PURPOSES OF PHYSICAL
EXAMINATION
A PHYSICAL EXAMINATION IS
PERFORMED FOR ANY OF SEVERAL
REASONS:
To obtain baseline data.
Data about the patient’s physical status
and functional abilities serve as a baseline
for comparison as the patient’s health
status changes.
To identify nursing diagnoses,
collaborative problems, and wellness
diagnoses.
Problem statements form the basis for the
plan of care and help to address the
patient’s nursing care needs.
To monitor the status of a previously
identified problem.
 To screen for health problems.
 Regular checkups can help to identify
health problems at early stages.
The type of physical examination perform
will depend on
The client’s health status,
The nature of the client , and the setting.
A comprehensive physical assessment,
which includes a
health history interview and
a complete head-to-toe examination of
every body system.
A focused physical assessment pertains to a
particular topic,
problem,
body part, or functional ability of the patient.
A system-specific assessment is a focused
assessment limited to one body system.
(e.g., the lungs, the peripheral circulation).
The following are examples of focused
and system-specific physical assessments,
respectively:
Assessing bowel sounds when a client
has abdominal pain.
Listening to breath sounds,
counting respirations, and obtaining pulse
oximetry readings to assess a patient’s
respiratory status.
ONGOING ASSESSMENT
Ongoing assessment is performed as
needed, after the initial database is
completed, and, ideally, at every interaction
with the patient.
For example, on a medical–surgical unit,
each nurse who provides care to a client
conducts a brief ongoing assessment to
determine changes in the client’s status and
evaluate client outcomes.
Develop a systematic approach and follow
the same order each time to perform a
physical exam.
A HEAD-TO-TOE APPROACH
A head-to-toe approach starts at the head
and neck and progresses down the body,
examining the feet last.
BODY SYSTEMS APPROACH
A body systems approach examines each
system in a predetermined order.
(e.g., Musculoskeletal, cardiovascular,
neurological).
Whatever the approach,
prepare the environment, and the client
before procedure begins.
Preparing for a physical examination requires
theoretical knowledge of anatomy and physiology,
Examination equipment and techniques,
therapeutic communication, and documentation.
Self-knowledge is also important.
PREPARE THE ENVIRONMENT :
Physical examination requires you to observe
and touch the client’s body, so privacy is
essential.
It needs a room with curtains or a door to
shield the client from view.
For additional privacy, drape your client
and uncover only the area you are
examining.
For convenience you may use bed linens
and/or a gown to drape.
Determine the instruments and equipment
you will need.
Take the time to establish rapport with the
client, to help him relax and cooperate fully
in the assessment.
Introduce yourself, ask the client how he
wishes to be addressed, and explain what
will be doing.
-Ask the client to void before the
examination;
-this promotes relaxation and also makes it
easier to palpate the abdomen.
-Always alert the client before touching
him.
The client will need to assume a variety of
positions during a comprehensive physical
examination.
-To begin the examination, seat the client on the
side of the bed or examination table.
-Face the client, and establish eye contact.
-An upright position allows the client to expand his
lungs fully and is useful for assessing vital signs, the
head and neck, the heart and lungs, the back, and the
upper extremities.
-As you place your client in positions that allow
to best observe the body system you are
examining, be alert to special needs that call for
you to modify the position.
THANKING YOU

Purpose of physical examination

  • 1.
  • 2.
    A PHYSICAL EXAMINATIONIS PERFORMED FOR ANY OF SEVERAL REASONS: To obtain baseline data.
  • 3.
    Data about thepatient’s physical status and functional abilities serve as a baseline for comparison as the patient’s health status changes.
  • 4.
    To identify nursingdiagnoses, collaborative problems, and wellness diagnoses.
  • 5.
    Problem statements formthe basis for the plan of care and help to address the patient’s nursing care needs.
  • 6.
    To monitor thestatus of a previously identified problem.
  • 7.
     To screenfor health problems.  Regular checkups can help to identify health problems at early stages.
  • 8.
    The type ofphysical examination perform will depend on The client’s health status, The nature of the client , and the setting.
  • 9.
    A comprehensive physicalassessment, which includes a health history interview and a complete head-to-toe examination of every body system.
  • 10.
    A focused physicalassessment pertains to a particular topic, problem, body part, or functional ability of the patient.
  • 11.
    A system-specific assessmentis a focused assessment limited to one body system. (e.g., the lungs, the peripheral circulation).
  • 12.
    The following areexamples of focused and system-specific physical assessments, respectively: Assessing bowel sounds when a client has abdominal pain.
  • 13.
    Listening to breathsounds, counting respirations, and obtaining pulse oximetry readings to assess a patient’s respiratory status.
  • 14.
    ONGOING ASSESSMENT Ongoing assessmentis performed as needed, after the initial database is completed, and, ideally, at every interaction with the patient.
  • 15.
    For example, ona medical–surgical unit, each nurse who provides care to a client conducts a brief ongoing assessment to determine changes in the client’s status and evaluate client outcomes.
  • 16.
    Develop a systematicapproach and follow the same order each time to perform a physical exam.
  • 17.
    A HEAD-TO-TOE APPROACH Ahead-to-toe approach starts at the head and neck and progresses down the body, examining the feet last.
  • 18.
    BODY SYSTEMS APPROACH Abody systems approach examines each system in a predetermined order. (e.g., Musculoskeletal, cardiovascular, neurological).
  • 19.
    Whatever the approach, preparethe environment, and the client before procedure begins.
  • 20.
    Preparing for aphysical examination requires theoretical knowledge of anatomy and physiology,
  • 21.
    Examination equipment andtechniques, therapeutic communication, and documentation. Self-knowledge is also important.
  • 22.
    PREPARE THE ENVIRONMENT: Physical examination requires you to observe and touch the client’s body, so privacy is essential.
  • 23.
    It needs aroom with curtains or a door to shield the client from view.
  • 24.
    For additional privacy,drape your client and uncover only the area you are examining.
  • 25.
    For convenience youmay use bed linens and/or a gown to drape.
  • 26.
    Determine the instrumentsand equipment you will need.
  • 27.
    Take the timeto establish rapport with the client, to help him relax and cooperate fully in the assessment.
  • 28.
    Introduce yourself, askthe client how he wishes to be addressed, and explain what will be doing.
  • 29.
    -Ask the clientto void before the examination; -this promotes relaxation and also makes it easier to palpate the abdomen.
  • 30.
    -Always alert theclient before touching him.
  • 31.
    The client willneed to assume a variety of positions during a comprehensive physical examination.
  • 32.
    -To begin theexamination, seat the client on the side of the bed or examination table. -Face the client, and establish eye contact.
  • 33.
    -An upright positionallows the client to expand his lungs fully and is useful for assessing vital signs, the head and neck, the heart and lungs, the back, and the upper extremities.
  • 34.
    -As you placeyour client in positions that allow to best observe the body system you are examining, be alert to special needs that call for you to modify the position.
  • 35.