NU 201 Chapter 8 & 11

Define history of health

Subjective data for health assessment

What does physical examination require the examiner to do?

Develop technical skills, the tools to gather data

What sense does the examiner use during the physical examination?

Sight

Smell

Touch

Hearing

List the skills performed one at a time IN THIS ORDER

IPPA

What does the I stand for in IPPA?

Inspection

What does inspection require during the physical examination?

Good lighting

Adequate exposure

Use of instruments to enlarge your view

What does the first P stand for in IPPA?

Palpation

what is palpation use to assess?

Texture

Temp

Moisture

Organ location and site

Swelling, vibration or pulsation

Crepitation

Presence of lumps or masses

Presence of tenderness or pain

What to parts of the hand can be used for palpation?

Fingertips

Fingers and Thumbs

When would you palpate with the finger tips?

Best for fine tactile discrimination of skin texture, swelling, pulsation, determining presence of lumps

When would you palpate with the fingers and thumbs?

Detection of position, shape, and consistency of an organ or mass

What is the ulnar of the hand best for detecting during palpation?

Best for fine detecting vibration

When is the dorsum part of the hand best for detecting during palpation?

Detection of temperature

What does the 2nd P stand for in IPPA?

Percussion

Define percussion

Tapping person’s skin with short, sharp stokes to assess underlying structures

What are the two methods of percussion?

Direct percussion and indirect percussion

what is direct percussion

The striking hand directly contacts the body wall

What is indirect percussion?

Using both hands, the striking hand contacts stationary hand fixed on person’s skin.

Describe resonant percussion sound

Over normal lung tissue

Describe hyper-resonant percussion sound

Emphysema

Describe Tympany percussion sound

Stomach (air filled)

Describe dull percussion sound

Liver, Spleen (dense organ) Pneumonia

Describe flat percussion sound

Thigh, muscle, bone or tumor

What does the A stand for in IPPA

Auscultation

Define Auscultation

Listening to sounds produced by body

What is the diaphragm used for on the stethoscope?

Used for high pitched sounds

what is the bell used for on the stethoscope?

Used for low pitched sounds

what is neuropathic pain?

Pain that does not adhere to typical phases

what is visceral pain?

Pain originates from larger interior organs

Where is somatic pain?

Comes from sources such as blood vessels, joints, tendons, muscles, and bone

Where is cutaneous pain?

Derived from skin surfaces and subcutaneous tissues

What is referred pain?

Pain that is felt at a particular site but originates form another location

What is acute pain?

Short term and self-limiting

What is chronic pain

Pain is diagnosed when pain continues for 6 months or longer

Is pain subjective or objective?

Subjective

What is pain?

Pain is whatever the experiencing person says it is

What is the most reliable indicator of pain?

Subjective report

Do physical findings always support patient’s pain complaints?

NO