2. Is the systematic assessment of human
body which involves the uses of senses to
determine the general physical and mental
condition of the body
Physical Examination
3. General Examination or Head to Toe Examination
General Appearance
Nourishment: well nourished or undernourished
Body build: thin or obese
Health: healthy or unhealthy
Activity: active or dull (tired)
Mental Status
Consciousness: conscious, unconscious, delirious, talking.
Look: anxious or worried, depressed
4. 1- Preparation of the Environment
2- Maintenance of Privacy
A separate examination room is needed. Keep the doctors closed. The relatives are not
allowed.
3- Lighting
As far as possible, natural light should be available in the examination room because if a
client is jaundiced, it may not be detected in the artificial light. There should be adequate
lighting.
4- Comfortable Bed or Examination Table
The client should be placed comfortably throughout the examination. e.g., a lithotomy
position may be maintained when examining the genitalia.
5- Preparation of the Equipment
the articles needed for the physical examination are kept ready for the examination at hand.
Rules in Physical Examination
5. Preparation of the Client
• Physical Preparation
• Keep the client clean. Shave the part if necessary. Keep the client in a
comfortable position which is convenient for the doctor to examine the
client. Empty the bladder prior to the examination. Empty the bowels by
an enema, if required. Loosen the garments and change into the hospital
dress, if it is the custom.
• Mental Preparation
• The client may be quite new to the hospital situation and they may be
anxious about his illness. He may have false ideas about the medical
examination. It is the duty of the nurse to relieve his anxieties and fears
by proper explanation. Explain the sequence of the procedure to gain his
confidence and cooperation.
6.
7.
8.
9.
10. 1. Inspection:
• Inspection is defined as “the use of the senses of vision, smell and
hearing to observe the normal condition or any deviations from
normal of various body parts.”
• The nurse inspects or looks body parts to detect normal
characteristics or significant physical sings.
• Inspection helps to know normal characteristics before trying to
distinguish abnormal findings in different ages.
• The quality of an inspection depends on the health professionals
willingness to spend time doing a thorough job.
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11. INSPECTION
• Use vision, hearing & smell
• Always first
• Look for symmetry
• Use good lighting
• Use good exposure
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12. PRINCIPLES OFACCURATE INSPECTION
• Good lightening either day light or artificial light is suitable.
• Expose body parts being observed only.
• look before touching.
• warm room for examination of the client “not cold not hot".
• Observe for color, size, location, texture, symmetry, odors,
and sounds.
• Compare each area inspected with the opposite side of body
if possible.
• Use pen light to inspect body cavities.
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13.
14. PALPATION
• Touch & feel with hands to determine:
Texture – use fingertips (roughness, smoothness).
Temperature – use back of hand (warm, hot, cold).
Moisture (dry, wet, or moist).
Organ location and size
Consistency of structure (solid, fluid, filled)
• Slow and systematic
• Light to deep
• Light palpation (tenderness)
• Deep palpation (abdominal organs/masses)
15. PRINCIPLES FORACCURATE PALPATION
• Examiner finger nails should be short.
• Use sensitive part of the hand.
• Start with light then deep palpation.
• Tender area are palpated last.
• Tell client to take slow deep breath to enhance muscle
relaxation.
• Examine condition of the abdominal organs
• Depressed areas must be approximately “2cm”
• Assess turger of skin measured by lightly grasping the body
part with finger tips.
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16.
17.
18.
19. PERCUSSION
Tap a portion of the body to elicit tenderness that varies
with the density of underlying structures.
Percussion denotes location, size and density of
underlying structures, percussion requires dexterity.
20. Methods of percussion:
Direct method: involving striking the body surface directly
with one or two fingers.
Indirect method: performed by placing the middle finger of
the examiner’s non dominant hand “pleximeter hand”
firmly against the body surface with palm and fingers
remaining off the skin, and the tip of the middle finger of
the dominant hand “plexor” strikes the base of the distal
joint of the pleximeter. Use a quick & sharp stroke
21.
22.
23.
24. AUSCULTATION
• Listening to body sounds
• Movement of air (lungs)
• Blood flow (heart)
• Fluid & gas movement (bowels)
• Remember the sound changes in the
abdomen…
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