Observation & Palpation

Question 1

What 6 things are you observing

Answer 1

General appearance
Position
Presence of lines, drains or evidence of surgery Oxygen therapy
Oxygen therapy & how much
Chest
Abdomen

Question 2

What are you looking for when observing the general appearance of cardio

Answer 2

Patient alertness
Response to voice
Pain
Unresponsivempness
AVOU are they agitated or restless
Breathless or confused
Face
Eyes
Mouth
Hands
Oedema

Question 3

What are you observing with regards to the chest for cardio

Answer 3

Respiratory rate
Chest shape
Chest wall movement
Breathing pattern
Work of breathing

Question 4

What are you looking for when observing the abdomen

Answer 4

Distended/incisions/post op drains/feeding tubes

Question 5

Name 11 charts you can observe

Answer 5

Blood pressure
Heart rate
Temperature
O2 requirements
O2 saturations
Respiratory rate
Weight
AVPU
fluid balance
Urine output
Medications

Question 6

When observing the face what are you looking for

Answer 6

Colore (pale or blue could be a sign of anaemia/low BP = Pallor, Ruddy/plethoric appearance & central cyanoses/peripheral cyanosis)
Use of accessory muscles
Nasal flaring (infants)
Speech
Pursed lips

Question 7

What are you looking for when observing the eyes

Answer 7

Pallor (pale) = anaemia
Redness (high hb levels)
Jaundice = liver disease/biliary obstruction
Drooping of one eyelid
Oedema (excessive fluid retained in the interstitial space)

Question 8

What are you looking for when observing the hands

Answer 8

Course flapping re our (high CO2)
Fine tremor (medication related)
Wastage
Nicotine stains
Cyanosis
Clubbing
Temperature

Question 9

Name the cardiac causes of clubbing

Answer 9

Congenital heart disease
Endocarditis

Question 10

Name the lung disease causes of clubbing

Answer 10

Cystic fibrosis
Infective (bronchiectasis, lung absence, emphysema
Fibrotic lung disease
Malignant lung disease

Question 11

Bowel disease causes of clubbing

Answer 11

Crohn’s disease
Unlcerative colitis

Question 12

What are you looking for when observing the mouth

Answer 12

Moist or dry
Dehydrated or drooling
Swelling or abnormalities
Colour of oral mucosa & lips
Pursed lips

Question 13

What are you looking for when observing the chest

Answer 13

Rising & fall8ng with breathing
Bucket handle
Pump handle
Abnorminal movement