Chapter 28: Assisting With the Physical Examination

What is the role of a Nursing Assistant in a LTCF?

• Collect needed linens

• Collect equipment and supplies

• Prepare the room for the exam

• Provide lighting

• Transport the person to and from the exam room

• Measure vital signs, weight, and height

• Position and drape the person

• Hand equipment and supplies to the examiner

• Label specimen containers

• Discard used supplies

• Clean equipment

• Help the person dress or move to a comfortable position after the exam

• Follow center policy for soiled linens

What is measured prior to physical exams?

Weight and height

What are the guidelines for weighting and taking the height of a resident?

• The person wears only a gown or pajamas. Clothes add weight. No footwear is worn. Footwear adds to the weight and height measurements.

• The person voids before being weighed. A full bladder adds weight.

• Weigh the person at the same time of day. Before breakfast is the best time. Food and fluids add weight.

• Use the same scale for daily, weekly, and monthly weights. Scales weigh differently.

• Balance the scale at zero (0) before weighing the person. For balance scales, move the weights to zero. A digital scale should read at zero.

What is required for a physical exam.

Informed Consent

What should be explained to a resident to avoid uncomfortable and embarrassing feelings?

• Why the position is needed.

• How to assume the position.

• How the body is draped for warmth and privacy.

• How long to expect to stay in the position.

What is the dorsal recumbent position used for?

Examine the abdomen, chest, and breasts

What is hte lithotomy position used for?

Examine the vagina and cervix

What is the knee-chest position used for?

Examine the rectum

What is the left side-lying position used for?

Examine the rectum

What should a NA do after an exam?

• Discard disposable items.

• Replace supplies so the tray is ready for the next exam.

• Clean reusable items according to center policy. Return them to the tray or storage area. This includes the otoscope and ophthalmoscope tips and stethoscope.

• Send a reusable speculum to the supply area. It needs to be sterilized.

• Cover the exam table with a clean drawsheet or paper.

• Label specimens. Take them to the designated area with a requisition slip.

• Clean and straighten the person’s unit or exam room.

• Follow center policy for soiled linens.