NUR-634 Advanced
Physical Assessment
Midterm CORRECT
ANSWERS.
Subjective Data - correct-answers--symptoms from the client's point of
view and include: feelings, perceptions, and concerns
-what the patient tells you
Objective Data - correct-answers--what the health professional
observes by inspecting, palpating, percussing, and auscultating during
the physical examination
-observed signs
Assessment - correct-answers--the clinical reasoning process that
interprets the patient's history and physical examination, singles out
identified problems, and movement from each problems to its action
plan
Plan - correct-answers--incorporates patient education, changes in
medications, needed tests, referrals to other clinicians, and return
visits for counseling and support
-requires good interpersonal skills and sensitivity to the patients goals,
economic means, competing responsibilities, and family
struggles/dynamics
Percussion - correct-answers--a diagnostic procedure designed to
determine the density of a body part by the sound produced by
tapping the surface with the fingers
, -use of the striking or plexor finger (usually the 3rd) to deliver a rapid
tap or blow against the distal pleximeter finger (usually the distal 3rd
finger of the left hand laid against the surface) to evoke a sound wave
-the 5 sounds are resonant, flat, dull, hyper resonant, and tympanic
-Resonant sounds are low pitched, hollow sounds heard over normal
lung tissue.
-Flat are normally heard over solid areas such as bones. thigh
-Dull or thudlike sounds are normally heard over dense areas such as
the heart or liver. Dullness replaces resonance when fluid or solid
tissue replaces air-containing lung tissues, such as occurs with
pneumonia, pleural effusions, or tumors.
-Hyperresonant sounds that are louder and lower pitched than
resonant sounds are normally heard when percussing the chests of
children and very thin adults. Hyperresonant sounds may also be heard
when percussing lungs hyperinflated with air, such as may occur in
patients with COPD, or patients having an acute asthmatic attack. An
area of hyperresonance on one side of the chest may indicate a
pneumothorax.
-Tympanic sounds are hollow, high, drumlike sounds. Tympany is
normally heard over the stomach, but is not a normal chest sound.
Tympanic sounds heard over the chest indicate excessive air in the
chest, such as may occur with pneumothorax.
Attributes of a Symptom - correct-answers--seven attributes
-OPQRST & Associated manifestations (anything else accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity, timing
Talkative Challenging Patient Intervention - correct-answers--give 5-10
minutes uninterrupted
-focus on and ask questions to what seems most important to patient
-summarize concerns and focus on #1 concern today
-avoid impatience
Physical Assessment
Midterm CORRECT
ANSWERS.
Subjective Data - correct-answers--symptoms from the client's point of
view and include: feelings, perceptions, and concerns
-what the patient tells you
Objective Data - correct-answers--what the health professional
observes by inspecting, palpating, percussing, and auscultating during
the physical examination
-observed signs
Assessment - correct-answers--the clinical reasoning process that
interprets the patient's history and physical examination, singles out
identified problems, and movement from each problems to its action
plan
Plan - correct-answers--incorporates patient education, changes in
medications, needed tests, referrals to other clinicians, and return
visits for counseling and support
-requires good interpersonal skills and sensitivity to the patients goals,
economic means, competing responsibilities, and family
struggles/dynamics
Percussion - correct-answers--a diagnostic procedure designed to
determine the density of a body part by the sound produced by
tapping the surface with the fingers
, -use of the striking or plexor finger (usually the 3rd) to deliver a rapid
tap or blow against the distal pleximeter finger (usually the distal 3rd
finger of the left hand laid against the surface) to evoke a sound wave
-the 5 sounds are resonant, flat, dull, hyper resonant, and tympanic
-Resonant sounds are low pitched, hollow sounds heard over normal
lung tissue.
-Flat are normally heard over solid areas such as bones. thigh
-Dull or thudlike sounds are normally heard over dense areas such as
the heart or liver. Dullness replaces resonance when fluid or solid
tissue replaces air-containing lung tissues, such as occurs with
pneumonia, pleural effusions, or tumors.
-Hyperresonant sounds that are louder and lower pitched than
resonant sounds are normally heard when percussing the chests of
children and very thin adults. Hyperresonant sounds may also be heard
when percussing lungs hyperinflated with air, such as may occur in
patients with COPD, or patients having an acute asthmatic attack. An
area of hyperresonance on one side of the chest may indicate a
pneumothorax.
-Tympanic sounds are hollow, high, drumlike sounds. Tympany is
normally heard over the stomach, but is not a normal chest sound.
Tympanic sounds heard over the chest indicate excessive air in the
chest, such as may occur with pneumothorax.
Attributes of a Symptom - correct-answers--seven attributes
-OPQRST & Associated manifestations (anything else accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity, timing
Talkative Challenging Patient Intervention - correct-answers--give 5-10
minutes uninterrupted
-focus on and ask questions to what seems most important to patient
-summarize concerns and focus on #1 concern today
-avoid impatience
