HA teachniques (IAPP) Exam 2

Inspection

Concentrated watching and visual appraisal of anatomical attributes and patient demeanors.

• 1st in assessment

Palpation

Tactile assessment using hand contact to evaluate structural features, temperature, and tissue characteristics.

• 2nd in assessment

Percussion

Striking body tissues to elicit sound notes reflective of underlying structural density.

• 3rd in assessment

Auscultation

Acoustic evaluation of internal organ sounds using a stethoscope.

Resonant

• Air in lung

• Healthy lung tissue

• Basic pulmonary resonance assessment.

Tympany

• Air in viscous organ

• stomach

• Differentiating gas-filled, hollow abdominal viscera.

Dull

• dense organ

• liver

• Identifying solid organ boundaries and tissue densities

Flat

• solid structure

• bone, mass, muscle

• identifying dense anatomical barriers or abnormal tissue masses

Eliciting Deep Tendon Reflexes (DTR)

Tapping tendons with a reflex hammer to assess spinal reflex arcs.

CVA Tenderness

Percussing the costovertebral angle to evaluate renal inflammation or pyelonephritis.

Diaphragm

• used most often

• press firmly aganist skin

• High-pitched sounds

• breath, bowel, and normal heart sounds

bell

• used less often

• press lightly aganist skin

• low-pitched sounds

• heart murmurs and extra heart sounds (S3/S4)

stethoscope must do’s

• earpieces must point forward

• environmental controls (privacy, silent while listening)

• direct skin contact

• clean after each patient to avoid nosocomial infections

Pediatrics & Infants

Alter sequence to perform least invasive procedures first. Listen to lungs and evaluate range of motion (ROM) early while calm. Save intrusive exams (inspecting throat/ mouth - "Say ahhh!") for last.

Adolescents (Teens)

Follow standard sequence, but maintain strict bodily coverage and privacy boundaries.

Older Adults (Elders)

Pace the exam carefully. Limit position changes (e.g., sitting to lying down) throughout the evaluation.

• Optimize room lighting and eliminate background ambient sounds. Speak clearly facing the patient.

Acutely Ill Patients

Perform a focused assessment targeting the acute chief complaint. Defer a complete head-to-toe exam until tolerated.

• Alter YOUR position as the examiner to accommodate patient movement limitations and prioritize immediate physical comfort.