now let's talk about assessment techniques this is going to be how you do a physical examination so previously we talked about health history right where a patient comes into your office your ER or even onto your floor the first thing you're going to do is ask them a series of background questions to really collect that subjective data now the next thing that follows is the physical exam so just let the name help you right we're getting physical with that client and this is what you're going to do as a nurse so includes everything that you see touch smell hear and even taste I'm just kidding not the taste part but this is considered an objective assessment so for each body system you're going to be doing a physical exam in a certain particular order so Allison can you explain that you're going to want to remember the acronym I PPA so the I stands for inspect you'll inspect first then the two P words you'll going to want to remember to put these two words in alphabetic order so the first one is palpate PA pal AG so that goes first then you're going to percuss PE so that's going to be second and finally you'll osculate so the a stands for osculate okay so first we inspect right yes second we palpate because the a comes first and Pa then you percuss which I remember that like as percussion because you're actually tapping stuff and then the last one is osculate listening right that's correct okay so starting with inspection what are we looking for so when you're inspecting you're going to do some close careful scrutiny of a lot of times it's the skin and looking at different body features okay but you actually start it when you very first walk in that door the moment that you walk into that room you start a General survey which is basically an overall inspection of the patient then as you go body system by body system you're going to go a little bit closer each time and look a little bit further okay and so that's where the six sense of the nurse comes in like right when you walk in the door you can immediately know if something's wrong absolutely where you get that spidey sense that you need to learn to trust and so then after that you're going to do palpation and so palpation you're going to explore further some things that you saw during inspection okay and with palpation you're actually going to lay your hands on the patient which is an important part because you're going to use different parts of your hands to feel for different things which we'll go into further in just a moment and then the second p is that percussion so percussion is just a fancy word for tapping so you're going to use your fingers and you're going to be percussing using short sharp Strokes to see what the underlying structures are and again we'll go further into that in just a moment okay and then finally we have oscilation so for oscilation you're to use your stethoscope and you're going to listen to those sounds produced by the body and so we're going to talk about the two sides of the stethoscope because they listen for different things now getting into the details here inspection includes a very General survey than a focused exam for body systems so inspection is simply a process of observation we're just going to be looking at the client where we're using all of our senses here so not just sight we're trying to inspect this patient so make sure you're you're looking at everything dead on and moving at all different angles right so remember first we're doing a hole and then specific body system so we start with that General overall survey here now for another practice question that's commonly missed which describes the nurse using the technique of oscilation so the correct answer here is the nurse detects gurgling throughout the abdomen