NUR-634 Advanced Physical
Assessment Midterm Study Guide
Subjective Data
-symptoms from the client's point of view and include: feelings, perceptions,
... [Show More] and
concerns
-what the patient tells you
Objective Data
-what the health professional observes by inspecting, palpating, percussing, and
auscultating during the physical examination
-observed signs0:15
Assessment
-the clinical reasoning process that interprets the patient's history and physical
examination, singles out identified problems, and movement from each problems
to its action plan
Plan
-incorporates patient education, changes in medications, needed tests, referrals
to other clinicians, and return visits for counseling and support
-requires good interpersonal skills and sensitivity to the patients goals, economic
means, competing responsibilities, and family struggles/dynamics
Percussion
-a diagnostic procedure designed to determine the density of a body part by the
sound produced by tapping the surface with the fingers
-use of the striking or plexor finger (usually the 3rd) to deliver a rapid tap or blow
against the distal pleximeter finger (usually the distal 3rd finger of the left hand
laid against the surface) to evoke a sound wave
-the 5 sounds are resonant, flat, dull, hyper resonant, and tympanic
-Resonant sounds are low pitched, hollow sounds heard over normal lung tissue.
NUR 634
-Flat are normally heard over solid areas such as bones. thigh
-Dull or thudlike sounds are normally heard over dense areas such as the heart
or liver. Dullness replaces resonance when fluid or solid tissue replaces aircontaining lung tissues, such as occurs with pneumonia, pleural effusions, or
tumors.
-Hyperresonant sounds that are louder and lower pitched than resonant sounds
are normally heard when percussing the chests of children and very thin adults.
Hyperresonant sounds may also be heard when percussing lungs hyperinflated
with air, such as may occur in patients with COPD, or patients having an acute
asthmatic attack. An area of hyperresonance on one side of the chest may
indicate a pneumothorax. [Show Less]