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physical examination .pptx
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- 2. INTRODUCTION HEALTH: Health isa state of complete physical, mental and social well being and not merely the absence of disease or infirmity. (WHO, 1947) ASSESSMENT: Assessment is defined as a systematic, dynamic process by which the nurse through interaction with client, significant others and health care providers, collects and analyze data about the client. (ANA)
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- 6. PHYSICAL EXAMINATION •It isthe systemic collection of objective information that is directly observed or is elicited through examination techniques.
- 7. PHYSICAL EXAMINATION CONTD.. • Itis the thorough inspection or a detailed study of the entire body or some parts of the body to determine the general physical or mental conditions of the body.
- 8. PURPOSES OF PHYSICAL EXAMINATION Tounderstand the physical and mental well-being of the clients. To detect diseases in its early stage. To determine the cause and the extent of disease. To understand any changes in the condition of diseases, any improvement or regression.
- 9. PURPOSES OF PHYSICALEXAMINATION CONTD… To determine the nature of the treatment or nursing care needed for the client. To safeguard the client and his family by noting the early signs especially in case of a communicable disease. To contribute to the medical research. To find out whether the person is medically fit or not for a particular task.
- 10. METHODS/TECHNIQUES OF PHYSICAL EXAMINATION INSPECTIONPALPATION AUSCULTATION PERCUSSION OLFACTION METHODS OF PHYSICAL EXAMINATION
- 11. INSPECTION It is asystematic visual examination of the client. It involves observation of the colour, shape, size, symmetry, position and movements. It also use the sense of smell to detect odor, and sense of hearing to detect sounds.
- 12. INSPECTION CONTD… Inspection beginswith the initial contact with the client and continues through the entire assessment. The optimal conditions for effective inspection are full exposure of the area and adequate lighting.
- 13. PALPATION • It isuse of hands and fingers to gather information through touch. • It is the assessment technique which uses sense of touch. • It is feeling the body or a part with hands to note the size and position of the organs.
- 14. PALPATION • The handsand fingers are sensitive tools and can assess temperature, texture(appearance), moisture, vibrations, size, position, masses, fluid etc. • The dorsum(back) surfaces of the hand and fingers are used to measure temperature. • The palmar(front) surfaces of the fingers and finger pads are used to assess texture, shape, fluid, size, consistency(healthy) and pulsation. • Vibration is palpated best with the palm of the hand.
- 15. ROLE OF ANURSE IN PALPATION The nurse’s hands should be warm and fingernails should be short. The touch should be gentle and respectful. She should palpate the area of tenderness at last. She should used light, moderate, or deep palpation. The purpose of deep palpation is to locate organs, determine their size and to detect abnormal masses.
- 16. PERCUSSION •It is theexamination by tapping the fingers on the body to determine the condition of the internal organs by the sounds that are produced.
- 17. PERCUSSION CONTD… • Thesound waves produced by the striking action over body tissues are known as percussion tones or percussion notes.
- 18. PERCUSSION CONTD… Resonance: Thedegree to which sound propagates(generate) is called resonance. Tones of percussion: Percussion provides five characteristics tones – TYMPANIC HYPER-RESONANT RESONANT DULL FLAT
- 19. PERCUSSION CONTD… • TYMPANIC:Tympanic sounds are hollow, high, drumlike sounds.. Tympanic sounds heard over the chest indicate excessive air in the chest, such as may occur with pneumothorax. • RESONANT: Resonant sounds are low pitched, hollow sounds heard over normal lung tissue. • HYPER-RESONANT: 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.
- 20. PERCUSSION CONTD… • DULL:Dull or thudlike sounds are normally heard over dense areas such as the heart or liver. • FLAT: Flat or extremely dull sounds are normally heard over solid areas such as bones.
- 21. TYPES OF PERCUSSION DIRECTINDIRECT
- 22. DIRECT PERCUSSION •Direct percussionis accompanied by tapping an area directly with the finger tip of the middle finger or thumb.
- 23. INDIRECT PERCUSSION • Indirectpercussion involves two hands. • The hand is placed on the area to be percussed and the finger creating vibrations that allows discrimination among five different tones.
- 24. AUSCULTATION • It isthe process of listening to sounds that are generated within the body. • Auscultation is usually done with the help of a stethoscope.
- 25. AUSCULTATION CONTD… • Theheart and blood vessels are auscultated for circulation of blood. • The lungs are auscultated for moving air(breath sounds). • The abdomen is auscultated for movement of gastro- intestinal contents(bowel sounds). • When auscultating a part, that area should be exposed, and should be quiet.
- 26. AUSCULTATION CONTD… FOUR CHARACTERISTICSOF SOUND ARE ASSESSED BY AUSCULTATION: 1. Pitch (ranging from high to low). 2. Loudness (ranging from soft to loud). 3. Quality (gurgling or swishing). 4. Duration (short, medium or long).
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