Chapter 3—Techniques Flashcards
position best for respiratory distress
Fowler’s
position best for checking peripheral pulse
some pts sleep
supine
position good for assessing hip joints, back
some surgical procedures
complications may occur with cardiac/respiratory disorders
prone
position used for procedures
low BP, postural drainage
promotes venous return
insertion of central catheter on chest
Trendelenburg’s
position for lower abdominal surgeries
reverse Trendelenburg’s
position providing comfort for patient
top leg flexed to prevent adduction & rotation of hip
lateral
position good for any insertion into anus
Sims’
position good for respiratory issues
allows for easier breathing
fluid drainage in surgery
thoracocentesis
orthopneic
position for gyn exam
lithotomy
position for rectal exam
knee-chest
position for exam of head, neck, chest, extremities
not ideal to assess abdomen
dorsal recumbent
position for colorectal surgery
jackknife
position for general surgical procedures
kidney position
Fowler’s
supine
prone
Trendelenburg’s
reverse Trendelenburg’s
lateral
sims
orthopneic
lithotomy
jackknife
kidney
4 assessment techniques in order
inspection
palpation
percussion
auscultation
exception to assessment order
abdominal
inspection
auscultation
palpation
percussion
3 surfaces for palpation & purposes
Finger pads - fine discrimination
Ulnar surface - vibrations, thrills, fremitus
Dorsal surface - temperature
light, moderate, deep depth of palpation
light - 1 cm to 1/4 inch
moderate - 1-2 cm
deep - 2-4 cm
looking for these variables when palpating
Tenderness, texture, temperature, size, shape, moisture, mobility, consistency
percussion
tapping & listening
resonance
over part air, part solid
loud, low, long length, hollow
ex normal lung
hyperresonance
over mostly air
very loud, low, long length, booming
ex lung c emphysema
tympany
over air
loud, high, moderate length, drumlike
ex puffed out cheek, gastric bubble
dullness
over more solid tissue
medium volume, medium pitch, moderate length, thudlike
ex liver, diaphragm, pleural effusion
flatness
over very dense tissue
soft, high, short length, flat
ex muscle, bone, sternum, thigh
______ is larger side of stethoscope used for higher sounds
_____ is smaller side used for lower sounds
diaphragm
bell
when should you not p/p abdomen?
AAA (abdominal aortic aneurysm)
Wilms’ tumor
appendicitis
organ transplant
direct percussion
tap directly on skin
indirect percussion
use nondominant hand as barrier - tap your own hand on pt’s skin
blunt percussion
strike ulnar surface of fist against your nondominant hand, held flat against pt’s skin
