1. Unit 7 Health Care Skills

2. Chapter 20 Physical Assessment

3. H&P Date Demographic data Source of referral Chief complaint(s) History of present illness Past history (continued)

4. H&P Current health status Family history of illness Psychosocial history Review of all systems Information called baseline

5. Variances from Normal Discriminate normal from abnormal –Use observation skills –Ask questions –Note changes in condition –Employ strong assessment skills Report variances to supervisor

6. General Survey Look at patient as whole Overall impression valuable –Determines where to focus if time limited What to look for in general survey

7. Psychosocial Observations Part of general survey Emotional status Mental status Appearance

8. Question True or False: –A critical function of the health care worker is to be able to discriminate between normal and abnormal conditions and situations.

9. Answer True Critical function of health care worker: –Discriminate between normal and abnormal conditions and situations

10. Physical Assessment Skills Inspection Auscultation Palpation Percussion

11. Assess Systems Musculoskeletal Integumentary Circulatory Respiratory Digestive Urinary (continued)

12. Assess Systems Eyes Ears Nervous Endocrine Female reproductive Male reproductive

13. Question Which of the following is using the senses of vision, hearing, and smell for observation of patient condition? A.Auscultation B.Palpation C.Inspection

14. Answer C. Inspection Inspection –Using senses of vision, hearing, and smell for observation of patient condition Auscultation –Listening to sounds inside body with aid of stethoscope

15. Answer C. Inspection Palpation –Using hands and fingers on exterior of body to detect evidence of abnormalities in various internal body organs

16. Pain Evaluation Subjective information Use pain rating scale –0 to 10 0 = no pain 10 = worst pain imaginable –Wong-Baker FACES Pain Rating Scale –Oucher Scale (continued)

17. Pain Scale Rating

18. Pain Evaluation Compare levels before and after pain medications Note nonverbal cues

19. Activities of Daily Living (ADL) Evaluation Actions done on regular basis to meet physical needs Inability to perform ADLs –Assistance needed as long as unable to do so

20. Vital Signs (VS) Temperature Pulse Respiration Blood pressure

21. Temperature Normal range essential to homeostasis Afebrile and febrile Intermittent fever Continuous fever Night sweats

22. Thermometer Routes Oral Axillary Rectal Aural Temporal artery

23. Question Which of the following would be an ADL (activity of daily living)? A.Doing laundry B.Gardening C.Playing piano

24. Answer A. Doing laundry Doing laundry is ADL –Action done on regular basis to meet physical needs Gardening and playing piano are not actions required to meet physical needs

25. Pulse Pulse points Rate Rhythm –Regular rhythm –Irregular rhythm Regular irregular rhythm Irregular irregular rhythm (continued)

26. Pulse Pulse volume Radial pulse Stethoscope Apical pulse Bradycardia (continued)

27. Pulse Tachycardia Pulse rates vary with age Apical-radial pulse deficit

28. Respiration Process of moving air through lungs Inhalation (inspiration) Exhalation (expiration) Eupnea Tachypnea Bradypnea (continued)

29. Respiration Ensure patient is unaware of respirations being counted Rate Rhythm –Apnea –Cheyne-Stokes (continued)

30. Respiration Respiratory effort Respiratory rates vary with age

31. Question What is tachycardia? A.Abnormally high heart rate B.Abnormally high respiratory rate C.Abnormally low heart rate

32. Answer A. Abnormally high heart rate Tachycardia –Abnormally high heart rate Tachypnea –Abnormally high respiratory rate Bradycardia –Abnormally low heart rate

33. Blood Pressure (B/P) Systolic Diastolic Hypotension Hypertension Sphygmomanometer (continued)

34. White coat syndrome Orthostatic (postural) hypotension Blood pressure readings vary with age When not to use arm to take blood pressure Blood Pressure (BP)

35. Question True or False: –Orthostatic hypotension is a rapid rise in blood pressure when the patient stands.

36. Answer False Orthostatic hypotension –Blood pressure falls when patient stands Rather than rises

37. Height and Weight Height usually stable after adulthood –Except with osteoporosis Many factors affect weight (continued)

38. Height and Weight Types of scales: –Standing balance –Chair and wheelchair –Mechanical lift –Bed BMI