PHYSICAL EXAMINATION

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 To obtain baseline data about the clients functional activities To supplement or confirm data obtained from nursing history To obtain data that will help establish nursing diagnosis and plan of care To evaluate the physiologic outcome of health care and thus the progress of a clients health
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PURPOSES OF THE PHYSICAL EXAMINATION

Head-to-Toe-Framework
1. General Survey 2. Vital Signs 3. Head (hair, scalp, eyes, ears, nose, mouth) 4. Neck (muscles, lymph nodes, veins) 5. Upper Extremities (skin, muscles, sensation) 6. Chest and Back (skin, shape & color, breast, etc. 7. Abdomen (abdominal sounds, specific organs) 8. Genitals (testicles, vagina, scrotum) 9. Anus and rectum 10.Lower Extremities (gait, balance, ROM)
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DIFFERENT CLIENT POSITIONS

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Lying on the back or having the face upward.

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patient lies on the left side in a modified left lateral position; the upper leg is flexed at hip and knees, the lower leg is straight, and the upper arm rests in a flexed position on the bed.
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a position with the patient lying face down with arms bent comfortably at the elbow and padded with the armboards positioned forward.
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the patient rests on the knees and chest with head is turned to one side, arms extended on the bed, and elbows flexed and resting so that they partially bear the patient's weight; the abdomen remains unsupported, though a small pillow may be placed under the chest.
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position of patient on the back, with lower limbs flexed and rotated outward; used in vaginal examination, application of obstetrical forceps, and other procedures.
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the patient lies on the back with the legs well separated, thighs acutely flexed on the abdomen, and legs on thighs; stirrups may be used to support the feet and legs.
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 The squatting position gives a greater increase of pressure in the pelvic cavity with minimal muscular effort. The birth canal will open 20 to 30% more in a squat than in any other position. It is recommended for the second stage of childbirth
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Sit up with your back straight and your shoulders back. Your buttocks should touch the back of your chair.
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Fowler's position is a standard patient position. It is used to relax tension of the abdominal muscles, allowing for improved breathing in immobile patients, and to increase comfort during eating and other activities. It is also used in postpartum women to improve uterine drainage.
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 The Semi-Fowler's position is when a patient is lying in bed in a supine position with the head of the bed at approximately 30 degrees. Patients who are on tube feedings are typically placed in the Semi-Fowler's position. Were the patient to lay flat the tube feeding fluid can possibly run into the lungs. Elevating the head of the bead to 30 degrees decreases the risk of the patient aspirating the tube feeding fluid.
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a position assumed to relieve orthopnea (difficulty breathing except when in an upright position); the patient assumes an upright or semi vertical position by using pillows to support the head and chest, or sits upright in a chair.
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PALLOR

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CYANOSIS

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JAUNDICE

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ERYTHEMA

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EDEMA

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MACULE
Non-palpable flat lesion with skin color change Examples: freckles, measles, vitiligo
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PAPULE
A small solid rounded bump rising from the skin that is usually less than 1 centimeter in diameter (less than 3/8 inch across). Papules may open when scratched and become crusty and infected. The term "papule" is derived from Latin from "papula," a pimple.
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PLAQUE
Skin plaque: A plaque is a broad, raised area on the skin. Because it is raised, it can be felt (palpated). By definition, a skin plaque has a greater surface than its elevation above the skin surface: it is broader than it is high.
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CYST
A cyst is a closed, saclike structure that contains fluid, gas, or semisolid material and is not a normal part of the tissue where it is located. Cysts are common and can occur anywhere in the body in people of any age.
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VESICLES
A vesicle is a small fluid-filled blister. Vesicles break easily and release their fluid onto the skin. When this fluid dries, yellow crusts may remain on the skin surface.
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WHEAL
A raised, itchy (pruritic) area of skin that is almost always an overt sign of allergy.
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 Warts, caused by the human papilloma virus, are generally harmless, benign tumors on the surface of the skin. Occasionally painful when they occur on the feet (plantar warts), warts can be treated with various medications or removed using freezing, burning, X rays, or surgery.

WART

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CONJUCTIVITIS

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HORDEOLUM

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CATARACT

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TUNING FORK
A tuning fork is a twopronged metal implement used for tuning musical instruments. When tapped, it produces a pure and stable pitch. Musicians use the standard pitch of a tuning fork as a reference while tuning their instruments.
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OTITIS MEDIA

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CRYPTORCHIDISM

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HYPOSPADIA & EPISPADIA

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PRIAPISM

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SYPHILIS
Syphilis, infectious dise ase caused by the spirochete Treponema pallidum (see Bacteria) and usually transmitted by sexual contact or kissing. Infection from contaminated objects is infrequent, because drying quickly kills the organisms.
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GONORRHEA
Gonorrhea, infectious se xually transmitted disease of humans caused by bacteria called Neisseria gonorrhoeae. Gonorrhea is almost always spread through sexual contact with the vagina, penis, anus, or mouth, although ejaculation is not necessary for infection to occur.

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