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Physical Assessment > 7 - Techniques + Equipment > Flashcards

7 - Techniques + Equipment Flashcards

1
Q

how are vibrations best perceived?

A

using the base of fingers (metacarpophalangeal joints), the ulnar surface of the hand (incl. fingers)

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2
Q

part of the hand that is best for determining position, consistency, texture, size of structures, pain + tenderness

A

palmar surface

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3
Q

which is more sensitive? dominant hand or non-dominant hand?

A

dominant

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4
Q

light palpation is used to assess…

A

skin texture, pulse, or a tender, inflamed area near the surface of the skin

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5
Q

which part of the hands are used for light palpations?

A

finger pads of dominant hand

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6
Q

in light palpation, finger pads move slowly at a depth of ______ in circular motions

A

1 cm

0.39 in

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7
Q

deep palpation is used to palpate…

A

the abdomen, organs that lie deep w/in the cavity

-kidney, liver, spleen, or when overlying musculature is thick, tense or rigid

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8
Q

deep palpation is performed at a depth of __

A

2 - 4 cm

0.75 - 1.5 in

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9
Q

2 methods of deep palpation

A

1 (moderate pressure) with fingers of dominant hand

2 (deep pressure) fingers of non-dominant hand OVER the of dominant hand, pressing + guiding fingers downward

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10
Q

T/F deep palpation is CI if rigidity is caused by inflammation or alterations in underlying organs + structures due to conditions
-such as dissecting aneurysm, peritonitis, or ectopic pregnancy

A

true

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11
Q

to prevent discomfort, the nurse should…

A
  • warm hands
  • keep nails short, smooth, trimmed
  • remove jewelry
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12
Q

nurse strikes thru a body part with an ___, ___, ___ to produce a measurable sound

A
  • object
  • finger
  • reflex hammer
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13
Q

direct percussion

A

-technique of tapping the body w fingertips of dominant hand

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14
Q

direct percussion is used to assess…

A
  • the thorax of an infant

- the sinus of an adult

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15
Q

blunt percussion

A

placing the palm of the nondominant hand flat against the skin + striking it w the dominant hand as a closed fist

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16
Q

blunt percussion is used to examine..

A

pain + tenderness in the:

  • gallbladder
  • liver
  • kidneys
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17
Q

indirect percussion

A

hammer or tapping finger used to strike an object

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18
Q

which type of percussion is the most commonly used one?

A

indirect percussion

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19
Q

plexor

A

the finger/object that does the striking

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20
Q

plecimeter

A

the past of the body/device that accepts the taps/blow

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21
Q

how to perform an indirect percussion

A
  • hyperextend the middle finger of NONdom hand
  • keep other fingers of NONdom hand off
  • middle finger of DOM hand makes contact w other middle finger
  • motion is from wrist
  • use the tip of the plexor finger… NOT the finger pad
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22
Q

how to perform an indirect percussion

A
  • hyperextend the middle finger of NONdom hand
  • keep other fingers of NONdom hand off
  • middle finger of DOM hand makes contact w other middle finger
  • motion is from wrist
  • use the tip of the plexor finger… NOT the finger pad
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23
Q

the MORE DENSE the tissue is, the ___ + __ the tone

A

softer + shorter

-less dense> louder + longer

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24
Q

5 percussion sounds

A 
1 tympany
2 resonance
3 hyperresonance
4 dullness
5 flatness
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25
tympany
Loud, high pitched | Drum-like tone
26
tympany is a normal finding in the...
air-filled stomach/intestines *tympany rhymes w empty
27
resonance
Loud, hollow tone | Low-pitched
28
resonance is a normal finding in the...
lungs
29
hyperresonance
abnormally loud, low pitched
30
hyperresonance is a normal finding in the...
air becomes trapped + over-inflates the lungs
31
dullness
High-pitched tone | Soft, short duration
32
dullness is a normal finding in the...
Heard over solid body organs (i.e. liver, heart) *dullness rhymes w fullness
33
flatness
High-pitched tone | Very soft, short duration
34
flatness is a normal finding in the...
Occurs over solid tissue (muscle, bone)
35
T/F stethoscopes work by amplifying sounds
FALSE | -stethoscopes work blocking out other noises in the environment
36
when auscultating, keep the patient warm because...
shivering is uncomfortable + can obscure body sounds
37
dopplers obtains readings of...
- pulse - fetal HR - in special circumstances, BP
38
otoscopes inspect the...
tympanic membrane + external ear canal
39
stadiometer measure the
height
40
goniometer
measures the angle of joint mvmt
41
skinfold calipers
measure thickness of body fat
42
wood's lamp
detects fungal in skin | -green/yellow = positive
43
monofilament
single strand of nylon to detect periph nerve sensation in feet
44
diaphragm are best for listening to ___ pitched sounds such as....
HIGH PITCH - lung sounds - normal hrt sounds - bowel sounds
45
bell are best for low pitch sounds like...
hrt murmurs
46
coarse body hear on a stethoscope may create a... and can be avoided by...
- crackling sound | - avoided by wetting the hair before auscultation
47
doppler vs stethoscope
doppler uses ultrasonic waves to detect sounds that are difficult to hear w a reg stethoscope
48
if periph pulses cannot be palpated..
use a doppler - use a gel to eliminate friction - don't use to much pressure bc it can impede blood flow
49
with dopples, the pitch sounds higher when....
the distance from the source is smaller -pitch is lower when the distance is greater
50
5 apertures of an ophthalmoscope
``` 1 large 2 small 3 red-free 4 grid 5 slit ```
51
large aperture
- used most often | - for viewing dilated pupils
52
small aperture
-for viewing undilated pupils
53
red-free aperture
shines a green beam to check optic disc for pallor or hemorrhage (which appears black)
54
grid aperture
assess size + location + pattern of lesions
55
slit aperture
examines the anterior eye | -checks for elevation or depression of lesions
56
T/F the otoscope is used to inspect the nose
TRUE | -must use the shortest + broadest speculum
57
specula of an otoscope is used to....
narrow the beam of light | -the nurse should select the largest one that will fit into the ear canal
58
swelling/edema of the legs is a cue to assess...
heart problems
59
bruising/ecchymosis of the skin is a cue to assess...
any hx of recent falls, trauma, injury, anticoag med, or bleeding problems
60
T/F in most cases, pt should empty their bladder before the assessment
TRUE | -helps pt feel for comfortable esp during palpation of abdomen/pubic area
61
pt feel more ___+__ when they understand when they understand what us about to happen
comfortable + cooperative
62
_____ position can be hard for obese patient's respiratory muscles, therefore the nurse should...
supine | -nurse should keep the head elevated as much as possible during the examination
63
special considerations for obese patients
- elevate the head if resp depress occurs - larger cuff sizes - larger exam gowns - scales fot 350+ - tables should be bolted - use gait belt/assistive devices
64
when to use light vs sterile cleaning for equipment
light is for equipment that DOES NOT touch membranous parts of the body

Physical Assessment (20 decks)

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