FIRST RLE TOPIC Flashcards
includes information about the client that the nurse directly observes during interaction with him, and information elicited through physical assessment techniques
objective data
what are the 4 assessment techniques
inspection
palpation
percussion
auscultation
to protect examiner in any part of the examination when the examiner may have contact with blood, body fluids, secretion
gloves and gown
equipment when taking vital signs
sphygmomanometer
thermometer
watch with second hand
pain rating scale
equipment for eye examination
penlight
snellen chart
ophthalmoscope
cover card
newspaper
when to wash hands
before beginning examination
after direct contact w fluids
after physical examination
what are the two inspection techniques
IPPA
IAPP
involves using the senses of vision, smell, and hearing to observe and detect any normal or abnormal findings
inspection
consists of using parts of the hand to touch and feel for texture, temp, moisture, mobility, consistency, strength of pulses, size, shape
palpation
4 types of palpation
light
moderate
deep
bimanual
to perform, place dominant hand lightly on the surface of the structure little to no other than depression
light palapation
depress surface 1-2 cm with your dominant hand and use a circular motion to feel asel
moderate palpation
dominant hand on the skin surface and your non dominant hand on top of dominant
deep palpation
use of two hand placing one on each side of the body part
bimanual palpation
involves tapping body parts to produce sound wave. these enable the fixator to assess underlying structure.
percussion
what are the 3 types of percussion
direct
blunt
indirest or interdiatte
type of assessment technique that requires the use of a stethoscope to listen to heart sounds
auscultation
what are the different client positioning
sitting
supine
dorsal recumbent
SIMS’
standing
prone
knee-chest
lithotomy
client should sit upright on the side of the examination table
sitting position
ask the client to lie down with the legs together
supine position
client lies down on the examination table or bed with knees bent, legs separated
dorsal recumbent position
client lies on his or her right or left side with lower arm placed behind the body
SIMS’ position
client stands still i a normal comfortable, resting posture
standing position
client lies down on his or her abdomen with the head to the side
prone position
client kneels on the examination table with the weight of the body supported by the chest and knees
knee chest position
client lies on his or her back with the hips at the edge of the examination table and feet supported by strirrups.
lithotomy position
