Discuss the purpose of the physical assessment. Differentiate a complete from a focused physical assessment.

Differentiate nursing physical assessment from medical physical assessment. Identify the tools used during a physical assessment.

Define physical assessment techniques. Demonstrate physical assessment techniques. Discuss variations in approaches for different age groups. Define the components of the physical assessment.

Provides an objective data base Identifies actual/potential health problems Identifies patients strengths Validates history data

Complete Focused Which type do you do? Reason for performing examination Patients condition Amount of time

General survey Measurements

Vital signs Height Weight

Head-to-toe, including all systems

Thermometer Doppler Pen light Otoscope

Stethoscope Visual acuity charts Ophthalmoscope Nasoscope

Transilluminator Tape measure Goniometer Triceps skinfold calipers

Ruler Scale Tongue depressor

Cotton balls Cup of water Safety pins or toothpicks Substances for smell and taste

Test tubes Coin Gloves

Lubricant Specula Cytology brush and scraper Slides Hemoccult test

Inspection Palpation Percussion Auscultation

Types Senses

Direct, indirect Sight, smell What can inspection tell you?

Surface characteristics Symmetry Gross abnormalities or signs of distress Unusual odors

Types Senses

Single-handed, bimanual Touch

Light: < 1/2 inch Deep: > 1/2 inch Ballottement: used to assess partially freefloating objects

Dorsal aspect

Best for temperature Best for vibrations

Balls & ulnar surface of hand

Fingertips

Best for fine sensations

What can palpation tell you? Light

Surface characteristics

Deep
Organs, masses, tenderness

Ballottement
Size, shape of free-floating objects

Types
Direct (immediate) Indirect (mediate) Fist or blunt

Senses
Touch Hearing

What can percussion tell you? Direct or indirect

Density (air, fluid, solid) Size and shape Tenderness Deep tendon reflexes

Fist or blunt
Tenderness

Types Senses

Direct, indirect: stethoscope Hearing What can auscultation tell you?

Heart sounds Lung sounds Bowel sounds Vascular sounds

System or region Be systematic. Minimize position change. Expose only the area being assessed.

Explain as you go. Share findings with patient and teach. Ensure privacy and confidentiality. Consider developmental level of patient. Consider cultural background of patient.

Age: actual and apparent Race Level of consciousness Obvious abnormalities or signs of distress

Gender Affect Dress Speech Posture

Temperature Respirations Height

Pulse Blood pressure Weight

Integumentary Breast Cardiovascular Musculoskeletal Genitourinary/repro ductive

HEENT Respiratory Gastrointestinal Neurological

Accurately Concisely Objectively Record by systems Chart pertinent negatives