Chapter 8 Key Points: Assessment Techniques and Clinical Setting

Flashcards covering key concepts from Chapter 8 regarding assessment techniques and the clinical setting, intended for exam preparation.

What are the four assessment techniques used in a physical examination?

Inspection, palpation, percussion, and auscultation

What is inspection in the context of physical examination?

Close, careful observation of the individual as a whole and then of each body system

What is palpation?

The use of touch to assess texture, temperature, moisture, and organ location and size

What are the fingertips best used for during palpation?

Fine tactile discrimination

What part of the hand is best for determining temperature during palpation?

The backs of the hands and fingers

What is the ulnar surface of the hand best for assessing?

Vibration

What is the difference between light and deep palpation?

Light palpation detects surface characteristics, while deep palpation assesses an organ or mass deeper in a body cavity.

What is bimanual palpation?

The use of both hands to envelop or capture certain body parts or organs

What is percussion?

Tapping the patient’s skin with short, sharp strokes to assess underlying structures

What can percussion assess?

Location, size, and density of an organ; superficial abnormal mass; or elicit a deep tendon reflex

How should the middle finger be positioned for percussion?

Hyperextended with its distal joint and tip firmly against the person’s skin

What are the four components of percussion sounds?

Amplitude, pitch (or frequency), quality (or timbre), and duration

What is auscultation?

Listening to sounds produced by the body, usually using a stethoscope

What part of the stethoscope is used for high-pitched sounds?

The diaphragm

What part of the stethoscope is used for soft, low-pitched sounds?

The bell

What is the single most important step to decrease microorganism transmission?

Thorough handwashing or using an alcohol-based hand rub

When should hand hygiene be performed?

Before and after physical contact with each patient, after contact with body fluids or contaminated equipment, and after removing gloves

What type of precautions should be used for all patients?

Standard Precautions

How can patient anxiety be reduced at the beginning of an examination?

By beginning with familiar, nonthreatening actions, such as measuring height, weight, and vital signs

What should be done after the person puts on a patient gown?

Return to the room and clean your hands in his or her presence.

What should you do during the examination?

Explain each step and how the patient can cooperate, proceed systematically, and offer brief teaching as appropriate.

How should the examination be adjusted for a child?

Consider the child’s developmental stage when determining the examination sequence.

How should the examination be adjusted for adolescents?

Keep in mind that adolescents are self-conscious and introspective, thus when examining the genitalia, do it last and quickly.

How should the examination be adjusted for an aging adult?

Adjust the position and preparation as needed, and pace the examination to match the older adult’s pace, which may be slowed.

What to do when examining a patient in distress?

Alter the position during the examination, first collect a mini-database, and then complete the assessment after the initial distress is resolved.