Physical assessment

physical assessment for nursing students
by
Melba Sahaya Sweety.D

1. METHODS OF
PHYSICAL
EXAMINATION

2. DEFINITION OF PHYSICAL
EXAMINATION
Physical Examination is defined as a
complete Assessment of a patient’s
physical and mental status
Physical assessment is a systematic
collection of objective information that
is directly observed or elicited through
examination technique.

3. DEFINITION OF PHYSICAL
EXAMINATION
•Physical
examination is a
systematic data
collection method
that uses the
sense of sight,

4. PURPOSE OF PHYSICAL
EXAMINATION
•To understand the physical and mental well-
being of the patient.
•To detect disease in its early stage
•To determine the cause and the extend of
disease
•To understand any changes in the condition
of disease, any improvement or regression.
•To determine the nature of the treatment or
nursing care needed for the patient.

5. METHODS OF PHYSICAL
EXAMINATION
INSPECTION
PERCUSSION
PALPATION
AUSCULTATION
OLFACTION

6. DEFINITION
•It is a deliberate,
purposeful and
systematic collection
of data from the client
through the visual
examination (that is,
assessing by using the
sense of sight )

7. GUIDELINES OF INSPCTION
•Make sure that adequate
lighting is available ,either
direct or tangential.
•Uses direct light sources
(eg., a penlight or lamp) to
inspect body cavities.
•Inspect each area for size,
shape, color, symmetry,
position, and abnormality.

8. GUIDELINES OF INSPCTION
•Position and expose
body parts as needed
so all surfaces can be
viewed but privacy can
be maintained.
•When possible, check
for side-to-side
symmetry by
comparing each area
with its match on the
opposite side of the
body

9. •Palpationis the
process of using
one's hands to
check the body,
especially while
perceiving
/diagnosing a
disease or
illness.

10. PURPOSE OF PALPATION
•Examination of the body surface (skin,
smoothness, dryness, irregularities
etc…)
•Examination of internal organs (shape,
size, consistency etc…)
•To look for abnormal resistances.
•Detection of painful areas
•To feel movement of fluids within the
body.

11. PRINCIPLES OF PALPATION
•Prepare for palpation by warming hands,
keeping fingernails short, and using a
gentle approach.
•Palpation proceeds slowly, gently, and
deliberately.
•Encourage the patient continue to
breath normally through out the
palpation.
•Ask the patient to point to more
sensitive areas.

12. PRINCIPLES OF PALPATION
•Ask the patient to point to more
sensitive areas.
•Watching for nonverbal signs of
discomfort.
•If the pain is experiencd during
palpation discontinue the palpation
immediately.

13. TYPES OF PALPATION
•LIGHT
PALPATION
•DEEP
PALPATION

14. LIGHT PALPATION
A method of
determining the
outlines of organs
or masses by
lightlypalpatingthe
surface with the tip
of a finger for 1 to 2
centimeter.

15. DEEP PALPATION
•Deep
palpationis
used to feel
internal organs
and masses,
usually
pressing down
4-5 centimeters.

16. •Percussion is a method of
tapping the skin with the
fingertips to vibrate
underlying tissues and
organs, to determine the
structure.

17. TYPES OF PERCUSSION
Direct percussion
Indirect percussion
Fist percussion

18. Direct percussion:-
It involve tapping lightly with the pad
of the fingers directly on the client
skin

19. Indirect percussion:-
•It can be performed
by using two finger left
middle
finger[Pleximeter
finger] is placed over
the area and its middle
phalanx is tapped with
the tip of the right
middle finger or index
finger [percussing
finger]

20. Fist percussion:-
•It involve placing
one hand flat
against the body
surface and striking
the back of the
hand with a
clenched fist of the
other hand

21. •Auscultation is
listening to the
internal sounds of
the body, usually
using a
stethoscope.

22. PURPOSE OF AUSCULATION
•Auscultation is
performed for the
purposes of examining
the circulatory and
respiratory systems, as
well as the
gastrointestinal system.
•Its helps to listening for
body sounds typically
from organs and tissues
to assess their
functions.

23. TYPES OF AUSCULTATION
Direct
auscultation
Indirect
Auscultation

24. Direct Auscultation
•It involve
listening to the
client body sound
without using any
assistive
instrument [eg
wheezing, chest
congestion]

25. Indirect Auscultation
•Involve
listening to
the client
body sound
with the use
of a
stethoscope

26. •Another skill that
used during
assessment, certain
alteration is body
function create
characteristic body
odors, smelling can
detect abnormalities
that unrecognized
by other means.

27. Assessment of characteristic
odors:
•Alcohol odor from oral cavity means
ingestion of alcohol.
•Ammonia from urine means urinary tract
infection.
•Bodyodorfromskin,particularlyin
areaswherebodypartsrubtogether
means poor hygiene, excess
perspiration(bromidrosis).

28. Assessment of characteristic
odors:
•Fecesodorfromwoundsitemeans
woundabscess,butifthisodorfrom
vomitusthismeansbowelobstruction,
andiftheodorfromrectalareathis
meansfecalincontinence.
•Foul–smellingstoolsininfantfrom
stoolmeansmalabsorptionsyndrome.
•Halitosisfromoralcavitymeanspoor
dentalandoralhygiene,gumdisease.

29. Assessment of characteristic odors
•Halitosisfromoralcavitymeanspoor
dentalandoralhygiene,gumdisease.
•Sweet,fruityketonefromoralcavitymay
befromdiabeticacidosis.
•Mustyodorfromcastedbodypartmeans
infectioninsidecast.
•Fetidodorfromtracheostomyormucous
secretionsmeansinfectionofbronchial
tree(pseudomonasbacteria).

30. THANK Uuuuuuuuuuuuu