7 - Techniques + Equipment

Question 1

how are vibrations best perceived?

Answer 1

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

Question 2

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

Answer 2

palmar surface

Question 3

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

Answer 3

dominant

Question 4

light palpation is used to assess…

Answer 4

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

Question 5

which part of the hands are used for light palpations?

Answer 5

finger pads of dominant hand

Question 6

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

Answer 6

1 cm

0.39 in

Question 7

deep palpation is used to palpate…

Answer 7

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

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

Question 8

deep palpation is performed at a depth of __

Answer 8

2 - 4 cm

0.75 - 1.5 in

Question 9

2 methods of deep palpation

Answer 9

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

Question 10

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

Answer 10

true

Question 11

to prevent discomfort, the nurse should…

Answer 11

• warm hands
• keep nails short, smooth, trimmed
• remove jewelry

Question 12

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

Answer 12

• object
• finger
• reflex hammer

Question 13

direct percussion

Answer 13

-technique of tapping the body w fingertips of dominant hand

Question 14

direct percussion is used to assess…

Answer 14

• the thorax of an infant

- the sinus of an adult

Question 15

blunt percussion

Answer 15

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

Question 16

blunt percussion is used to examine..

Answer 16

pain + tenderness in the:

• gallbladder
• liver
• kidneys

Question 17

indirect percussion

Answer 17

hammer or tapping finger used to strike an object

Question 18

which type of percussion is the most commonly used one?

Answer 18

indirect percussion

Question 19

plexor

Answer 19

the finger/object that does the striking

Question 20

plecimeter

Answer 20

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

Question 21

how to perform an indirect percussion

Answer 21

• 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

Question 22

how to perform an indirect percussion

Answer 22

• 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

Question 23

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

Answer 23

softer + shorter

-less dense> louder + longer

Question 24

5 percussion sounds

Answer 24

1 tympany
2 resonance
3 hyperresonance
4 dullness
5 flatness

Question 25

tympany

Answer 25

Loud, high pitched

Drum-like tone

Question 26

tympany is a normal finding in the…

Answer 26

air-filled stomach/intestines

*tympany rhymes w empty

Question 27

resonance

Answer 27

Loud, hollow tone

Low-pitched

Question 28

resonance is a normal finding in the…

Answer 28

lungs

Question 29

hyperresonance

Answer 29

abnormally loud, low pitched

Question 30

hyperresonance is a normal finding in the…

Answer 30

air becomes trapped + over-inflates the lungs

Question 31

dullness

Answer 31

High-pitched tone

Soft, short duration

Question 32

dullness is a normal finding in the…

Answer 32

Heard over solid body organs (i.e. liver, heart)

*dullness rhymes w fullness

Question 33

flatness

Answer 33

High-pitched tone

Very soft, short duration

Question 34

flatness is a normal finding in the…

Answer 34

Occurs over solid tissue (muscle, bone)

Question 35

T/F stethoscopes work by amplifying sounds

Answer 35

FALSE

-stethoscopes work blocking out other noises in the environment

Question 36

when auscultating, keep the patient warm because…

Answer 36

shivering is uncomfortable + can obscure body sounds

Question 37

dopplers obtains readings of…

Answer 37

• pulse
• fetal HR
• in special circumstances, BP

Question 38

otoscopes inspect the…

Answer 38

tympanic membrane + external ear canal

Question 39

stadiometer measure the

Answer 39

height

Question 40

goniometer

Answer 40

measures the angle of joint mvmt

Question 41

skinfold calipers

Answer 41

measure thickness of body fat

Question 42

wood’s lamp

Answer 42

detects fungal in skin

-green/yellow = positive

Question 43

monofilament

Answer 43

single strand of nylon to detect periph nerve sensation in feet

Question 44

diaphragm are best for listening to ___ pitched sounds such as….

Answer 44

HIGH PITCH

• lung sounds
• normal hrt sounds
• bowel sounds

Question 45

bell are best for low pitch sounds like…

Answer 45

hrt murmurs

Question 46

coarse body hear on a stethoscope may create a… and can be avoided by…

Answer 46

• crackling sound

- avoided by wetting the hair before auscultation

Question 47

doppler vs stethoscope

Answer 47

doppler uses ultrasonic waves to detect sounds that are difficult to hear w a reg stethoscope

Question 48

if periph pulses cannot be palpated..

Answer 48

use a doppler

• use a gel to eliminate friction
• don’t use to much pressure bc it can impede blood flow

Question 49

with dopples, the pitch sounds higher when….

Answer 49

the distance from the source is smaller

-pitch is lower when the distance is greater

Question 50

5 apertures of an ophthalmoscope

Answer 50

1 large
2 small
3 red-free
4 grid
5 slit

Question 51

large aperture

Answer 51

• used most often

- for viewing dilated pupils

Question 52

small aperture

Answer 52

-for viewing undilated pupils

Question 53

red-free aperture

Answer 53

shines a green beam to check optic disc for pallor or hemorrhage (which appears black)

Question 54

grid aperture

Answer 54

assess size + location + pattern of lesions

Question 55

slit aperture

Answer 55

examines the anterior eye

-checks for elevation or depression of lesions

Question 56

T/F the otoscope is used to inspect the nose

Answer 56

TRUE

-must use the shortest + broadest speculum

Question 57

specula of an otoscope is used to….

Answer 57

narrow the beam of light

-the nurse should select the largest one that will fit into the ear canal

Question 58

swelling/edema of the legs is a cue to assess…

Answer 58

heart problems

Question 59

bruising/ecchymosis of the skin is a cue to assess…

Answer 59

any hx of recent falls, trauma, injury, anticoag med, or bleeding problems

Question 60

T/F in most cases, pt should empty their bladder before the assessment

Answer 60

TRUE

-helps pt feel for comfortable esp during palpation of abdomen/pubic area

Question 61

pt feel more ___+__ when they understand when they understand what us about to happen

Answer 61

comfortable + cooperative

Question 62

_____ position can be hard for obese patient’s respiratory muscles, therefore the nurse should…

Answer 62

supine

-nurse should keep the head elevated as much as possible during the examination

Question 63

special considerations for obese patients

Answer 63

• 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

Question 64

when to use light vs sterile cleaning for equipment

Answer 64

light is for equipment that DOES NOT touch membranous parts of the body