Physical Assessment Guide

Physical Exam Study Guides
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Vital Signs
Head and Neck Exam
Eye Exam
Chest and Lung Exam
Cardiovascular Exam
Abdominal Exam
Back and Extremity Exam
Neurologic Exam

Vital Signs
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Equipment Needed
General Considerations
Temperature
Respiration
Pulse
❍ Interpretation
Blood Pressure
❍ Interpretation
Notes

Equipment Needed
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A Stethoscope
A Blood Pressure Cuff
A Watch Displaying Seconds
A Thermometer

General Considerations
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The patient should not have had alcohol, tobacco, caffeine, or performed vigorous exercise within
30 minutes of the exam.
Ideally the patient should be sitting with feet on the floor and their back supported. The examination room should be quiet and the patient comfortable.
History of hypertension, slow or rapid pulse, and current medications should always be obtained.

Temperature
Temperature can be measured is several different ways:
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Oral with a glass, paper, or electronic thermometer (normal 98.6F/37C) [1]
Axillary with a glass or electronic thermometer (normal 97.6F/36.3C)
Rectal or "core" with a glass or electronic thermometer (normal 99.6F/37.7C)
Aural (the ear) with an electronic thermometer (normal 99.6F/37.7C)

Of these, axillary is the least and rectal is the most accurate.

Respiration
1. Best done immediately after taking the patient's pulse. Do not announce that you are measuring respirations. [p129, p237] [2]
2. Without letting go of the patients wrist begin to observe the patient's breathing. Is it normal or labored? 3. Count breaths for 15 seconds and multiply this number by 4 to yield the breaths per minute.

4. In adults, normal resting respiratory rate is between 14-20 breaths/minute. Rapid respiration is called tachypnea.

Pulse
1. Sit or stand facing your patient.
2. Grasp the patient's wrist with your free (non-watch bearing) hand (patient's right with your right or patient's left with your left). There is no reason for the patient's arm to be in an awkward
position,