1. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 3 Techniques of Physical Examination and Equipment

2. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Techniques and Equipment Introduction The four techniques of inspection, palpation, percussion, and auscultation form the basis for physical assessment –Inspection –Palpation –Percussion –Auscultation

3. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Precautions to Prevent Infection Diligent hand hygiene Standard precautions –Respiratory hygiene/cough etiquette Latex allergy Skin reactions

4. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Inspection Consciously observing patients One technique that is performed for every body part and body system Overall observation = general survey Adequate exposure of each body part is necessary

5. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Devices may limit visibility Appropriate labeling and documentation of findings are important Pay attention to individual details of inspection

6. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Palpation Assessment of the patient through touch Use different parts of the hand depending on the data that you are gathering Light palpation Moderate to deep palpation

7. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Percussion Produces sound or elicits tenderness –Dense tissue –Travel through air Two methods of percussion –Direct –Indirect

8. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Percussion sounds –Pitch or frequency –Duration –Quality

9. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Auscultation Listen for sounds produced by the body Common assessments Stethoscope –Conducts sound –Blocks environmental noise –Parts

10. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Advanced Techniques Ophthalmoscope Otoscope Tuning fork

11. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Equipment for a Complete Physical Assessment Gather all equipment Appropriate equipment depends on the type of examination

12. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins For the general assessment in a hospital setting –Vital signs equipment –Scale –Flashlight –Materials for recording findings

13. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural Considerations Each assessment must be individualized Many patients are anxious Ask patients about their preferences Perform least invasive assessments first