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99 Cards in this Set
- Front
- Back
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Normal order of physical assessment
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inspection
palpation percusion ausculatation |
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factors to look for during inspection
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size
shape color symmetry position |
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what area of hand to use for asessing texture, shape, size, constistancy, and pulse
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pads (fingertips)
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what area of hand to use for asessing vibration
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palm of hand or ulnar surface
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sound characteristic for lungs during percussion
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resonance (hollow)
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sound characteristic for gastric bubble during percussion
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tympany (drumlike)
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sound characteristic for lungs w/ emphaysemia during percussion
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hypereasonace (lower hollow)
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sound characteristic for organs during percussion
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dullness (thudlike)
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sound characteristic for muscle during percussion
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flatness
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sound characteristic for bone during percussion
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flatness
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what part of stephoscope is used for heart/ vascular
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bell
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what part of stephoscope is used for bowels and lungs
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diaphram
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what is used when unable to palplate peripheral pulses
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doppler (soundwaves) (listen)
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position for physical that allows for full expansion of lungs
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sitting
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position for physical that is used for rectal exams
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sims
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position for physical that has client on side with upper leg flexed
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sims
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position for physical that allows observation for abdominal pulsations
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supine
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position for physical that is the most relaxed, easy access to abdomen
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supine
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position for physical that is used for female exam
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lithotomy
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position for physical that has a limited time in position
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lithotomy
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position for physical that has knees flexed, feet flat on bed, and promotes abdomenal relaxation
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dorsal recumbent
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position for physical that is intolerable for patients with respitory difficultly
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prone
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position for physical that is used for musculoskeletal observation
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prone
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what is inspection of diaphoresis
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moisture of skin
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cancer of the breast is the leading cause of women age?
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30-45 years old
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positions during breast exam
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supine
sitting hands over head hands pressed on hips leaning forward |
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what area to perucuss during abdomen assessment
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along the edge of the liver
should hear dullness |
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spleenic dullness may indicate
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enlargement, should be tympanic
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a barrel chest indicate
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emphasemia
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clubbing of the fingers may indicate....
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hypoxia
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what are tactile fremiutus
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vibrations in chest created by vocal sound
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how is tactile fremiutus assessed
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instruct client to say "99" and palpate using ulnar over right apex of lung
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there is a decrease in tactile fremiutus if....
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there is mucous, a collapse, or leasions
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there is an increase in tactile fremiutus if
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there is pnemonia
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heart contraction
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systole
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ejection of blood froom ventricles
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systole
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relaxation of heart muscles
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diastole
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filling of ventricle
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diastole
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blood pumped by each ventricle in 1 min.
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cardiac output
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PMI point of maximal impulse
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4th or 5th intercostal
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PMI IN CHILDREN under 7
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3rd or 4th intercostal
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what do thrills indicate in heart assessment
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murmurs
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what should you do if you can not palpate PMI pulse
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turn client on left side
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what should you use first during asculatation of heart
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diaphram then bell
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what are clicks
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abrupt, brief sounds heard during asculatation of the heart
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what are blowing or whooshing sounds created by blood flow changes through valves
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murmers
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when is S1 heard
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just before ventalation contraction (systole)
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whhere is S1 heaRD
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PMI, tricuspid, & mitrial
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when is S2 heard
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just before ventalation relaxation (diastole)
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where is S2 heard
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base of heart, aortic, and pulmonary
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what sound is ventricular gallop
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S3
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When is S3 sound normal
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in children and young adult
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when is S3 seen
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CHF
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S3 is also known as
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"kentuckey"
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S3 is associated with.....
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S2
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S3 is characterized by....
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rapid filling of ventricle
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what sound is atrial gallop
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S4
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S4 is characterized by
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atria contract to enhance ventricular filling due to ventricular stiffness
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S4 is also known as
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"tennessee"
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S4 is associated with
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S1
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the ability to recieve and process stimili recieved through the sensory organs
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sensation
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ability to experience, recognize, organize, and interpret sensory stimuli
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perception
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ability to recieve sensory impressions, relate the stimuli to past experiences, and form an impression of the nature of the stimulis
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sensory perception
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intellectual ability to think
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cognition
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what are the neurological functions
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sensation
perception cognition |
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ascending pathways that transmit sensory impulses to the brain
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afferent nerve pathways
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descending pathways that send sensory impulses from the brain
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efferent nerve pathways
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what are the components of sensation and perception
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afferent and efferent nerve pathways
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what are the components of coginition
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-consciousness (awareness & arousal)
-memory |
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consciousness depends on the functioning of the .......
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RAS
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what controls mood and sleep
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serotonin
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what sound shound you hear by percussing the liver
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dullness
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what can palpation tell you?
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Light: surface characteristics such as temp and texture
Deep: organ size, masses, and tenderness |
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what is striking the body surface using elicit vibrations & sounds
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percussion
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sound produced by percussion is determenined by
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the density of the underlining organ or tissue (solid or filled with air or fluid)
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whatcan percussion tell you
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density
size/shape tenderness deep tendon reflexes tenderness |
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what are the types of percussions
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direct
indirect fist or blunt (for tenderness) |
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during ascultation what pressure should be applied for low pitch sound
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light pressure
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during ascultation what pressure should be applied for high pitch sound
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firm pressure
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what position is used for abdomen/ pelvic area
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dorsal recumbent
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what position is used for rectal
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sims
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what position is used for musculoskeletal
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prone
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what position is used best for cardiac auscultaion
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left lateral recumbent
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what position is used for rectal and prostate
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knee chest
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what position is used for spine, joints, ROM, and neurologic
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standing
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what are the general 3 phases of physical exam
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interview, physical exam, and documentation
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what approaches can be done for assessment
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head to toe
systems |
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how to prepare for exam
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wash hands
have ptient void before exam |
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When should you do vitals
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begin with vitals and do survey along with vitals
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what items are in the general survey
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age
race facial expression mental state hygiene and dressing body type and posture obvious abnormalities |
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what is the 4th level of orientaion
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purpose (client know why is being examine and functioning of items)
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what factor are associated with a neuro exam
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head
eyes ears nose throat and mouth |
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during documentation avoid....
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terms normal, good, adequate
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how is health history obtained
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interview (subjective info)
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where would it be normal to hear tympany
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gastric air bubble
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where would it be normal to hear resonance
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(hollow) lungs
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where would it be normal to hear hyperresonance
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(lower hollow)
lungs with emphysemia |
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where would it be normal to hear dullness
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(thudlike) organs
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where would it be normal to hear flatness
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muscle and bone
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