Fundamentals of Physical Assessment, Safety & Infection Control

Flashcards cover physical-exam steps, inspection details, palpation & percussion techniques, auscultation, stethoscope use, infection control (hand hygiene, PPE, standard vs. transmission-based precautions), safety measures, general survey components, vital measurements, and key definitions from the lecture.

List the four basic steps of a physical examination in their usual order.

Inspection, Palpation, Percussion, Auscultation.

Which assessment sequence is altered for the abdomen and why?

Inspection → Auscultation → Percussion → Palpation, because palpation/percussion can stimulate bowel sounds.

When does inspection begin during patient care?

The moment you or the patient enters the room.

During inspection, why is proper lighting essential?

Dim light can hide color changes such as dusky skin or cyanosis, potentially missing emergencies.

During inspection, what should you do if the body part is paired?

Compare right side to left side for symmetry.

Which part of the hand is most sensitive for detecting temperature?

The dorsal surface or back of the hand.

Which fingertips are recommended for counting a pulse and why?

Index and middle fingers (not the thumb) to avoid feeling your own pulse.

Why is palpation started lightly before deep palpation?

To accustom the patient to touch and assess surface characteristics before applying deeper pressure.

Give two situations in which deep palpation of the abdomen should be avoided.

Suspected abdominal trauma (e.g., possible spleen/liver rupture) or severe abdominal pain.

Describe the proper percussion technique.

Place the middle finger of the nondominant hand firmly on the surface; strike its distal joint briskly with the middle finger of the dominant hand twice, then lift.

Match the percussion note to the underlying tissue: resonant, tympany, dull, flat.

Resonant—normal lung; Tympany—stomach/intestine; Dull—liver or consolidated lung; Flat—bone or large muscle.

How should a stethoscope be positioned in the ears for best seal?

Earpieces angled forward toward the nose.

Which stethoscope side is used for low-pitched sounds such as bruits or murmurs?

The bell (baby = low).

Which stethoscope side is used for normal high-pitched heart, lung, and bowel sounds?

The diaphragm (daddy = high).

State three environmental or equipment factors that improve auscultation accuracy.

Quiet room (TV off), warm/clean stethoscope, placement directly on skin (not over clothing).

What is the single most effective way to protect patients from infection?

Hand hygiene before and after patient contact.

Define standard (universal) precautions.

Gloves and hand hygiene for all patients regardless of diagnosis to prevent contact with blood or body fluids.

Name the three categories of transmission-based precautions and give one example each.

Contact—draining wound/scabies; Droplet—influenza; Airborne—tuberculosis/COVID-19.

Which type of mask is required for airborne precautions?

An N95 or higher-level respirator that is fit-tested.

List the correct order for donning PPE (CDC).

Gown → Mask/respirator → Goggles/face shield → Gloves.

List the correct order for doffing PPE (CDC).

Gloves → Goggles/face shield → Gown → Mask/respirator → Hand hygiene.

Who is considered the mother of modern nursing and advocated hand hygiene?

Florence Nightingale.

How many patient identifiers are required before procedures, and give two examples?

Two; e.g., full name and date of birth.

How many side rails may be safely raised without creating a restraint?

Two (or three per some policies); four constitutes a restraint.

What are the four main components of the general survey?

Physical Appearance, Body Structure, Mobility, Behavior.

Define "alert and oriented ×4."

The patient correctly identifies person, place, time, and situation.

What patient posture often indicates respiratory distress?

Tripod position—sitting leaning forward with hands on knees.

At what waist circumference do cardiac and type 2 diabetes risks rise (men vs. women)?

40 inches (102 cm) in men and >35 inches (88 cm) in women.

Give the BMI ranges for normal weight and obesity.

Normal: 18.5–24.9 kg/m²; Obesity: ≥30 kg/m².

Why should daily weights be taken on the same scale at the same time?

To ensure comparability and detect true changes in fluid or body mass.

List two age-related body changes that affect measurement findings in older adults.

Decreased height from vertebral compression and increased truncal adiposity with reduced muscle mass.

What is the maximum number of gloves changes allowed within one patient encounter?

No set maximum; change whenever gloves are torn, soiled, or when switching from dirty to clean tasks.

Which precaution category requires both gloves and a gown for room entry?

Contact precautions.

Explain the difference between dysarthria and dysphasia.

Dysarthria—motor speech difficulty; comprehension intact. Dysphasia—language comprehension or expression deficit (aphasia).

What lighting advice was given to ensure accurate skin assessment?

Turn on bright lights or provide extra lighting; dim rooms can mask color changes.

What mnemonic was taught to recall donning sequence?

"Dance Hands"—Gown, Mask, Goggles, Gloves (hands revealed last).

In palpation, what is "crepitation"?

A crackling or grating sensation felt under the skin or in joints, as with TMJ.

Why should weight be taken with shoes removed and minimal clothing?

To obtain an accurate baseline free of variable extra weight.