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PHYSICALbEXAMINATIONbANDbHEALTHbASSESSME ISBN:b978-1-4557-2810-7
NT,b SEVENTHbEDITION
Copyrightb©b2016bbyb Elsevier,bInc.bAllbrightsbreserved.
Copyrightb©b2012,b2008,b2004,b2000,b1996,b1993,bbybSaunders,banbaffiliatebofbElsevierbInc.bAllbrightsbreserved.
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Thebfollowingbcolorbbarsbarebusedbconsistentlybforbeachbsectionbwithinbabchapterbtobhelpblocatebspecificbinformation.
b b
STRUCTURE b AND b FUNCTION
Anatomybandbphysiologybbybbodybsystem
MORE THAN b
b DATA
A TEXTBOOK!
b
EvolvebStudentbResourcesbforbJarvis:bPhysicalbExaminationba
*
Healthbhistorybthroughbquestionsb(examinerbasks)bandbexplanationb(rationale)
ndbHealthbAssessment,bSeventhbEdition,bincludebthebfollow
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• Audiob Glossary
• CasebStudies
b
• ClinicalbReference
• Bedsideb Assessmentb Summaryb Checklists
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• CompletebOlderbPersonbEvaluation
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• Video—Assessment
ABNORMAL b FINDINGS
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Tablesbofbartbandbphotographsbofbpathologicbdisordersbandbconditions;babnormalbfindingsbforbadvancedbpracticeborbspeci
albcir-b cumstancesbwherebappropriate
NEWbtextbookbpurchasebbybregisteringbat
http://evolve.elsevier.com/Jarvis/ RE b
GISTER TODAY! b
YoubcanbnowbpurchasebElsevierbproductsbonbEvolve!
Gob tob evolve.elsevier.com/html/shop-promo.htmlb tob searchb andb browseb forb products.
, Thisbpagebintentionallybleftbblank
3251bRiverportbLane
St.bLouis,bMissourib63043
PHYSICALbEXAMINATIONbANDbHEALTHbASSESSME ISBN:b978-1-4557-2810-7
NT,b SEVENTHbEDITION
Copyrightb©b2016bbyb Elsevier,bInc.bAllbrightsbreserved.
Copyrightb©b2012,b2008,b2004,b2000,b1996,b1993,bbybSaunders,banbaffiliatebofbElsevierbInc.bAllbrightsbreserved.
NANDAbInternationalbNursingbDiagnoses:bDefinitionsbandbClassificationsb2012-
2014;bHerdmanbT.H.b(ED);b copyrightb©b2012,b1994-
2012bNANDAbInternational;busedbbybarrangementbwithbJohnbWileyb&bSons,bLimited.bInb orderbtobmake
bsafebandbeffectivebjudgmentsbusingbNANDA-
Ibnursingbdiagnosesbitbisbessentialbthatbnursesbreferbtob thebdefinitionsbandbdefiningbcharacteristicsbofbt
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nicborb mechanical,bincludingbphotocopying,brecording,borbanybinformationbstoragebandbretrievalbsystem
,bwithoutb permissionbinbwritingbfrombthebpublisher.bDetailsbonbhowbtobseekbpermission,bfurtherbinfor
mationbaboutbtheb Publisher’sbpermissionsbpoliciesbandbourbarrangementsbwithborganizationsbsuchbasbt
hebCopyrightbClearanceb CenterbandbthebCopyrightbLicensingbAgency,bcanbbebfoundbatbourbwebsite:bw
ww.elsevier.com/permissions.
ThisbbookbandbthebindividualbcontributionsbcontainedbinbitbarebprotectedbunderbcopyrightbbybthebP
ublisherb (otherbthanbasbmaybbebnotedbherein).
Detailsbonbhowbtobseekbpermission,bfurtherbinformationbaboutbthebPublisher’sbpermissionsbpoliciesband
bourb arrangementsbwithborganizationsbsuchbasbthebCopyrightbClearancebCenterbandbthebCopyrightbLice
nsingbAgency,b canbbebfoundbatbourbwebsite:bwww.elsevier.com/permissions.
ThisbbookbandbthebindividualbcontributionsbcontainedbinbitbarebprotectedbunderbcopyrightbbybthebP
ublisherb (otherbthanbasbmaybbebnotedbherein).
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Knowledgebandbbestbpracticebinbthisbfieldbarebconstantlybchanging.bAsbnewbresearchbandbexperienceb
broadenb ourbunderstanding,bchangesbinbresearchbmethods,bprofessionalbpractices,borbmedicalbtreatm
entbmaybbecomeb necessary.
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ingbandb usingbanybinformation,bmethods,bcompounds,borbexperimentsbdescribedbherein.bInbusingb
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bproductbtobbeb administered,btob verifyb theb recommendedb doseb orb formula,btheb methodb andb dur
ationb ofb administration,b andb contraindications.bItb isb theb responsibilityb ofb practitioners,brelyingb onb
theirb ownb experienceb andb knowledgebofbtheirbpatients,btobmakebdiagnoses,btobdeterminebdosagesba
ndbthebbestbtreatmentbforbeachb individualbpatient,bandbtobtakeballbappropriatebsafetybprecautions.
Tobthebfullestbextentbofbtheblaw,bneitherbthebPublisherbnorbthebauthors,bcontributors,borbeditor
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ductsbliability,b negligenceborbotherwise,borbfrombanybuseborboperationbofbanybmethods,bproducts,
binstructions,borbideasb containedbinbthebmaterialbherein.
InternationalbStandardbBookbNumber:b978-1-4557-2810-7
ExecutivebContentbStrategist:bLeebHenderson
ContentbDevelopmentbManager:bLauriebGowerb S
eniorbContentbDevelopmentbSpecialist:bHeatherbBa
ysb PublishingbServicesbManager:bDeborahbL.bVog
elb SeniorbProjectbManager:bJodibM.bWillard
DesignbDirection:bJuliabDummitt
PrintedbinbCanada
Lastbdigitbisbthebprintbnumber:b9b 8b 7b 6b 5b 4b 3b 2b 1
,SusanbCaplan,bPhD,bMSN,bAPRN-BC Sarahb Jarvis,b BSN,b RN,bDNPc Jenniferb TaylorbAlderman,bMSN,bRNC- GwenbSherwood,bPhD,bRN,bFAAN
ThebcontributorbforbChapterb2,bCulturalbCompetence,bandbt Thebco- OB,bCNLb ClinicalbAssistantbProfessor/Academ ProfessorbandbAssociatebDeanbforbAcademicbAffa
heb culturebcontentbinbChapterb7,bDomesticbandbFamilybV contributorbforbChapterb10,bPainbAssessment:bTheb Fifthb icbCounselorb SchoolbofbNursing irsb Universityb ofb Northb Carolinab atb Chapelb H
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b titionerbSpecialtybDirectorbatbRutgersbUniversity.bDr.bCa hi- ConstancebSinclair,bCNM,bMSN
planb completedbherbPhDbinbNursingbatbYalebUniversity.b b gan.bShebhasb7byearsbofbexperiencebworkingbwithbcanc Susanb Caplan,b PhD,b MSN,b FNP-BC Chiefb Nurse-Midwife
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ralbcompe-b tencybinbthebhealthbcarebprofessions. b relatedbpainbmanagement.bShebisbalsobabdoctoralbstude b RutgersbUniversit b SantabRosa,bCalifornia
ntbatb WaynebStatebUniversitybinbDetroit,bMichigan. yb Newark,bNewbJe
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ThebcontributorbforbthebHealthbPromotionbboxesbisbanbAss Joyceb K.b Keithley,b DNSc,b RN,b FAAN SeniorbInstructorb Unive
oci- ThebcontributorbforbChapterb11,bNutritionalbAssessment,bi ElizabethbDay,bRN,bMSN,bCHPN rsitybofbColoradob Colleg
b atebProfessorbinbthebSchoolbofbNursingbatbOregonbHeal sbab ProfessorbatbRushbUniversitybCollegebofbNursingband NursingbFacultyb Fres ebofbNursingb Aurora,bC
thb&b SciencebUniversity.bShebreceivedbherbPhDbfrombOreg bRushb UniversitybMedicalbCenterbinbChicago.bBecausebsh nobCitybCollege;b Aca olorado
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drenbinbhealth-relatedb decisionsbthatbaffectbthem. bareabofbclinicalbnutrition. SchoolbofbNursingbandbHealthbScienc
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chbfocusbisb symptomatologybinbheartbdisease. Dr.bMuddbisbabco- AssistantbProfessorbofbNursingb P
contributorbforbChapterb7,bDomesticbandb FamilybViolence urduebUniversitybNorthbCentralb JobA.bVoss,bPhD,bRN,bCNS
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contributorbforbChapterb31,bFunctionalbAssessmentbofb the ricbnursebpractitionerbinbthebpediatricbemergencyb depart Maryb Lashley,bPhD,b RN,bAPHN,b BC WestbRiverbDepartmentbofbNursin
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as
vi viii
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healthbcare.
Chaptersb1bthroughb7bfocusbonbhealthbassessmentbofb opmentalbcontent.bDevelopmentalbanatomy,bmodificationsb of
theb wholebperson,bincludingbhealthbpromotionbforballbage-
• Individualsbacrossbtheblifebcycle,bsupportingbthebb
bexaminationbtechnique,bandbexpectedbfindingsbarebgivenb for
INbCONCLUSION
eliefb thatb abperson’sbstatebofbhealthbmustbbebc
groups,b culturalbenvironmentbandbassessment,binterviewin binfantsbandbchildren,badolescents,bpregnantbfemales,b andb Throughoutballbstagesbofbmanuscriptbpreparationbandbpr
onsideredbinblightbofb developmentalbstage.bAllbch
gbandbcom- agingbadults. o-
aptersbintegratebrelevantbdevel-
b pletebhealthbhistorybgathering,bthebsocialbenvironmentb b duction,bwebmakebeverybeffortbtobdevelopbabbookbthatbis
ofb mentalbstatus,bandbthebchangesbtobthebwholebperson bread-
bonbtheb occasionsbofbsubstancebuseborbdomesticbviolenc
FEATURESb FROMb EARLIERb EDITIONS b able,binformative,binstructive,bandbvital.bThankbyoubforb
e. PhysicalbExaminationb&bHealthbAssessmentbisbbuiltbonbtheb str yourb enthusiasticbresponsebtobthebearlierbeditionsbofbPhysi
Chaptersb8bthroughb11bbeginbthebapproachbtobthebclin engthsbofbthebpreviousbeditionbandbisbdesignedbtobengageb stu calbExam-
icalb carebsetting,bdescribingbphysicalbdata- dentsbandbenhanceblearning: b inationb&bHealthbAssessment.bIbambgratefulbforbyourben
gatheringbtechniques,b howbtobsetbupbthebexaminationbsit 1. Methodbofbexaminationb(ObjectivebDatabsection)bisbclear,b o cour-
e,bbodybmeasurementbandb vitalbsigns,bpainbassessment,b rderly,bandbeasybtobfollow.bHundredsbofboriginalbexami- b agementb andb forb yourb suggestions,bwhichb areb incorpor
andbnutritionalbassessment. b nationbillustrationsbarebplacedbdirectlybwithbthebtextbtob ated
Chaptersb12bthroughb26bfocusbonbthebphysicalbexami demonstratebthebphysicalbexaminationbinbabstep-by-
na- stepb format.
b tionbandbrelatedbhealthbhistorybinbabbodybsystemsbappr 2. Two-
oach.b Thisbisbthebmostbefficientbmethodbofbperformingbth columnbformatbbeginsbinbthebSubjectivebDatab section,bwh
ebexamina- erebthebrunningbcolumnbhighlightsbthebratio-
b tionbandbisbthebmostblogicalbmethodbforbstudentblearni b nalesbforbaskingbhistorybquestions.bInbthebObjectivebData
ngb andbretrievalbofbdata.bBothbthebnovicebandbthebadvanc b section,bthebrunningbcolumnbhighlightsbselectedbabnor-
edbprac- b malbfindingsbtobshowbabclearbrelationshipbbetweenbnormal
b titionerbcanbreviewbanatomybandbphysiology;blearnbtheb b andbabnormalbfindings.
skills,b expectedbfindings,bandbcommonbvariationsbforbge 3. AbnormalbFindingsbtablesborganizebandbexpandbonb mat
nerallyb healthybpeople;bandbstudybabcomprehensivebatlasb erialbinbthebexaminationbsection.bThebatlasbformatbofb thes
ofbabnormalb findings. ebextensivebcollectionsbofbpathologybandboriginalb illustrati
Chaptersb27bthroughb31bintegratebthebcompletebhealt onsbhelpsbstudentsbrecognize,bsort,bandbdescribeb abnormalb
hb assessment.bChaptersb27,b28,bandb29bpresentbthebchor findings.bWhenbapplicable,bthebtextbunderbab tablebentrybis
eogra-b phybofbthebhead-to- bpresentedbinbabSubjectivebData–Objectiveb Databformat.
toebexambforbabcompletebscreeningbexami- 4. Geneticsbandbracialbvariationsbinbdiseasebincidencebandb r
b nationbinbvariousbage- esponsebtobtreatmentbarebcitedbthroughoutbusingbcurrentb re
groupsbandbforbthebfocusedbexambinbthisb uniquebchapter search.bThebJarvisbtextbhasbthebrichestbamountbofb cultural
bonbabhospitalizedbadult.bChaptersb30bandb31b presentbsp -racial-geneticbcontentbavailablebinbanybassess-b mentbtext.
ecialbpopulations— 5. Developmentalbapproachbinbeachbchapterbpresentsbab pro
thebhealthbassessmentbofbtheb pregnantbwomanbandbtheb totypebforbthebadult,bthenbage-
functionalbassessmentbofbthebolderb adult,bincludingbasses specificbcontentbforb thebinfant,bchild,badolescent,bpregnantb
smentbtoolsbandbcaregiverbandbenviron- female,bandbagingb adultbsobstudentsbcanblearnbcommonbv
b mentalbassessment. ariationsbforballb age-groups.
Thisbtextbisbvaluablebtobbothbadvancedbpracticebstude 6. Culturalbcompetenciesbarebextensivebthroughoutbandb pre
ntsb andbexperiencedbcliniciansbbecausebofbitsbcomprehe sentbthebexpectedbvariationsbforbculturallybdiverseb people.
nsiveb approach.bPhysicalbExaminationb&bHealthbAssessment bChapterb2bkeynotesbthebculturalbcontent,binclud-
bcanbhelpb cliniciansblearnbthebskillsbforbadvancedbpractice b ingbcustomsbtobconsiderbwhenbplanningbthebinterview,b c
,brefreshbtheirb memory,breviewbabspecificbexaminationbtec ulturalbvariationsbtobconsiderbwhenbreviewingbexamina-
hniquebwhenbcon- b tionbfindings,bandbabHeritagebAssessmentbGuide.
b frontedbwithbanbunfamiliarbclinicalbsituation,bcompareb 7. Stunningbfull-
andb labelbabdiagnosticbfinding,bandbstudybthebAbnormalb colorbartbshowsbdetailedbhumanbanatomy,b physiology,bexa
Findingsb forbAdvancedbPractice. minationbtechniques,bandbabnormalb findings.
8. Healthbhistoryb(SubjectivebData)bappearsbinbtwobplaces:
(1)binbChapterb4,bThebCompletebHealthbHistory,bandb(2)b in
CONCEPTUALb APPROACH bpertinentbhistorybquestionsbthatbarebrepeatedbandb expan
PhysicalbExaminationb&bHealthbAssessmentb isbcommittedbt dedbinbeachbregionalbexaminationbchapter,binclud-
o: b ingbhistorybquestionsbthatbhighlightbhealthbpromotionb a
• Holism,bthebindividualbasbabwhole,bbothbinbwellnessbne ndbself-care.bThisbpresentationbhelpsbstudentsbunder-
edsb andbillnessbneeds. b standbthebrelationshipbbetweenbsubjectivebandbobjectiveb
• Healthbpromotionbinbthebhealthbhistorybquestionsbth data.bConsideringbthebhistorybandbexaminationbdatab toget
atb elicitbself- her,basb youb dob inb theb clinicalb setting,bmeansb thatb each
carebbehaviors,bthebPromotingbabHealthybLifestyleb boxe
s,bnutritionbinformation,bandbthebself-
examinationb teachingbpresentedbforbskin,bbreast,band
btesticles.
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binb healthbcarebbybdiscussingbwhatbthebpersonbcurre
ntlybisb doingbtobpromotebhealthbandbbybengagingbthe
bpersonbtob participatebinbself-care.
• Culturalbcompetenciesbthatbtakebintobaccountbthisb gl
obalbsocietybinbwhichbculturallybdiversebpeoplebseekb
