NUR-634 Advanced Physical Assessment Midterm Study Guide

NUR-634 Advanced Physical Assessment Midterm Study Guide Subjective Data -symptoms from the client's point of view and include: feelings, perceptions, 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. -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 air-containing 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. -Tympanic sounds are hollow, high, drumlike sounds. Tympany is normally heard over the stomach, but is not a normal chest sound. Tympanic sounds heard over the chest indicate excessive air in the chest, such as may occur with pneumothorax. Attributes of a Symptom