NUR-634 Advanced Physical Assessment Midterm Study Guide
Study online at https://quizlet.com/_6taa3d
1. Subjective Data -symptoms from the client's point of view and include: feelings, perceptions, and
concerns
-what the patient tells you
2. Objective Data -what the health professional observes by inspecting, palpating, percussing, and
auscultating during the physical examination
-observed signs
3. Assessment -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
4. Plan -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
5. Percussion -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
, NUR-634 Advanced Physical Assessment Midterm Study Guide
Study online at https://quizlet.com/_6taa3d
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.
6. Attributes of a -seven attributes
Symptom -OPQRST & Associated manifestations (anything else accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity, timing
7. Talkative Chal- -give 5-10 minutes uninterrupted
lenging Patient -focus on and ask questions to what seems most important to patient
Intervention -summarize concerns and focus on #1 concern today
-avoid impatience
8. Angry Challeng- -acknowledge any involvement you may have in their anger and make amends
ing Patient Inter- -avoid reinforcing criticism of other clinicians
vention -validate their feelings without agreeing with their reasons
-ensure a safe environment, alert staff/security
-stay calm and avoid being confrontational
-keep a relaxed and nonthreatening posture
9. Silent Challeng- -be attentive and respectful and encourage patient to continue when they are
ing Patient Inter- ready
vention -watch for nonverbal cues such as difficulty controlling emotions
-watch for signs of depression
-ask why they are quiet
10. Confusing Chal- -guide questions, ask for clarification, and summarize
lenging Patient -watch for underlying issue if there is interference with communication
Intervention -when there are multiple symptoms focus on context of the symptoms emphasizing
the patients perspective
-consider delirium or intoxication
Study online at https://quizlet.com/_6taa3d
1. Subjective Data -symptoms from the client's point of view and include: feelings, perceptions, and
concerns
-what the patient tells you
2. Objective Data -what the health professional observes by inspecting, palpating, percussing, and
auscultating during the physical examination
-observed signs
3. Assessment -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
4. Plan -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
5. Percussion -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
, NUR-634 Advanced Physical Assessment Midterm Study Guide
Study online at https://quizlet.com/_6taa3d
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.
6. Attributes of a -seven attributes
Symptom -OPQRST & Associated manifestations (anything else accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity, timing
7. Talkative Chal- -give 5-10 minutes uninterrupted
lenging Patient -focus on and ask questions to what seems most important to patient
Intervention -summarize concerns and focus on #1 concern today
-avoid impatience
8. Angry Challeng- -acknowledge any involvement you may have in their anger and make amends
ing Patient Inter- -avoid reinforcing criticism of other clinicians
vention -validate their feelings without agreeing with their reasons
-ensure a safe environment, alert staff/security
-stay calm and avoid being confrontational
-keep a relaxed and nonthreatening posture
9. Silent Challeng- -be attentive and respectful and encourage patient to continue when they are
ing Patient Inter- ready
vention -watch for nonverbal cues such as difficulty controlling emotions
-watch for signs of depression
-ask why they are quiet
10. Confusing Chal- -guide questions, ask for clarification, and summarize
lenging Patient -watch for underlying issue if there is interference with communication
Intervention -when there are multiple symptoms focus on context of the symptoms emphasizing
the patients perspective
-consider delirium or intoxication
