examination

Examination Equipment for Physical Assessment

Overview of Examination Equipment

  • Essential tools used by nurses during physical assessment to evaluate patient's health status.

  • Commonly used items include:

    • Stethoscope

    • Otoscope

    • Ophthalmoscope

    • Penlight

    • Tape measure

Stethoscope

  • Purpose: Used to auscultate body sounds, including lung, heart, and bowel sounds.

  • Components:

    • Diaphragm: Detects high frequency sounds (e.g., bowel or lung sounds).

    • Bell: Detects low frequency sounds (e.g., heart sounds).

  • Usage:

    • Diaphragm: Place firmly against patient’s skin for effective sound transmission.

    • Bell: Place lightly on patient’s skin; too much pressure alters function and listening accuracy.

  • Artifact Elimination:

    • Remove potential extra sounds that can interfere with auscultation, caused by:

    • Room noise

    • Patient's body hair or clothing

    • Handling of the stethoscope tubing

    • Recommendations to eliminate artifacts:

    • Conduct auscultation in a quiet environment.

    • Avoid bumping or knocking the tubing.

    • Ensure the diaphragm or bell directly contacts the patient’s skin instead of through clothing.

  • Earpiece Positioning:

    • Ensure earpieces are oriented in the same direction as ear canals, pointing towards the nose.

Otoscope

  • Purpose: Visualizes the ear canal and tympanic membrane (eardrum) using light.

  • Components:

    • Base: Acts as a handle and encompasses the battery and on/off switch.

    • Head: Contains magnifying lens and light source.

    • Speculum: A disposable, appropriately sized plastic funnel attached to the head to guide light into the ear.

  • Usage Guidance:

    • Prior to speculum insertion, ensure optimal visualization:

    • For patients under three years old: Pull the pinna down and back.

    • For patients three years old and older: Pull the pinna up and back.

Ophthalmoscope

  • Purpose: Facilitates examination of the internal structures of the eyes, particularly the fundus.

  • Components:

    • Lenses and Mirrors: Allow viewing through the pupil into the back of the eye.

    • Base / Head: Similar to otoscope; adjusts focus and judiciously manages light for visibility.

    • Viewing Aperture: Adjusted based on patient’s pupil dilation.

    • Mirror Window: Reflects light to enhance visibility of internal structures.

Penlight

  • Purpose: Provides focused light for enhanced inspection of various body parts and pupil assessment.

  • Common Use: Evaluating pupils for equal size, roundness, reaction to light, and accommodation (abbreviated as PERLA).

    • Pupil Measurement: Some penlights have a side gauge for accurate pupil size measurement.

  • Applications:

    • Visualizing structures such as:

    • Eyes

    • Ears

    • Nose

    • Mouth

    • Throat

    • Identifying lesions or skin changes.

Tape Measure

  • Purpose: Measures dimensions of different body parts.

  • Applications:

    • Circumference measurements of swollen extremities.

    • Fundal height measurements in pregnant patients.

    • Circumference of an infant's head.

  • Specifications:

    • Typically composed of flexible fabric or paper.

    • Marked in both centimeters and inches.

Summary

  • Equipment essential for performing a thorough physical assessment includes:

    • Stethoscope

    • Otoscope

    • Ophthalmoscope

    • Penlight

    • Tape measure