techniques andch06 lecture
TRANSCRIPT
8/12/2019 Techniques AndCH06 Lecture
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Health & Physical
Assessment in NursingFirst Edition
Chapter 6
Techniques and
Equipment
Donita D’Amico
andColleen Barbarito
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Inspection
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.1 Inspection of client.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Palpation
• Characteristics
– Size
– Shape
– Location
– Mobility
– Position
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Palpation• Characteristics
– Vibrations
– Temperature – Texture
– Moisture
– Tenderness
– Edema
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.2 Sensitive areas of the hand.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Palpation
• Light
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.3 Light palpation.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Palpation
•Moderate
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.4 Moderate palpation.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Palpation
•Deep
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Percussion
•Methods – Direct
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.6 Direct percussion.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Percussion
•Methods – Blunt
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Percussion
•Methods – Indirect
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.8 Indirect percussion.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Percussion Sounds
•Tympany
• Resonance
• Hyperresonance
• Dullness• Flatness
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Characteristics of Percussion Sounds
•Intensity or amplitude
• Pitch or frequency
• Duration
• Quality
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE ONE
Auscultation
•Sounds – Intensity
– Pitch
– Duration
– Quality
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE TWO
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE TWO
Equipment used During Physical
Assessment• Stethoscope
• Doppler ultrasonic stethoscope
• Ophthalmoscope• Otoscope
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Table 6.1 Equipment Used During the Physical Assessment
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Table 6.1 (continued) Equipment Used During the Physical Assessment
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE TWO
Stethoscope
•Bell
• Diaphragm
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.9 A. Stethoscope with both a bell-shaped and flat-disc amplifier. B. Close-up of a flat-disc amplifier (left) and a bell amplifier
(right).
A
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.9 (continued) A. Stethoscope with both a bell-shaped and flat-disc amplifier. B. Close-up of a flat-disc amplifier (left) and a
bell amplifier (right).
B
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.10 Nurse using a stethoscope.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE TWO
Doppler Ultrasonic Stethoscope
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.11 Doppler ultrasonic stethoscope.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE TWO
Ophthalmoscope
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.12 Ophthalmoscope demonstrating aperture.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.13 Apertures of ophthalmoscope.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE TWO
Otoscope
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
Figure 6.14 Otoscope.
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE THREE
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Health and Physical Assessment in Nursing, 1eBy Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice HallUpper Saddle River, NJ 07458
LEARNING OBJECTIVE THREE
Measures• Warm, private, distraction-free exam room
• Good overhead lighting with a portable lamp
• Clean, firm exam surface
• Knowledge of client’s preferences for personalvalues and beliefs
• Decreasing client’s anxiety
• Providing privacy and draping
• Handwashing
• Use of standard precautions
• Explanation of procedures
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Health and Physical Assessment in Nursing, 1e
By Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice Hall
Upper Saddle River, NJ 07458
LEARNING OBJECTIVE FOUR
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Health and Physical Assessment in Nursing, 1e
By Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice Hall
Upper Saddle River, NJ 07458
LEARNING OBJECTIVE FOUR
Critical Thinking and Physical Assessment
•Organize data
• Analyze data
• Interpret findings
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Health and Physical Assessment in Nursing, 1e
By Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice Hall
Upper Saddle River, NJ 07458
LEARNING OBJECTIVE FIVE
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Health and Physical Assessment in Nursing, 1e
By Donita D’Amico and Colleen Barbarito
© 2007 Pearson Education, Inc.
Pearson Prentice Hall
Upper Saddle River, NJ 07458
LEARNING OBJECTIVE FIVE
Standard Precautions - Guidelines to
Protect the Client and Healthcare
Workers
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Health and Physical Assessment in Nursing 1e
© 2007 Pearson Education, Inc.
Pearson Prentice Hall
LEARNING OBJECTIVE FIVE
Guidelines
• Handwashing
• Gloves
• Protective barriers
• Disposal of sharps
• Cautionary handling of specimens
• Proper disposal of body wastes