Chapter 8-11: Initial Assessments Flashcards Preview

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Flashcards in Chapter 8-11: Initial Assessments Deck (113)
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1

Inspection

A concentrated watching that begins at the moment you meet, a close scrutiny first of the individual as a whole and then of each body system

2

What are you looking for while you inspect?

Consciousness, Skin color, Hygiene, Bruises, Redness, Injuries

3

Palpation

applies your sense of touch to assess (texture, temp, moisture, organ location and size, any swelling, vibration or pulsation, rigidity or spasticity, crepitation (sounds like hair rubbing together), presence of lumps or masses and presence of tenderness or pain.

4

Different methods when palpating

- Fingertips: best for fine, tactile discrimination, as of the skin texture, swelling, pulsation and determining presence of lumps
- A grasping action of the fingertips and thumb -- to detect the position, shape, and consistency of an organ or mass
- The dorsa (backs) or hands and fingers: best for determining temp because the skin here is thinner than on the palms
- Base of fingers or ulnar surface of the hand ---best for vibration
- Bimanual palpation = using two hands

5

Percussion purpose

Mapping out location and size or organ, Signaling the density (air, fluid or solid), Detecting an abnormal mass and eliciting a deep tendon reflex using percussion hammer

6

Direct palpation

Using your fingers on one hand to directly tap the patient to feel vibration

7

Indirect Palpation

Using two hands and tapping your own finger, not tapping directly the patient

8

Amplitude

Intensity of sound

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Pitch

Frequency or number of vibrations per second

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Quality

A subjective difference by overtones of sounds

11

Duration

Length of time the note lingers

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What has resonant sounds?

Lungs

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What has hyper-resonant sounds?

Childs lung or lung with emphysema

14

What has Tympany sounds?

Stomach, Intestine

15

What makes a Dull Sound?

Liver or Spleen

16

What makes a Flat sound?

Thigh muscles or bone or tumor

17

Auscultation

Listening to sounds produced by the body like the heart, blood vessels, abdomen and lungs
DO NOT listen through gown

18

Diaphragm of stethoscope: purpose

used for high pitched sounds like breath, bowel, and normal heart sounds (press down firmly with this one)

19

Bell of a stethoscope: purpose

used for soft, low pitched sounds like murmurs and extra heart sounds (press lightly with this one)

20

Physical exam on Infant

Child should be on an exam table or parents lap, parent should be in view to the toddler, plan exam 1-2 hrs after feeding

21

Physical exam on the toddler

Toddler should be on parents lap sitting and nurse on a seat as well, child should have a security object

22

Physical exam with preschool child

Child can go on the exam table if comfortable, verbal communication with child is important at this point, do most invasion things at the end

23

Physical exam of the school aged child

The child should e sitting on the exam table, decide if they want parents in the office, make small talk and teach them what you're doing and why, head to toe evaluation

24

Physical exam on the adolescent child

Have the child sitting on the exam table and communicate with care, treat adolescent not as a child and promote positive practices and attitude

25

Physical exam on the aging adult

On exam table, give feedback, dont rush, break up the exam into parts if needed, use physical touch, don't mistake diminished vision and hearing for confusion

26

The ill person

Alter positions during exam based on patient and their distresses if present , just do what you need to do

27

What general observations should you make when the patient walks in?

Physical appearance, Body structure, Mobility, Behavior

28

Normal BMI

Between 19 - 25

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BMI between 25 - 29.9

Overweight

30

BMI between 30 - 34.5

Obese