Sherpath Lesson 1 - Examination Techniques

Blunt (fist)

Tenderness of kidney

Steps for indirect percussion technique

1. Expose patient's skin by removing gown as needed. 2. Place middle finger of nondominant hand firmly on patient's skin. 3. Keep the fingers of the nondominant hand fanned out and off the surface of the skin. 4. Snap the wrist of the dominant hand downward. 5. With dominant hand, strike the middle finger of nondominant hand.

Which condition is necessary for accurate inspection?

Adequate time to complete exam

Auscultate directly on skin

Avoids obscured sounds

Which part of the hand is best used to assess for fremitus, or vibrations

Ball of hand

Listen to one sound at a time

Distinguishes between two sounds

Which techniques are required to conduct accurate percussion?

Downward snap the striking finger, Tap sharply and rapidly, Use the tip of the finger to strike, Have short fingernails

What guidelines should the nurse follow to ensure that auscultation sounds are accurately heard?

Ensure that the stethoscope endpiece is firmly held against the skin

Which part of the hand is used to palpate the patient's abdomen?

Finger pads

Which part of the hand would the nurse use to palpate pulsations?

Finger pads

Direct (immediate)

Flat sound on spine

Which tone would the nurse expect to hear when percussing over bone?

Flatness

What percussion tone would indicate air-filled (emphysematous) lungs?

Hyperresonance

Take time for auscultation

Important to identify characteristics

Which auscultation techniques are correct for auscultating the heart and lungs?

Isolate each sound and listen to it separately, Focus on the characteristics of each sound

What components are included in a general inspection of the patient?

Overall color of skin, Symmetry of body, Obvious injuries

To ensure accurate findings, what information would the nurse verify prior to beginning inspection?

Overhead lighting and a lamp are available

During an abdominal assessment, palpation occurs after auscultation for what reason?

Palpation may increase intestinal activity.

Have a quiet environment

Prevents distraction

Which tone would the nurse expect to hear when percussing over the lungs?

Resonance

Indirect (mediate)

Resonance of lungs

Which tone would the nurse expect to hear when percussing over the stomach?

Tympany