Ch.8: Assessment Techniques and Safety in the Clinical Setting Flashcards

1
Q

The skills requisite for the physical examination. IN ORDER ARE

A

Inspection
Palpation
Percussion
Auscultation

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2
Q

Inspection:

A

ALWAYS COMES FIRST**
concentrated watching (whole then body systems)
begins the moment you first meet the person “general survey”
SYMMETRY

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3
Q

Palpation:

A

confirms points from previous step
sense of touch: texture, temp, moisture, organ location, and size, (Swelling, vibration, or pulsation, tenderness)
Technique: start with light palpation, accustom them to touch. Intermittent better*

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4
Q

Palpation techniques

A

fingertips- fine tactile discrimination (swelling, pulsation)
action of thumb and fingers- detect position/shape
dorsa of hands and fingers- temperature
base of fingers- best for vibrations

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5
Q

Percussion:

A

tapping the person’s skin with short, sharp strokes to assess underlying structures
Maps location and size of an organ, signaling density, detecting abnormal mass

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6
Q

Auscultation:

A

listening to the sounds produced by the body such as the heart and blood vessels and the lungs and abdomen
use of stethoscope

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7
Q

Diaphragm of stethoscope

A

flat edge-best for high pitch sounds, breath, bowel and normal heart sounds

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8
Q

Bell of stethoscope

A

deep, hollow, cup-like: best for low, soft pitched sounds such as extra heart sound or murmurs

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9
Q

Before listening to the body sounds, you must

A
eliminate extra room noise, 
make room warm, 
clean the stethoscope,
 friction(no-no), 
NEVER LISTEN THROUGH A GOWN,
 avoid you own "artifact"
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10
Q

funnels light into the ear Cana and onto the tympanic membrane.
Five specula each a different size are available to attach to the head. (short, broad-nares) & ( largest one- ear)

A

otoscope

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11
Q

illuminates the internal eye structure (small spot for undiluted pupils) & (large full spot for dilated pupils)

A

ophthalmoscope

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12
Q

measure range of motion

A

goniometer

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13
Q

augment pulse or blood pressure measurement

A

dopler sonometer

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14
Q

test sensation in the foot

A

monofilament

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15
Q

to asses urine retention

A

bladder scanner

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16
Q

True or false: you must clean your stethoscope end piece with an alcohol wipe only before every patient contact

A

FALSE:

Before and After every patient contact*** combine with hand hygiene routine

17
Q

HAND WASHING:

A

most important step to decrease risk of microorganism transmission
Wash BEFORE & AFTER every physical patient encounter / contact with blood& bodily fluids / contact with contaminated equipment / removing gloves
use when hands are visibly soiled / when patients are infected with spore forming organisms

18
Q

ALCOHOL USE:

A

more quickly and highly effective against gram-positive & negative bacteria

19
Q

TRUE OR FALSE: wearing gloves is NOT a protective substitute for washing hands.

A

TRUE:

because gloves may have undetectable or become torn during use or hands may become contaminated as gloves are removed

20
Q

General Approach:

A

an examiner must be confident, self-assured, considerate, and unhurried to reduce the anxiety of the patient

21
Q

Hands on:

A

begin by measuring their vitals, height/weight
ICEBREAKER
GOWN CHANGE (make sure to knock)
WASH/ CLEAN HANDS
Begin by touching their hands and inspecting for skin color, nail beds, joints (knuckles)
One step at time (avoid distractions)
maintain privacy/modesty
do not hesitate to write
occasionally brief teaching about the person’s body
ok to linger, reassure them
SUMMARIZE YOUR FINDINGS & SHARE NECESSARY INFO, thank them

22
Q

Before you leave a hospitalized person you must

A
lower the bed (lowest level)
call light nearby
return bedside table
make sure they are comfy
wash hands
23
Q

How does working with various developmental/age apply in the assessment?

A
  • different sequences are act upon depending on the level
  • different ways of acting/ behavior towards each age group
  • parent interaction
  • modesty
24
Q

With an ill-person it may be necessary to just examine the body areas appropriate to the problem, thus collecting a

A

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