Assessment and Technique and Safety in the Clinical Setting (Chapter 8)

Question 1

what is inspection

Answer 1

Careful, through observations

Question 2

what is the very first step of the assessment process

Answer 2

inspection

Question 3

when does inspection process begin

Answer 3

moment you meet individual

Question 4

why do we compare patients right side with left side

Answer 4

looking for similarities, differences, and symmetry

Question 5

we want to use good

Answer 5

lighting

Question 6

what tools will we use

Answer 6

penlight, oto, opthalmoscope

Question 7

what can change sounds

Answer 7

listening over clothing

Question 8

palpation uses the sense of

Answer 8

touch

Question 9

what do we assess during palpation

Answer 9

texture, temp, moisture, organ location and size

Question 10

can we determine the disease state of an organ by palpating

Answer 10

no

Question 11

we can detect what during palpation

Answer 11

swelling, vibration, pulsation, rigidity, crepitation, lump, mass, tenderness, or pain

Question 12

light palpation

Answer 12

use to detect surface characteristics

Question 13

deep palpation

Answer 13

use intermittent pressure to examine abdominal contents

Question 14

what type of palpations do we start with

Answer 14

light and then do deep

Question 15

what do we use fingertips for during palpation

Answer 15

fine discrimination such as texture, swelling, pulsation, presence of lumps

Question 16

what do we use a grasping action for during palpation

Answer 16

finger and thumb can be used to detect shape, size, position, and consistency of an organ

Question 17

what do we use the base of fingers for during palpation

Answer 17

ulnar surface to detect vibration

Question 18

what do we use the dorm of our hands for during palpation

Answer 18

detect temp changes

Question 19

why would we do bimanual palpation

Answer 19

compare both sides

Question 20

why would we use the dorm of hand for temp

Answer 20

thinner skin and more sensitive

Question 21

during palpation we want to ask the patient if there are any tender areas and palpate these areas

Answer 21

LAST

Question 22

why do we want to palpate tender areas last

Answer 22

this could change vital signs

Question 23

we can’t treat if we do not know so ask if in

Answer 23

pain

Question 24

flow of palpation

Answer 24

top to bottom
left to right
Simultaneously
compare symmetry

Question 25

what are some common areas of palpation

Answer 25

lymph nodes (neck) simultaneous sinuses (simultaneous) abdomen (clockwise pattern) Quadrants spine (top to bottom) pulses (simultaneous right and left or individually) uterus (bimanual) heart (fingertips over precordium)

Question 26

if there is no vibration in fistula what do we call it

Answer 26

dead fistula

Question 27

characteristics assessed by palpation

Answer 27

texture temp moisture organ location and size swelling vibration or pulsation rigidity crepitation presence of lumps or massess presence of tenderness or pain

Question 28

what is the 3rd step after palpation

Answer 28

percussion

Question 29

percussion

Answer 29

tapping the skin with short, sharp strokes that produce a vibration to assess underlying structures

Question 30

percussion emits a sound that depicts

Answer 30

size, location, density of an organ

Question 31

percussion mapping location and size

Answer 31

sound will change as you move off/away from an organ

Question 32

percussion density

Answer 32

sound will change as you precise over air, fluid, or solid structures

Question 33

abnormal mass can be detected up to ___ cm deep

Answer 33

5

Question 34

pain can detect underlying

Answer 34

inflammation

Question 35

tendon cen elicit a _______ _______ ________

Answer 35

deep tendon reflex

Question 36

how does the stationary hand look during percussion

Answer 36

hyperextend middle finger place distal portion firmly against skin lift the rest of the hand off the skin to avoid dampening vibrations

Question 37

how does the striking hand look during perucssion

Answer 37

use the tip of the middle finger of dominant hand to strike 2 times place forearm close to skin keep upper arm and shoulder steady action is all in wrist bounce your middle finger off the stationary finger just behind the nail bed, lift off quickly use enough force to get clear note move systematically

Question 38

how will structures with more air sound

Answer 38

louder, longer, deeper sound because it can vibrate freely (ex: lungs)

Question 39

denser, more solid structures will sound like

Answer 39

softer, higher, shorter because they cannot vibrate easily (ex: liver)

Question 40

resonant

Answer 40

over lung fields, sound clear and hollow

Question 41

hyperresonant

Answer 41

over child lungs or COPD

Question 42

tympany

Answer 42

over abdomen (air filled areas) sounds drum like

Question 43

dull

Answer 43

over organs (liver) sounds like a muffled thud

Question 44

flat

Answer 44

over bone, muscle, tumor, sounds come to a dead stop

Question 45

Diaphragm of the stethoscope is used to detect what

Answer 45

high pitched sounds (lungs, abdomen, heart)

Question 46

bell is red to detect

Answer 46

low pitched sounds (vascular sounds, extra, heart sounds) soft

Question 47

what do we want to do before placing stethoscope on patient

Answer 47

clean with alcohol and warm it

Question 48

how should the ear pieces face

Answer 48

toward your nose

Question 49

how do we place the diaphragm

Answer 49

place firmly

Question 50

how do we place the bell

Answer 50

place lightly

Question 51

what side do we want to preform the exam on

Answer 51

right side of patient

Question 52

for the older adult we want to go at a ____ pace

Answer 52

slow

Question 53

older adults may need what in between areas of exams

Answer 53

rest periods

Question 54

the bell of the stethoscope A. is used for soft, low pitched sounds B. is used for high pitched sounds C. is held firmly against the skin D. magnifies sound

Answer 54

A

Question 55

which of the following techniques used the sense of touch when assessing a patient A. palpation B. Inspection C. Percussion D. Ascultation

Answer 55

A

Question 56

what is the order for the full exam

Answer 56

inspection palpation percussion auscultation