Clinical Examination Flashcards
What paperwork must be looked at prior to a clinical examination?
NEWS charts.
Nursing / medical notes.
What information can be gathered about a patient’s appearance?
Sex.
Estimates on age and weight.
Rashes, colour and sweating.
What can be gathered about a patient’s cognitive state?
Agitation and anxiety.
Confusion.
What can be gathered about a patient’s environment?
Medical equipment.
Walking aids.
Medication and carers.
How can you reflect on the initial assessment of a patient?
Urgent rapid assessment (ABCD).
Treatment (medication).
Steps to improve the consultation.
How do you introduce yourself in a clinical examination?
Wash your hands.
Say your name and status.
Ask the patient for their name and DOB.
How do you get consent from a patient?
Verbally.
Explain that you would like to examine them, and what the examination will entail.
How do you prepare the patient for clinical examination?
Ask the patient to remove necessary clothes.
Position the patient at 45 degrees.
Adjust the bed height for your comfort.
What do you do first when examining a patient’s hands?
Radial pulse and respiratory rate.
General colour (tar staining?).
Nails (colour? shape? texture?)
Capillary refill time.
What do you check on the palms of a patient’s hands?
Colour of creases.
Temperature / sweatiness.
How do you check for tremors of a patient’s hands?
Stretch out their hands with their fingers up.
Fine / coarse / flapping.
How do you examine a patient’s arms?
Bruising / pigmentation / rashes / lesions / scars / wounds.
Venous damage.
Skin turgor.
How do you examine a patient’s face?
Facial symmetry / colour / hair distribution.
Facial expressions specific to an illness.
How do you examine a patient’s ears?
Shape / swelling.
Presence of a hearing aid.
How do you examine a patient’s eyes?
Unequal pupils / yellow sclerae / eyelid position / symmetry.
How do you examine a patient’s conjuctiva and buccal mucosa?
Pull down lower eyelids and ask the patient to look up, to examine the conjunctiva.
Use a pen torch to see ulceration or pigmentation of the buccal mucosa.
How do you examine a patient’s mouth?
Colour of lips.
Tonsils (use a wooden spatula).
Swelling of gum margins.
State of dentition.
Colour / size / shape / movements / texture / moistness of the tongue.
How do you examine a patient’s lymph nodes?
From the back.
Shoulders, up the side of their neck.
From the jaw to the chin.
In front of and behind the ears.
From the ears, down the neck.
How do you examine a patient’s chest?
Inspect and palpate any skin lesions.
Check for gynaecomastia.
How do you examine a patient’s lower limbs?
Skin - colour / hair distribution / ulcerations / varicose veins.
Temperature - palpate to check.
Check the soles of the feet.
How do you examine deformities of a patient’s lower limbs?
Joint swelling.
Skin thickness.
Toe movement.
How do you conclude a clinical examination?
Let the patient know you have finished and thank them.
Given them privacy to redress.
Wash your hands.
How do you document any findings?
Write legibly, in a clear and logical sequence.
Identify each sheet with the patient’s ID / initials.
Date, time and sign your notes.
Print your name and status on your notes.
What are the four examination stages?
Inspection - looking.
Palpation - feeling.
Percussion - tapping.
Auscultation - listening.
