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ASSESSMENT FALL'14 EXAM 1 > Assessment Techniques Ch.8 > Flashcards

Assessment Techniques Ch.8 Flashcards

1
Q

The skills requisite for the physical examination are ?

A

IPPA [ inspection, palpation, precussion, and ausculation]

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2
Q

You will always IPPA except with the ___, then you would___.

A

abdomen. inspection, ausculation, precussion then palpate

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3
Q

Palpation applies your senses of touch to assess these factors:

A 
texture
tempature
moisture
organ location or size
swelling
vibration or pulsation
rigidity or spasticity
crepitation
presenses of lumps of masses
presenses of tenderness or pain
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4
Q

what is best for fine tactile discrimination, as of skin texture, swelling, pulsation, and determining presense of lumps?

A

fingertips

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5
Q

what is best for detecting the position, shape, and consistency of an organ or mass?

A

a grasping action of the fingers and thumb

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6
Q

best for determining temperture

A

the dorsa (back) of fingers and hand

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7
Q

best for vibration

A

base of fingers (metacarpophalangeal joints) or ulnar surface of the hand

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8
Q

Identify any tender areas, and palpate them ____.

A

last

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9
Q

what is light palpation?

A

1 cm deep usng finger pads with very light touch and assess for : surface abnomalities, texture, tenderness, temperature, moisture, elasticity, pulsations, superficial organs, and masses

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10
Q

what is deep palpation?

A

4 to 5 cm deep with firm, deep pressure. used to assess internal organs and masses for : size, shape, tenderness, symmetry, mobility.

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11
Q

what is 75% of assessment technique?

A

inspection

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12
Q

_____ requires the use of both of your hands to envelope or capture certain body parts or organs - such as kidneys, uterus, or adnexa- for more precise delimitation.

A

bimanual palpation

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13
Q

___ is tapping the person’s skin with short, sharp stroke to assess underlying structures

A

percussion.

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14
Q

The strokes yield a _____ and a characteristic sound that depicts the ___,___, and____.

A

palpable vibration.
location
size
density of the underlying organ

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15
Q

precussion can detect an abnormal mass if it is ____.

A 
fairly superficial
( the percussion vibration penetrate about 5 cm deep; a deeper mass would give no change in percussion)
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16
Q

percussing over a bone yeilds no data because it sounds ___.

A

dull

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17
Q

uses 1 or 2 fingers to tap directly on the body part. for wht?

A

direct percussion

tenderness of sinuses

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18
Q

elicits sounds that give clues to the makeup of the underlying tissue.

  • used to locate organ borders
  • identify organ shape and position
  • determine if an organ is solid or filled with gas/fluid
A

indirect percussion

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19
Q

form of indirect percussion

-used to asses for tendernes of the _______.

A

fist percussion

-liver and kidneys

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20
Q

percussion sound over muscle or bone? (no air present, over tumor)

A

flatness

21
Q

percussion sound over organs (dense..like liver or spleen)

A

dullness

22
Q

percussion sound over normal lungs

A

resonance

23
Q

percussion sounds not normal in adults (with increased amounts of air like emphysema) but normal in lungs of children

A

hyperresonance

24
Q

percussion sound over gastric air bubble and abdomen.. ( air filled viscus; stomach or intestines)

A

tympany

25
Q

best for high pitched sounds—-breath,bowel, and normal heart sounds.

A

diaphragm

26
Q

It is best for soft, low pitched sounds such as extra heart sounds or murmurs.

A

bell endpiece

27
Q

Name & describe the four components or sounds to listen for during percussion

A

Amplitude- is the sound’s intensity, which may be loud or soft.
Pitch- describes the number of vibrations per second and may be high-pitched or low-pitched.
Quality (or timbre)- is the subjective difference due to a sound’s distinctive overtones.
Duration- is the length of time the note lingers.

28
Q

What are the most commonly auscultated areas?

A

The heart, blood vessels, lungs, and abdomen

29
Q

When performing indirect percussion, where is the stationary finger struck?

A

at the distal interphalangeal joint

30
Q

The best description of the pitch of a sound wave obtained by percussion is:

A

the number of vibrations per second.

31
Q

The bell of the stethoscope is used for what pitch of sounds?

A

soft-low pitched sounds

32
Q

an instrument that illuminates the ear canal, enabling the examiner to look at the ear canal and tympanic membrane

A

otoscope

33
Q

the length of time the note lingers

A

duration

34
Q

(or timbre) a subjective difference due to a sound’s distinctive overtones

A

quality

35
Q

(or frequency) the number of vibrations (or cycles) per second of a note

A

pitch

36
Q

(or intensity) how loud or soft a sound is

A

amplitude

37
Q

an instrument that illuminates the internal eye structures, enabling the examiner to look through the pupil at the fundus of the eye

A

ophthalmoscope

38
Q

an infection acquired during hospitalization

A

nosocomial infection

39
Q

What are the three “methods” or “styles” of palpation and what are they used for?

A

Palpation may be light, deep, or bimanual. Light palpation evaluates surface characteristics and identifies areas of tenderness. Deep palpation assesses an organ or mass deeper in a body cavity. Bimanual palpation is the use of both hands to envelop or capture certain body parts or organs, such as the kidneys

40
Q

Deep palpation is used to:

A. identify abdominal contents. .

B. evaluate surface characteristics.

C. elicit deep tendon reflexes.

D. determine the density of a structure

A

A. Identify abdominal contents.

41
Q

Amplitude is:

A. the intensity (soft or loud) of sound.

B. the length of time the note lingers.

C. the number of vibrations per second.

D. the subjective difference in a sound’s distinctive overtones.

A

A. the intensity (soft or loud) of sound.

42
Q

The dorsa of the hands are used to determine:

A. vibration.

B. temperature

C. an organ’s position.

D. fine tactile discrimination.

A

B. Tempature

43
Q

Fine tactile discrimination is best achieved with the:

A. opposition of the fingers and thumb.

B. fingertips.

C. back of the hands and fingers.

D. base of the fingers.

A

B. Fingertips

44
Q

Which of the following is considered when preparing to examine an older adult?

A. Base the pace of the examination on the patient’s needs and abilities.

B. Avoid physical touch to offset making the older adult uncomfortable.

C. Be aware that loss will result in poor coping mechanisms.

D. Confusion is a normal, expected finding in an older adult.

A

A

45
Q

When performing percussion, the examiner:

A. strikes the flank area with the palm of the hand.

B. strikes the stationary finger at the distal interphalangeal joint.

C. strikes the stationary finger at the proximal interphalangeal joint.

D. taps fingertips over bony processes.

A

B. strikes the stationary finger at the distal interphalangeal joint.

46
Q

When should the examiner use hand washing instead of an alcohol-based hand rub?

A. if the patient has an infection with Mycobacterium tuberculosis

B. if the patient has an infection with Clostridium difficile

C. if the patient has an infection with hepatitis B virus

D. if the patient is HIV positive

A

B. if the patient has an infection with Clostridium difficile

47
Q 
When performing a physical assessment, the technique the nurse will always use first is:
A) Percussion
B) Inspection
C) Palpation
D) Auscultation
A

B. Inspection

48
Q

The nurse is assessing a patient’s skin during an office visit. What is the best technique to use to best assess the patient’s skin temperature?
A) Use the fingertips because they’re more sensitive to small changes in temperature.
B) Use the palmar surface of the hand because it is most sensitive to temperature variations because of increased nerve supply in this area.
C) Use the dorsal surface of the hand because the skin is thinner than on the palms.
D) Use the ulnar portion of the hand because there is increased blood supply that enhances temperature sensitivity.

A

C) Use the dorsal surface of the hand because the skin is thinner than on the palms

49
Q

The nurse would use bimanual palpation technique in which situation?
A) Palpating the thorax of an infant
B) Palpating the kidneys and uterus
C) Assessing pulsations and vibrations
D) Assessing the presence of tenderness and pain

A

B) Palpating the kidneys and uterus

ASSESSMENT FALL'14 EXAM 1 (7 decks)

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