NUR3411

Explain the components of health hx - Purpose: to collect subjective data (what a person says about him or herself). description: Made up of biographic data, source/reliability, reason for seeking care, HPI, past health, Family hx, review of systems .The hx is combined with the objective data from the physical examination and laboratory studies to form the database. Rationale: health hx provides a complete picture of the person's past & present health. Describes the individual as a whole and how the person interacts with the environment. Describe the skills needed to perform a physical exam - The physical examination requires you to develop technical skills and a knowledge base. The technical skills are the tools to gather data. You use your senses - sight, smell, touch, and hearing to gather data. The skills requisite for the physical examination are: inspection, palpitation, percussion, and auscultation (in this order) **different order for abdomen -- auscultate first, palpate, percussion (changes the orientation of what's inside) Inspection : concentrated watching. Close, careful scrutiny, first of the individual as a whole and then of each body system. Begins the moment you first meet the pt. Develop a "general survey" Palpatation : applies your sense of touch to assess these factors: texture, temperature, moisture, organ location and size, any swelling, vibration or pulsation, rigidity or spasticity, crepitation, presence of lumps or masses, and presence of tenderness of pain. fingertips -- best for fine tactile discrimination, as of skin texture, swelling, pulsation, and determining presence of lumps grasping action of fingers & thumbs -- to detect the position, shape, and consistency of an organ or mass dorsa (back of hands & fingers) -- determining temp b/c skin is thinner here than on the palms base of fingers -- best for vibration percussion : tapping the person's skin with short, sharp strokes to assess underlying structures. Strokes yield a palpable vibration & a characteristic sound that depicts the location, size, and density of the underlying organ. Percussing hands are always available, are easily portable, and give instant feedback (as opose to xray). Uses for percussion -- mapping out the location & size of an organ, signaling the density, (air, fluid, or solid), detecting an abnormal mass, eliciting a deep tendon reflex