NURS 190 PHYSICAL ASSESSMENT STUDY GUIDE QUIZ # 1 SPRING 2 2021/2022

NURS 190 PHYSICAL ASSESSMENT STUDY GUIDE QUIZ # 1 SPRING 2 2021/2022 Basic techniques of physical assessment Pg. 145 Ch. 9 Ch. 7 p. 82-83 (4th edition) • IPPA = Inspect/ Palpate/ Percuss/ Auscultate • Abdomen = IAPerPal • Observe for: size, shape, location, mobility of a part, position, vibrations, temperature, texture, moisture, tenderness, edema • Dorsal side of hand – for temp • Nurse should warm the hands; keep fingernails short, smooth, and trimmed; and not wear jewelry. • Use the tip of the plexor finger, NOT the finger pad, to deliver the blow. • Use two strikes and then reposition the pleximeter. • Percussion: The denser the tissue is, the softer and shorter the tone. Less dense the tissue is, the louder and longer the tone. • The five percussion sounds are classified as follows: o Tympany is a loud, high-pitched, drumlike tone of medium duration characteristic of an organ that is filled with air. It is heard commonly over the gastric bubble in the stomach or over air-filled intestines. o Resonance is a loud, low-pitched, hollow tone of long duration. It is the normal finding over the lungs. o Hyperresonance is an abnormally loud, low tone of longer duration than resonance; heard when air is trapped in lungs. o Dullness is a high-pitched tone that is soft and of short duration. It is usually heard over solid body organs such as the liver or a stool-filled colon. o Flatness is a high-pitched tone, very soft, and of very short duration. It occurs over solid tissue like muscle or bone. Equipment used during the physical assessment Pg. 149-152, 155 Ch. 9 Ch. 7 p. 87-88 • Computer, laptop, or tablet • Cotton balls or wisps • Cotton-tipped applicators • Culture media • Dental mirror • Doppler ultrasonic stethoscope – to obtain BP, pulse, fetal HR, or peripheral pulses that cannot be easily palpated • Ophthalmoscope – inspect eye • Otoscope – inspect ear • Stadiometer – measures height • Reflex hammer, smelling thing, second hand watch, penlight, gloves Hand hygiene Pg. 155 Ch.9 Ch. 7 p. 93 • WHO recommendations, nurses should scrub and rinse hands with soap for 40–60 seconds when the hands are visibly soiled, after using the restroom, after removing gloves, and before and after contact with medical equipment Gathering data Pg. 211-212, 219, 220-221 Ch. 13 Ch. 12 p. 173 • Subjective Data- Health History and ask Focused Interview Questions while conducting a patient interview. • O= Onset • L=Location • D=Duration • C=Character