Ch.8: Assessment Techniques and Safety in the Clinical Setting

Question 1

The skills requisite for the physical examination. IN ORDER ARE

Answer 1

Inspection
Palpation
Percussion
Auscultation

Question 2

Inspection:

Answer 2

ALWAYS COMES FIRST**
concentrated watching (whole then body systems)
begins the moment you first meet the person “general survey”
SYMMETRY

Question 3

Palpation:

Answer 3

confirms points from previous step
sense of touch: texture, temp, moisture, organ location, and size, (Swelling, vibration, or pulsation, tenderness)
Technique: start with light palpation, accustom them to touch. Intermittent better*

Question 4

Palpation techniques

Answer 4

fingertips- fine tactile discrimination (swelling, pulsation)
action of thumb and fingers- detect position/shape
dorsa of hands and fingers- temperature
base of fingers- best for vibrations

Question 5

Percussion:

Answer 5

tapping the person’s skin with short, sharp strokes to assess underlying structures
Maps location and size of an organ, signaling density, detecting abnormal mass

Question 6

Auscultation:

Answer 6

listening to the sounds produced by the body such as the heart and blood vessels and the lungs and abdomen
use of stethoscope

Question 7

Diaphragm of stethoscope

Answer 7

flat edge-best for high pitch sounds, breath, bowel and normal heart sounds

Question 8

Bell of stethoscope

Answer 8

deep, hollow, cup-like: best for low, soft pitched sounds such as extra heart sound or murmurs

Question 9

Before listening to the body sounds, you must

Answer 9

eliminate extra room noise, 
make room warm, 
clean the stethoscope,
 friction(no-no), 
NEVER LISTEN THROUGH A GOWN,
 avoid you own "artifact"

Question 10

funnels light into the ear Cana and onto the tympanic membrane.
Five specula each a different size are available to attach to the head. (short, broad-nares) & ( largest one- ear)

Answer 10

otoscope

Question 11

illuminates the internal eye structure (small spot for undiluted pupils) & (large full spot for dilated pupils)

Answer 11

ophthalmoscope

Question 12

measure range of motion

Answer 12

goniometer

Question 13

augment pulse or blood pressure measurement

Answer 13

dopler sonometer

Question 14

test sensation in the foot

Answer 14

monofilament

Question 15

to asses urine retention

Answer 15

bladder scanner

Question 16

True or false: you must clean your stethoscope end piece with an alcohol wipe only before every patient contact

Answer 16

FALSE:

Before and After every patient contact*** combine with hand hygiene routine

Question 17

HAND WASHING:

Answer 17

most important step to decrease risk of microorganism transmission
Wash BEFORE & AFTER every physical patient encounter / contact with blood& bodily fluids / contact with contaminated equipment / removing gloves
use when hands are visibly soiled / when patients are infected with spore forming organisms

Question 18

ALCOHOL USE:

Answer 18

more quickly and highly effective against gram-positive & negative bacteria

Question 19

TRUE OR FALSE: wearing gloves is NOT a protective substitute for washing hands.

Answer 19

TRUE:

because gloves may have undetectable or become torn during use or hands may become contaminated as gloves are removed

Question 20

General Approach:

Answer 20

an examiner must be confident, self-assured, considerate, and unhurried to reduce the anxiety of the patient

Question 21

Hands on:

Answer 21

begin by measuring their vitals, height/weight
ICEBREAKER
GOWN CHANGE (make sure to knock)
WASH/ CLEAN HANDS
Begin by touching their hands and inspecting for skin color, nail beds, joints (knuckles)
One step at time (avoid distractions)
maintain privacy/modesty
do not hesitate to write
occasionally brief teaching about the person’s body
ok to linger, reassure them
SUMMARIZE YOUR FINDINGS & SHARE NECESSARY INFO, thank them

Question 22

Before you leave a hospitalized person you must

Answer 22

lower the bed (lowest level)
call light nearby
return bedside table
make sure they are comfy
wash hands

Question 23

How does working with various developmental/age apply in the assessment?

Answer 23

• different sequences are act upon depending on the level
• different ways of acting/ behavior towards each age group
• parent interaction
• modesty

Question 24

With an ill-person it may be necessary to just examine the body areas appropriate to the problem, thus collecting a

Answer 24

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