Techniques, Equipment
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Created by:
janiestrick1 on April 19, 2009
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40 terms
Terms | Definitions |
|---|---|
 Inspection | visual examination of body (movement, posture, including smell), stated age?, dress and personal hygiene, body and breath odors, assistive devices, behavior |
| body structure upon inspection | stature, posture, gait, coordination, symmetry between right and left sides |
| Four skills/Techniques | Inspection, palpation, percussion, auscultation |
| palpation | sensation of hands to feel texture, size, shape, consistency, location of certain parts, painful/tender areas; need to move into personal space; touch (gentle, warm hands, short nails); gloves worn: mucous membranes, body fluids; palmar surface of fingers/finger pads more sensitive than fingertips; ulnar surface vibration; dorsal surface temperature; palmar surfaces of fingers (light/deep -light before deep) |
| percussion | evaluate size, borders, consistency, tenderness, extent of fluid; direct striking finger/hand directly against body: sinuses, indirect: both hands required; methods vary by system being assessed; wrist action: rapid flexion, relaxed; forearm stationary |
| Striking produces what | vibration (sound waves) obese/muscular individuals: stronger percussion: dense tissue: quiet sounds |
| five percussion tones | tympany: loud, high pitched (abdomen); resonance: lung; hyperresonance hyperinflated lung; dullness: liver; flatness: bone, muscle |
| auscultation | listening for sounds:bell-low-pitched sounds; lightly against skin (vascular sounds, extra heart sounds); diaphragm: high-piched sounds; firmly against skin (breath/bowel sounds); sounds: intensity, pitch, duration, quality; selective listening |
| stethoscope | earpieces: (Hard and soft, fit snuglly, fill ear canal); binaurals: adjust angle, earpieces pointed toward nose; tubing: thick, firm rubber, no longer than 12-18 inches; if longer, sounds distorted; decorative fabric on tubing source of infection |
| blood pressure sphygmomanometer | aneroid (glass-enclosed gauge, not as reliable; mercury: upright manometer filled with mercury, most reliable (mercury hazard) |
| NIBP | electronic device on BP cuff; blood flow vibrations converted to electriacl impulses; BP/pulse/MAP: can't determine pulse quality |
| If blood pressure cuff is too wide | underestimate BP |
| if bp cuff is too narrow | overestimate BP |
| fifth vital sign | pulse oximetry (noninvasive) LED probe reflects off oxygenated/deoxygenated Hgb for estimation of oO2 percentage/pulse, highly accurate |
| Snellen chart | wall chart 20 feet from client measuring visual acuity and screening; top number is distance from chart; bottom number= distance with normal vision should be able to read line |
| Doppler | amplifies sounds too difficult to hear with acoustic stethoscope; ultrasonic waves (fetal heart tones, pulses); gel/transducer slid over skin until blood flow heard |
| goniometer | determine degree of flexion or extension of joint; 2-piece ruler, jointed with protractor type of measuring device; placed over joint-either flexion or extension and degree measured on protractor |
| calipers for skinfold thickness | measure thickness of subcu tissue to estimate amount of body fat; different models for different points on body; most frequent location: posterior aspect of triceps |
| testing deep tendon reflex, you would use | reflex hammer |
| vaginal speculum | spread walls of vagina canal to visualize vaginal tissue and cervix; three types ( graves: variety of sizes and blade lengths, pedersen's blades as long as Graves but narrower and flatter and helps visualization); pediatric (virginal) smaller in all dimesions; plastic or metal differ in ease and positioning |
| principles of infection control | standard precautions apply to all clients; assessment safe but still potential for infection transmission; (handwashing, PPE, protect client and healthcare worker, standard precautions, CDC guideline) |
| intensity | loudness of the sound, described as soft, medium or loud |
| pitch | frequency or number of sound waves generated per second. |
| duration of sound vibrations | short, medium, long, layers of soft tissue dampen the duration of sound from deep organs |
| quality | refers to the description of the sounds (hollow, dull, crackle) |
| dorsal recumbent | position used for abdominal assessment because it promotes relaxation of abdominal muscles |
| lithotomy | osition provides maximal exposure of genitalia and facilitates insertion of vaginal speculum |
| sims | flexion of hip and knee improves exposure of rectal area |
| lateral recumben | position aids in detecting murmurs (lying on left side with top leg bent over bottom leg) |
| knee-chest | position provides maximal exposure of rectal area |
| diaphragm of stethoscope | used to hear high-pitched sounds like breath sounds, bowel sounds, normal heart sounds |
| bell of stethoscope | used to hear soft, low-pitched sounds such as extra heart sounds or vascular sounds (bruit) |
| fetoscope | used to auscultate fetal heart |
| NIBP | monitor is an electronic device attached to a bp cuff and operates by sensing circulating blood flow vibraitons through a blood pressure cuff sensor and converting these vibrations into electric impulses, used when clients need bp taken repeatedly, notifies of abnormal results |
| pulse oximetry | to estimate the arterial oxygen saturation in the blood |
| Jaeger and Rosenbaum charts | used to evaluate near vision |
| ophthalmoscope | to inspect the internal structures of the eye |
| otoscope | to inspect the external auditory canal and tympanic membrane |
| penlight | to provide a focused light source to facilitate inspection, used for illuminiation of mouth, nose, highlight a lesion, or pupillary constriction |
| nasal speculum | to spread the opening ofthe nares so the internal surfaces of the nose may be inspected |
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