Bates Nursing Guide to Physical Examination and History Taking:
Chapter 6
your access to the patient's body is a unique and time-honored
... [Show More] privilege in the role of the nurse. showing sensitivity for privacy and patient modesty must be - ANSWER-ingrained in your professional behavior and conveys respect for the patient's vulnerability
what should you do before the examination begins when making the patient comfortable? - ANSWER--close nearby doors
-draw the curtains in the hospital or examining room
-wash your hands thoroughly
a finding in one system may not be an ____________ finding - ANSWERisolated
for example, the patient who presents with a chief complaint of blurred vision may be having vision changes because of age, an injury, a retina or macular affliction, or changes due to hyperglycemia
what is the purpose of the physical examination? - ANSWER-to determine changes in a patient's health status and how to respond to a problem as well as promote healthy lifestyles and well-being
how to prepare for the physical examination? - ANSWER--reflect on your approach to the patient
-adjust the lighting and the environment
-check that the equipment is available and in working order
-make the patient comfortable
-choose the sequence of examination
as you enter the room to conduct a physical examination, identify - ANSWER-yourself as a nursing student
appear calm and organized, even when you feel inexperienced it is common to forget part of the examination, especially at first if that occurs, simply examine that area out of sequence
it is not unusual to go back to the patient and ask to check one or two items that might have been overlooked
beginners will need to spend more time than experienced nurses on select portions of the examination, such as - ANSWER-the fundoscopic examination or cardiac auscultation
to avoid alarming the patient, warn the patient ahead of time by saying, for example, - ANSWER-"i would like to spend extra time listening to your heart and the heart sounds, but this doesn't mean i hear anything wrong"
many patients view the physical examination with some anxiety. they feel - ANSWER-vulnerable, physically exposed, apprehensive about possible pain, and uneasy about what the nurse may find
at the same time, they appreciate your concern about their health and respond to your attention
the skillful nurse is thorough without _____________, systematic but ______________, and ___________ yet not afraid to cause discomfort should it be required - ANSWER--wasting time
-flexible
-gentle
when doing a physical examination the skillful nurse - ANSWER-examines each region of the body and at the same time is aware of the whole patient, notes the wince or worried glance, and shares information that calms, explains, and reassures
as a beginner, avoid _________________ your findings - ANSWERinterpreting
you are not the patient's primary caregiver, and your views may be premature or incorrect
as you grow in experience and responsibility, sharing findings will become more appropriate
if the patient has specific concerns, discuss them with your - ANSWERfaculty
at times, you may discover abnormalities such as an ominous mass or a deep ulceration. always avoid - ANSWER-showing distaste, alarm, or other negative reactions
keeping your verbal and nonverbal communication in check is always paramount
if you find anything that is unusual or disturbing, always talk with your clinical instructor
nurses practice in a variety of settings and ___________ and ____________ are warranted to insure adequate lighting and a conductive environment for physical examination and patient care - ANSWER--flexibility -creativity
for the best results in a physical examination it is important to
"__________________" so that both you and the patient are comfortable - ANSWER-set the stage
awkward positioning for both you and the patient, impairs - ANSWERdetection of physical findings
take time to do these things whenever this makes examining selected areas of the body easier - ANSWER-adjust the bed to a convenient height (but be sure to lower it when finished), and ask the patient to move toward you, turn over or shift position
good lighting and a quiet environment make a difference in this but may be hard to arrange - ANSWER-what you see and hear do the best you can
if a television interferes with auscultating heart sounds, politely ask the nearby patient to - ANSWER-lower the volume and remember to thank the patient as you leave
tangential lighting - ANSWER-is optimal for inspecting structures such as the jugular venous pulse, the thyroid gland, and the apical impulse of the heart
it casts light across body surfaces that show contours, elevations, and depressions, whether moving or stationary, into sharper relief
when light is perpendicular to the surface or diffuse, - ANSWER-shadows are reduced and subtle undulations across the surface are lost
prior to the start of the physical examination, collect all necessary equipment and supplies and check that all are - ANSWER-in working order [Show Less]