Assessment Techniques: Physical Examination

Introduction

• The physical examination follows the collection of the health history, which involves subjective data collection.
• The exam consists of observing, touching, smelling, and hearing, forming an objective assessment.

Order of Physical Examination

• Use the acronym IPPA:
  1. Inspect
  2. Palpate
  3. Percuss
  4. Auscultate

Inspection

• Objective: Close, careful scrutiny, often starting with the skin and body features.
• Process:
  • Begins with a general survey upon entering the room.
  • Involves an overall inspection and then a more focused examination of each body system.
• Nurses' Sixth Sense: Trusting intuition when entering the room to identify potential issues.

Palpation

• Objective: Explore further into observations made during inspection.
• Method:
  • Lay hands on the patient using different parts of the hands to feel for various things.
• Details:
  • Different hand parts are used for different sensations and observations.

Percussion

• Objective: Tapping to assess underlying structures.
• Method: Use fingers to create short, sharp strokes.
• Purpose: Helps detect the condition of structures beneath the skin.

Auscultation

• Objective: Listen to sounds produced by the body using a stethoscope.
• Details:
  • Different sides of the stethoscope are used for different sounds.
  • Example: Detecting gurgling sounds in the abdomen as an assessment of auscultation.

Key Points

• Inspection involves a general survey followed by specific body system examination.
• Auscultation example question: A nurse detects gurgling throughout the abdomen, indicating auscultation.