Question

what is a physical assessment

Answer 1

In nursing the nurse follows a process to provide client centered care and quality care .physical assessment is part of the first step of nursing process . It involves a structured examination of the patients body

It includes basically four steps

INSPECTION,PALPATION,PERCUSSION &AUSCULTATION

INSPECTION

the nurse observes the patient for any visible anatomical changes such as swelling, wounds,cuts, scars etc that corresponds to the history of illness or reason for admission ,Temperature ,respiration pattern

PALPATION

The nurse palpates the skin to feel for tenderness ,warmth ,enlargement of liver etc.The nail beds of the middle three fingers are used

Percussion

Percussion is done by tapping against the surface to determine the underlying structures basically done over thorax and abdomen.

AUSCULTATION

ausculation is done using a sthethoscope to identify heart sounds, breathing patterns

Physical examination or assessment can be catogarised as the following

Admission assessment : general whole body assessment on admission to hospital

Specific assessment : Of the affected system eg patient came with lower abdomen pain..checking for abdominal tenderness mc burny point abdominal girth etc

Shift assessment : essential for bed ridden or critically ill clients for skin status,changes in vital signs

Physical assessment system wise

Baseline data ,present and past history

Temperature,pulse,respiration,pain scale reading

Hair:colour,texture

Scalp: wounds,dandruff,lice

Eyes:vision,colour,allergies,acuity

Nose:deviated nasal septum,polyps

Ears:rinnes and webers test,ear lobes,wax deposition

Mouth:colour of lips,tongue ,teeth decay,missing teeth,halitosis,gums,gingivities or any other depostions or swelling or fungal growth,ulcers

Neck:distended veins,range of motion,thyroid enlargment

Skin or integumentary:texture ,wounds scars,skin turgor signs of bedsore

Cardiovascular: heart beat ,blood pressure ,cold extremities ,pulses on distal parts, signs of cynosis

GI: abdominal girth ,distention,stool pattern,percussion,abdominal sounds

Respiratory: respiratory rate,variation in sounds such as wheezing,use of accessory muscless

Musculosketal: muscle strength,fractures,gait ,rombergs test

Neurological: GCS, cranial nerve functioning , history of seizures head injury

Genito urinary: hypospadiasis,epispadiasis,swelling,infections ,STD

Gynaecology: menstrual cycle,dysmennorhea,no of pregnancies

Above are few examples of covering a whole body assessment it is not complete

Physical examination or assessment will only be complete with laboratory asessments such as electrolyrte values,ecg,scan,xray echo etc