiety Providing privacy and draping Handwashing Use of standard precautions Explanation of procedures

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE FOUR

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE FOUR

Critical Thinking and Physical Assessment
Organize data Analyze data Interpret findings

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE FIVE

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE FIVE

Standard Precautions - Guidelines to Protect the Client and Healthcare Workers

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE FIVE

Guidelines
Handwashing Gloves Protective barriers Disposal of sharps Cautionary handling of specimens Proper disposal of body wastes
2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito