Term
| What order do you perform "physical exam"? |
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Definition
Inspection
Palpation
Percussion
Auscultation |
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Term
| Where do you change the order in which you perform the "physical exam"? |
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Definition
Abdomen: order is as follows:
Inspection
Auscultation
Palpation
Percussion |
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Term
| Why do you Auscultate the abdomen before you palpate or percuss? |
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Definition
| When you palpate and percuss the bowels you may stimulate bowel movements that does not represent the true state of the bowels. You want to listen to the bowels "as they are." |
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Term
| When does inspection begin? |
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Definition
| When you first enter a patients room or meet the patient. You are taking a "general survey". |
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Term
| What could you do to train yourself not to "rush" into the assessment and remind yourself to thoroughly inspect the patient? |
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Definition
| Perform inspection while holding your hands behind your back |
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Term
| True or False: You should be inspecting for a person's symmetry by comparing the right and left side of the body. |
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Definition
| True. The two side should be nearly symmetric. |
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Term
| When you are palpating, what might you be searching for? (15 to list) |
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Definition
| texture, temperature, moisture, organ size, organ location, swelling, vibration, pulsations, spasticity (twitching (spastic)), crepitation, lumps, masses, tenderness, pain |
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Term
| What part of your hand is best for tactile discrimination? (Such as texture, swelling, determining lumps and masses?) |
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Definition
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Term
| What part of the hand is best for determining temperature? |
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Definition
| Back of hand (dorsum of hand) |
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Term
| What part of the hand is best for feeling vibration? |
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Definition
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Term
| If someone tells you they are having pain in their right abdomen before you begin palpation, what should you do? |
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Definition
| Start at the location furthest away from the pain and using light palpation at first work in the direction of the pain. Noting where the pain begins. |
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Term
| True or False: You should avoid any situation where deep palpation could cause internal pain or injury. |
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Definition
| TRUE! DO not hurt the patient! Also, if there is a rupture, deep palpation could make things worse! |
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Term
| Percussion is used for many reasons! Name 4. |
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Definition
1. It is free. Your hands are portable and with you everywhere. And gives instant feedback.
2.Allows you to map out location and size of certain organs.
3.Signals the density of a structure by a characteristic tone (air, fluid, solid)
4. Detect abnormal mass that is fairly superficial
5. Elicit pain if underlying tissue is inflamed. |
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Term
| What type of percussion are you using when you directly tap on a patients sinuses? |
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Definition
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Term
| What type of percussion are you using if you use the index finger of one hand and use a "striker" finger of your other hand? |
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Definition
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Term
| What sound do you hear if you percuss over bone? |
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Definition
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Term
| What sound would you expect to find over "normal lung tissue?" (while percussing) |
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Definition
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Term
| What sound would you expect to find over a child's lung tissue or in someone with an increased amount of air in lungs? (while percussing) |
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Definition
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Term
| Where would you expect to hear "tympany" during a physical exam? (while percussing) |
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Definition
| Air-filled viscus: stomach and intestines |
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Term
| Where would you expect to hear dull sounds (while percussing)? |
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Definition
| Dense organs: spleen or liver |
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Term
| What end of the stethoscope would you use to listen for heart murmurs or extra heart sounds? |
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Definition
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Term
| Why should you press gently when listening with the bell? |
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Definition
| If you press too hard, the bell will act as a diaphragm and obliterate low pitched sounds |
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Term
| When should you use the diaphragm? |
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Definition
| When listening to normal heart sounds, lung sounds, and bowel sounds. |
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Term
| How often should you clean your stethoscope? |
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Definition
| Before each use and between patients. |
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Term
| You are auscultating the chest of a very hairy man who has come to your clinic with sprained ankle. Upon listening, you determine that man sounds like he has crackles in his lungs. What should you do next in this situation? |
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Definition
| Wet the man's chest hair and listen again. A hairy chest may causes sounds that resemble the abnormal breath sound of "crackles". |
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Term
| What instrument should you use to examine a patients otitis media? |
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Definition
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Term
| The doctor has asked you to bring him an opthalmoscope. You know that he will be examining what part of the patient? |
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Definition
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Term
| True or false: You should wear eye protection, a mask, and gown when drawing blood from a healthy patients brachial artery? |
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Definition
| False. You only need to wear this PPE when you anticipate there could be splashes of a patients body fluids. This needle stick should be uneventful. |
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Term
| True or false. Recap a used needle before placing it in the sharps container? |
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Definition
| False. Never recap a used needle. |
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Term
| What type of precautions should you use with all patients? |
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Definition
| Standard precautions. You should assume that all patients could have AIDS/HIV or similar disease (for your safety!) |
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Term
| What is the single most important measure you can take to decrease the risk of microorganism transmission to yourself or others? |
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Definition
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Term
| How longer should you wash your hands? (in seconds) |
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Definition
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Term
| What is the major developmental task for the infant? How might this affect your ability to perform an exam? |
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Definition
| Trust. Parent should always be present. Smile. Use a soft crooning voice, Bright colored toys for distraction. Pacifier. |
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Term
| When should you elicit the Moro or startle exam on an infant? |
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Definition
| Last! This may make the infant cry... and then how can you do the rest of the exam? |
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Term
| What age groups should you perform the "Eye,Ear, nose and throat" exam until last? |
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Definition
| Infant, toddler, preschooler. |
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Term
| The developmental stage for the toddler is what? |
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Definition
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Term
| Developmental stage for the preschool child? |
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Definition
| Initiative. Usually cooperative, helpful and easy to involve. |
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Term
| School age child's stage of development? |
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Definition
| Developing industry. Perform exam from head to toes. |
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Term
| Adolescent major developmental task? How will this effect how you perform an exam? |
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Definition
| Self-identity. Use a head to toe approach but do genital exam LAST and be brief. |
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Term
| If you are performing an exam on an ill person, you may do a "mini" or focused exam which is problem focused and complete a full assessment after distress is resolved. |
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Definition
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Term
| In examining persons across the lifespan, it is important to consider: |
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Definition
1.the developmental stage when determining the sequence of the exam.
2.privacy for all ages.
3.pacing the examination to meet the physical, mental, and emotional needs of the aging adult. |
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Term
| What technique is used to elicit the deep tendon reflex? |
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Definition
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Term
| Fundoscopic exam is an exam of the? |
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Definition
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Term
| At the end of the exam, the nurse should: |
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Definition
| Review findings with the patient. |
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Term
| What must be considered when examining the older adult? |
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Definition
1. Base the pace of the examination on the patient's individual needs and abilities.
2. Use physical touch to offset the disadvantages of diminishing vision and hearing.
3. Beware that loss is inevitable and adaptation to loss affects health status. |
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