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Assessment Techniques and The Clinical Setting

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64 views16 pages

Assessment Techniques and The Clinical Setting

.

Uploaded by

alphabennydelta4468
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Assessment Techniques

and the Clinical Setting


Chapter 8

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Chapter 8: Assessment Techniques and the Clinical Setting

Cultivating Your Senses

Inspection

Do not rush

Compare patients right side with left side

Use good lighting

Obtain adequate exposure (of the patient)

Will include instruments in many body systems

Otoscope/ophthalmoscope
Specula: vaginal, nasal
Penlight
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-2

Chapter 8: Assessment Techniques and the Clinical Setting

Cultivating Your Senses


(cont.)

Palpation

Purpose

Use different parts of the hands

Light vs. deep palpation

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-3

Chapter 8: Assessment Techniques and the Clinical Setting

Palpation Specifics
Characteristics Assessed by Palpation
Texture
Temperature
Moisture
Organ location
and size

Swelling
Vibration or

Rigidity or
spasticity

Crepitation
Presence of

lumps or masses

Presence of

tenderness or
pain

pulsation

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-4

Chapter 8: Assessment Techniques and the Clinical Setting

Palpation Specifics
(cont.)

Uses for particular parts of the hand

Fingertipsbest for fine tactile discrimination, as of skin


texture, swelling, pulsation, and determining presence of
lumps

A grasping action of the fingers and thumbto detect the


position, shape, and consistency of an organ or mass

The dorsa (backs) of hands and fingersbest for


determining temperature because the skin here is thinner
than on the palms

Base of fingers (metacarpophalangeal joints) or ulnar


surface of the handbest for vibration
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-5

Chapter 8: Assessment Techniques and the Clinical Setting

Cultivating Your Senses

Percussion
Purpose
Indirect percussion
Stationary hand
Striking hand
Characteristics of percussion notes
Resonant
Hyperresonant
Tympany
Dull
Flat

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-6

Chapter 8: Assessment Techniques and the Clinical Setting

Cultivating Your Senses (cont.)

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-7

Chapter 8: Assessment Techniques and the Clinical Setting

Cultivating Your Senses


(cont.)

Auscultation

Fit and quality of


stethoscope

Diaphragm and bell


endpieces

Eliminate confusing
artifacts

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-8

Chapter 8: Assessment Techniques and the Clinical Setting

Setting

Examination room

Examination table

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-9

Chapter 8: Assessment Techniques and the Clinical Setting

Equipment

Platform scale with height attachment

Skinfold calipers

Sphygmomanometer

Stethoscope with diaphragm and bell

Thermometer

Pulse oximeter (in hospital setting)

Flashlight or penlight

Otoscope/ophthalmoscope

Tuning fork

Nasal speculum

Tongue depressor
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-10

Chapter 8: Assessment Techniques and the Clinical Setting

Equipment
(cont.)

Pocket vision screener


Skin-marking pen
Flexible tape measure and ruler
Reflex hammer
Sharp object (split tongue blade)
Cotton balls
Bivalve vaginal speculum
Clean gloves
Materials for cytologic study
Lubricant
Fecal occult blood test materials

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-11

Chapter 8: Assessment Techniques and the Clinical Setting

A Safer Environment

Clean the equipment

Clean vs. used area for handling equipment

Nosocomial infections

Handwashing or alcohol-based hand rub

Wear gloves

Standard precautions

Transmission-based precautions
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-12

Chapter 8: Assessment Techniques and the Clinical Setting

Approach to the
Clinical Setting

General approach

Patients emotional state

Examiners emotional state

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-13

Chapter 8: Assessment Techniques and the Clinical Setting

Approach to the Clinical Setting


(cont.)

Hands on

Measurement and vital signs

Begin with persons hands

Concentrate on one step at a time

Examination sequence

Brief health teaching

When findings are complicated

Summarize findings for person


Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-14

Chapter 8: Assessment Techniques and the Clinical Setting

Your physical examination of the patient


should begin on the hands because
A.

They are easy to reach from any position.

B.

They reveal a great deal about the patient.

C.

They will always be clean and dry.

D.

They are a place people are accustomed to


being touched by strangers.

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-15

Chapter 8: Assessment Techniques and the Clinical Setting

Which of the following characteristics


is not evaluated via palpation?
A.

Temperature

B.

Resilience

C.

Density

D.

Crepitation

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 8-16

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