Fundamentals Chapter 30 Flashcards
Alcohol
Oral cavity/Ingestion of alcohol, diabetes
Ammonia
Urine/Urinary tract infection, renal failure
Body odor
Skin, particularly in areas where body parts rub together (e.g., underarms and uPoor hygiene, excess perspiration (hyperhidrosis), foul-smelling perspiration (bromhidrosis)nder breasts)/
Feces
Vomitus/oral cavity (fecal odor)
Bowel obstruction
Rectal area
Fecal incontinence
Foul-smelling stools in infant
Stool/Malabsorption syndrome
Halitosis
Oral cavity/Poor dental and oral hygiene, gum disease
Sweet, fruity ketones
Oral cavity/Diabetic acidosis
Stale urine
Skin/Uremic acidosis
Sweet, heavy, thick odor
Draining wound/Pseudomonas (bacterial) infection
Musty odor
Casted body part/Infection inside cast
Fetid, sweet odor
Tracheostomy or mucus secretions/Infection of bronchial tree (Pseudomonas bacteria)
Techniques of Physical Assessment
four techniques used in a physical examination are inspection, palpation, percussion, and auscultation.
Inspection
occurs when interacting with a patient, watching for nonverbal expressions of emotional and mental status. Physical movements and structural components can also be identified in such an informal way. Most important, be deliberate and pay attention to detail.
Guidelines for Inspection
Make sure that adequate lighting is available, either direct or tangential.
- Use a direct lighting source (e.g., a penlight or lamp) to inspect body cavities.
- Inspect each area for size, shape, color, symmetry, position, and abnormality.
- Position and expose body parts as needed so all surfaces can be viewed but privacy can be maintained.
- When possible, check for side-to-side symmetry by comparing each area with its match on the opposite side of the body.
- Validate findings with the patient.
PALPATION
involves using the sense of touch to gather information. Through touch you make judgments about expected and unexpected findings of the skin or underlying tissue, muscle, and bones.
PERCUSSION
involves tapping the skin with the fingertips to vibrate underlying tissues and organs. The vibration travels through body tissues, and the character of the resulting sound reflects the density of the underlying tissue. The denser the tissue, the quieter the sound. By knowing how various densities influence sound, it is possible to locate organs or masses, map their edges, and determine their size. An abnormal sound suggests a mass or substance such as air or fluid within an organ or body cavity.
Auscultation
Involves listening to sounds the body makes to detect variations from normal. Some sounds such as speech and coughing can be heard without additional equipment, but a stethoscope is necessary to hear internal body sounds.
cyanosis
(bluish discoloration) in the lips, nail beds, palpebral conjunctivae, and palms. In recognizing pallor in the dark-skinned patient, observe that normal brown skin appears to be yellow-brown and normal black skin appears to be ashen gray. Also assess the lips, nail beds, and mucous membranes for generalized pallor; if pallor is present, the mucous membranes are ashen gray. Assessment of cyanosis in the dark-skinned patient requires observing areas where pigmentation occurs the least (conjunctiva, sclera, buccal mucosa, tongue, lips, nail beds, and palms and soles). In addition, verify these findings with clinical manifestations (Seidel etal., 2011).
Pallor (decrease in color)
Reduced amount of oxyhemoglobin/Anemia/Face, conjunctivae, nail beds, palms of hands
Loss of pigmentation
Vitiligo/Congenital or autoimmune condition causing lack of pigment/Patchy areas on skin over face, hands, arms
Yellow-orange (jaundice)
Increased deposit of bilirubin in tissues/Liver disease, destruction of red blood cells/Sclera, mucous membranes, skin
Red (erythema)
Increased visibility of oxyhemoglobin caused by dilation or increased blood flow/Fever, direct trauma, blushing, alcohol intake/
Face, area of trauma, sacrum, shoulders, other common sites for pressure ulcers
Tan-Brown
Increased amount of melanin/Suntan, pregnancy/Areas exposed to sun: face, arms, areolas, nipples
Hyperopia
Hyperopia is farsightedness, a refractive error in which rays of light enter the eye and focus behind the retina. Persons are able to clearly see distant objects but not close objects.
