L2 GENERAL EXAMINATION Flashcards
What are the 6 initial steps of a general examination?
1) Wash Hands/ Sanitize
2) Introduce yourself
3) Confirm patient- Name, Age
4) Explain Process and Gain consent
5) Expose with modesty in mind
6) If required, position patient properly – their hands at the side, either lying flat or at a 45 degree angle
What side of the patient is an examination conducted and using what hand?
Examination is always at the right side of patient and using your right hand
What does inspection at the foot of the bed entail?
General inspection:
looking at patient’s general appearance,
facial expression, level of consciousness, in any distress, general state of health (if they are appropriate BMI for age, or if cachexic, etc), bed side adjuncts
What does a closer inspection entail?
Inspecting hands, face,
neck, chest, abdominal region
What does inspection of hands entail?
3
Examine fingers and nails: look for colour, clubbing (put to fingers together almost like forming a heart) if there is no window between two nails that is clubbing- Schamroth’s Window- tell you about lungs
Peripheral cyanosis- look at bed of finger nail it will be blue due to inadequate oxygen.
Stretch out hands in front of themselves and look for tremor, ask to let palm face the ceiling ( if drops the patient’s can’t keep it up)
What does inspection of face entail?
Start with eyes: Colour: pull down ask patient to look up and do opposite: look for pale, yellow- liver icterus.
Nose: look inside: septum deviation?
Mouth: look at tongue, is it smooth? ask patient to touch the roof of mouth with tip of tongue, under tongue you have capillaries- central cyanosis- blue- indication of lung or heart issues
What does palpation entail?
Using your right palm to palpate/ feel
What does Percussion entail?
Using the third digit of the left hand to place on the area to percuss, and using the right third digit to tap on the left third digit between the two joints of that finger
(wrist movement of the right hand)
What do the sounds during percussion signify?
Resonant sound- low pitched, hollow sounds heard over normal lung tissue
Dull - heard over dense areas such as the heart or liver
What are the three final steps after completing a general examination?
Cover patient
Thank patient
Summarize findings
What does inspection of neck entail?
Neck: lymph nodes in neck: swollen: infection. start from chin area
What does inspection of chest entail?
Palpate with pad of your fingers to feel chest.
Male: Breast high- liver failing to do job wrt oestrogen production
What does inspection of abdomen entail?
Palpate abdomen.
Look for signs of pain on patient’s face.
