Physical Assessment

Question 1

Preparation:

Answer 1

• Organize/Gather Equipment
• Review patient history
• Identify using two identifiers (name, DOB)
• introduce yourself and explain procedure
• wash hands
• move bed to appropriate height

Question 2

General Survey

Answer 2

• Assess overall status, include four indicators (appears stated age and nutritional status, level of consciousness, skin color congruent w race, posture/position)
• no acute stress or discomfort (unless it is apparent)

Question 3

Vitals/Pain/A&O x4

Answer 3

1. temp, HR, RR, BP
2. Pain scale
3. alert and oriented (person, place, time, why they are there)

Question 4

Skin

Answer 4

must be inspected and palpated within each body system. Things such as color, symmetry, thickness, edema, swelling, lesions, temp/moisture

Question 5

Head

Answer 5

1. inspection
   scalp (skin), and hair (too brittle etc.
2. Palpate head for masses, edema, pain, symmetry. head should be NORMOCEPHALIC

Question 6

Face

Answer 6

1. Inspection

a. skin
b. cranial nerves (smile, frown, puff out cheeks

2. Palpate for pain, edema, symmetry

a. frontal (eyebrows) and maxillary sinuses (cheeks )
b. TMJ clicking present or not

Question 7

Ears

Answer 7

1. inspection (use penlight) symmetry, position, lesions, drainage
2. palpate around and down ear for pain, tenderness, growth, then tragus for dizziness and pain

Question 8

Nose

Answer 8

1. inspection inside nares for redness, swelling, drainage, deviation/symmetry, masses
2. palpate down nose for edema, growth and check nares for patency.

Question 9

Eyes

Answer 9

1. inspection for sclera being white/red, drainage, edema . check conjunctiva for pink, moist, drainage, eyebrows eyelash present .
2. pupil inspection. state meaning of PERRLA, six cardinal directions.
3. palpate top eyelids and bottoms (w gloves) for fullness, palpate lacrimal ducts for pain and drainage

Question 10

Mouth/Pharynx

Answer 10

1. inspection lips (full, pink, moist) teeth (good dentition), tongue (pink moist no edema), gingival & buccal mucosa (pnik, moist, no growth/lesion), hard & soft palate (pink moist, intact), pharynx (pink, moist, intact w no lesions.)
   State tonsil appearance +0-+4)
2. palpate lips and outer mouth for pain, edema, growth.
3. cranial nerve exam. (uvula rises midline on phonation, and sticking tongue out. )

Question 11

Neck

Answer 11

1. inspection of skin, trachea is midline. Range of motion

2. palpate the trachea, palpate carotid arteries and rate pulse

Question 12

Upper extremities

Answer 12

1. inspection of skin, nails for clubbing, and muscle bulk
2. Palpation checking for capillary refill, brachial/radial pulse, muscle bulk, temp/moisture, sensation
3. strength testing: grips, up/down, push/pull
4. range of motion

Question 13

anterior thorax

Answer 13

1. inspection (gown down) assess skin and use of accessory muscle effort.
2. palpate the 8 spots for pain, crepitus, and masses .
3. auscultation of 8 spots, in correct order, listen to a full inhalation and exhalation

Question 14

posterior thorax

Answer 14

1. inspection (gown down) assess skin and use of accessory muscle effort.
2. palpate the 8 spots for pain, crepitus, and masses. CVA tenderness.
3. auscultation of 8 spots, in correct order, listen to a full inhalation and exhalation

Question 15

cardiac

Answer 15

1. inspection (gown down) for heaves, PMI, skin.
2. palpate all 5 locations and name them (aortic, pulmonic, erbs point, tricuspid, mitral) and feel for PMI
3. auscultate all positions down with diaphragm, apical pulse listening for 1 minute, back up with bell. carotid arteries for bruits using the bell

Question 16

abdomen

Answer 16

1. inspection (gown up)
   umbilicus is midline, skin is intact w out edema redness or breaking,
2. auscultation for all 4 regions ( hypo/normo/hyperactive findings)
3. light palpation in all quadrants to assess for guarding .

MAKE SURE KNEES ARE BENT

Question 17

lower extremities

Answer 17

1. inspection of skin, nails for clubbing and condition, and muscle bulk .
2. palpate down legs, checking muscle bulk, temp/moisture, sensation. pulses (dorsalis pedis and posterior tibialis and rate them)
3. inspect and palpate for edema
4. strength testing. feet push pull, legs up down. rate strength.
5. range of motion . check adduction, abduction, ROM for knees hips ankles, (watch vid)

Question 18

posterior surfaces

Answer 18

roll onto side, make sure rail is up on opposite side.

1. inspection of skin and bony prominences . (head elbows, spine, sacrum, hips, heels.)
2. palpate all areas listed above . palpate for blanching in any red areas, or state that you would .