Sign of Distress
-Labored breathing
-Wincing
-Sweatiness
-Trembling
Apparent State of Health
-Robust
- Acute or Chronically ill
- Frail
Skin Color
- Palor
-Cyanosis
- Jaundice
Sexual Development
- Facial hair
-Voice change
-Breast development
Weight, by appearance or measurement
-Ectomorph
-Endomorph
-Mesomorph
Posture and Gait
- sway back
- Lumbar Lordosis
Gait
- spastic
- scissors
- prepulsive
- Steppage
- Waddling
Arm and leg on one side (hemiplegic)
General Principles in PE
1) Reflect approach to the patient
- Let the patient know you are a student, and try to appear calm.
2) Decide the scope of examination
-Comprehensive or focused
- How complete should it be? Decide whether to use a comprehensive physical examination (mostly done on new patients or patients admitted to the hospital)
3) Choose the examination sequence
ORDER of assessment:
1. Skin
2. Hair
3. Nails
4. Head
5. Face
6. Ears
7. Eyes
8. Nose
9. Sinuses
10. Mouth
11. Throat
12. Neck
13. breast and Axillae
14. thorax and Back
15. heart and peripheral vessels
16. upper extremities
17. abdomen
18. anus and rectum
19. genitals
20. lower extremities
Major-Body-Systems Approach individual body systems are appraised, wherein the examiner evaluates one system eg. assessment of the systems
Problem-oriented approach (focused assessment the nurse assesses the patient as often as it is needed for problems encountered
PHYSICAL ASSESSMENT SKILLS
A. Inspection- usint the senses of vision, smell and hearing to observe and dtect any normal condition or any deviations from normal of various body parts
Always look before touching
Observe for color, size, location texture, symmetry, odors and sounds
USE GOOD LIGHTING
POSITION
Expose body parts being observed while keeping the rest f the client properly draped
B. Palpation- to touch and feel body parts with hands in order to determinet he following characteristics:
a)