RNSG 1413 - Foundations for Nursing Practice

Module: Physical Assessment Part I

Module Objectives: 

Upon completion of the study of this module, the student is expected to be able to:

Perform physical assessment: General Survey, Assessment interview, Skin, Hair, Nails, Vision and Hearing, Head and Neck

Prior to coming to the learning lab for practice you should be able to:

  1. Identify the purpose of three types of assessment.
    • Initial
    • Focused
    • Ongoing
    • Shift assessment
  2. Describe components of the health history.
  3. Describe the 4 techniques of and equipment for physical examination.
  4. Identify the planes of the body as a means to describe findings of the physical examination
  5. Describe the elements of the general survey.
  6. Identify the characteristics to be assessed during inspection and palpation of the skin.
  7. Describe the components of nail assessment
  8. Describe the components of hair assessment
  9. Describe the characteristics of common skin disruptions
    • macules, papules, nodules, vesicles, bulla, scales, plaque, patches (vitiligo), petechiae, necrosis, keloid
    • linear, annular, local vs. generalized
    • color: cyanosis (central, peripheral, circumoral), jaundice, pink tone, pallor, erythema
  10. Describe the examination procedures for the head and neck.
    • size, symmetry, position and movement of head
    • temporomandibular joint
    • examine sensation and movement of the face: the facial nerve--CN VII and the trigeminal nerve--CN V
  11. List the function of each cranial nerve. Which ones are used for swallowing?
  12. Describe examination of the eye
    • structures of the external eye to be examined and describe common abnormalities.
    • define visual acuity.
      • near sited, far sited
    • differentiate between general screening and the use of the Jaguar chart and Snellen chart.
    • interpret the results from a Snellen chart screening, eg. 20/40.
    • define visual fields and discuss the examination.
      • peripheral vision
      • central vision
    • describe pupillary assessment and define terms: PERRLA, direct/consensual, accommodation.
    • demonstrate the examination of extraocular movements.
    • identify the structures of the internal eye and the instruments and the technique of examination.
  13. Describe the examination of the ear
    • Discuss techniques used in the assessment of auditory acuity.
    • Discuss the instrument and techniques used in the examination of the internal ear.
    • Describe the structures of the normal tympanic membrane.
    • Demonstrate correct procedure in examination of the structures of the mouth and oropharynx.
  14. Demonstrate techniques of examination of the structures in the neck. pp146-148
    • thyroid gland
    • lymph nodes; what do enlarged lymph nodes mean? What are the parameters for normal findings?
    • jugular vein distention: as a reflection of central venous pressure.
    • carotid artery (bruits): as a reflection of atherosclerosis.

Learning Activities:


Review module objectives.
Read:

Review:

Optional Audiovisual Resources: You may go to the library to use them. Please let your instructors know if you have any problems.

  • Physical Assessment with Geriatric Emphasis; video recording; Wy 152 P578 1992 Evaluating the elderly in a home health care situation through physical assessment. Clinical examples are used to present the rationale for physical assessment.
  • The Physical Examination Putting It all Together; videocassette (37 minutes); WB 205 P5788 1991 Lecture on the basics of the physical exam with examples of techniques and procedures.

Bring to lab:

  • Pen light, watch with second hand, stethoscope
  • Wear loose T-shirt & bathing suit top or some other garment that allows for practice of physical assessment

Print off and Bring to Lab: Practice Exercises and Mastery Check-off

Complete Critical Thinking Exercises: Physical Assessment (go to assignments on Blackboard)

Practice use of otoscope, opthalmoscope.

Practice measurement of blood glucose.

Practice examination of the head and neck.

Discuss observations to be made in the general survey.

Supplemental Learning: Web links (Please note that these may present information beyond the objectives and are to be used only to enhance your understanding of the objectives.)
Review module objectives and check for knowledge gaps.

Complete module quiz - "Physical Assessment"

http://acconline.austincc.edu/