Explain the process of health assessment, health history , four step Physical assessment of and Techniques of Physical Examination in Nursing?
Health assessment is the systematic collection of objective information that is directly observed or is elicited through physical examination techniques. Techniques of Physical examination involves the use of one’s senses to obtain information about the structure and function of an area being observed or manipulated.Health assessment is the thorough inspection or a detailed study of the entire body or some parts to determine the general physical or mental conditions of the Patient or its body.
Purpose of Health assessment
- To understand the physical and mental well-being of the patient.
- To detect diseases in early stages.
- To determine the cause and the extent of disease.
- To understand any changes of diseases condition, or any improvement.
- To determine the nature of the treatment or nursing care that needed for the client.
- To safeguard the client and his family by reporting the early signs especially in case of a communicable disease.
- To contribute to the medical research.
- To find out whether person is medically fit or not for any particular task.
Techniques of Physical Examination
The four basic techniques used in physical examination are explained as follows:
Inspection is first Techniques of Physical Examination. It is the systematic visual examination of the patient, or it is the Technique of performing deliberate purposeful observation in a systematic manner. Inspection Technique involves observation of color, shape, size, symmetry, position and movements. It also use the sense of smell to detect odor and also sense of hearing to detect sounds.
Inspection begins with the initial contact with the patient and continues through the entire health assessment. The best conditions for effective inspection are full exposure of the area and proper lighting. General inspection Technique of Physical Examination of a client focuses on the following areas:
- Overall appearance of health
- Signs of distress
- Facial expression and mood of client
- Body size
- Grooming and personal hygiene
Besides being used in general survey, inspection is the first method used in examination of a specific area. The chest and abdomen are inspected before palpation and auscultation Techniques of Physical Examination.
Palpation Technique of Physical Examination is use of hands and fingers to gather information through touch. It is the assessment technique which uses sense of touch. It is feeling the body with hands to note the size shape and position of the body organs.
The hands and fingers are also sensitive tools that can assess temperature, turgor, texture, moisture, vibrations, size, position,shape, consistency, masses and fluid. The back surfaces of hand and fingers are used to measure temperature. The palmar surfaces of the fingers and finger pads are used to assess texture, shape, fluid, size, consistency and pulsation. Vibration is palpated (measure) best with the palm of the hand.
The nursing staff hand should be warm and fingernails short and the touch should also be gentle and respectful. Areas of tenderness are palpated last. The purpose of palpation Technique of Physical Examination is to locate organs, determine their size and to detect abnormal masses.
Percussion is third basic Techniques of Physical Examination. It is the examination by tapping the fingers on the body to determine the condition of the internal body organs by the sounds that are produced internal body organs. Percussion is the act of striking one object against another to produce sounds. The sound waves produced by the striking one object against another are known as percussion tones or percussion notes. Percussion provides information of the nature of an underlying structure. It is used to outline the size of an organ. Percussion is also used for determine if a structure is air filled, fluid filled or solid.
The degree to which sound propagates is called resonance. Percussion Techniques of Physical Examination produces five characteristic tones:
- Tympanic -Percussion of the abdomen is tympanic
- Hyper– resonant -hyper-inflated lung tissue is hyper-resonant
- Resonant-normal lung tissue is resonant
- Dull – the liver is dull
- Flat -he bone flat
Types of Percussion Techniques of Physical Examination
There are two types of percussion, direct and indirect.
Direct percussion is accomplished by tapping an area directly with the finger tip of the middle finger or thumb.
Indirect percussion involves two hands. The hands are placed on the area to be per cussed and the finger creating vibrations that allows discrimination among five different characteristic tones.
Auscultation Techniques of Physical Examination is the process of listening to sounds that are generated within the body. Auscultation is usually done with the help of a stethoscope. The heart and blood vessels are auscultated for circulation of blood, the lungs are auscultated for breath sounds, the abdomen is auscultated for movement of gastrointestinal sounds. When you auscultating a part that area should be exposed and should be quiet.
Four characteristics of sound are assessed by auscultation Techniques of Physical Examination
- Pinch -ranging from high to low
- Loudness-ranging from soft to loud
- Quality-gurgling or swishing
- Duration-short, medium or long