P.P. is a 32-year-old man who presents to the occupational health clinic for a physical before beginning employment at a local hospital. The patient is in good health, has no complaints of pain, and exercises on a daily basis. His body mass index is 23.4; the physical exam is unremarkable; and vital signs are T 97.5, P 68, R 16, and BP 120/60. The patient is to begin work after obtaining physical clearance. Labs and immunization reports are pending. The nurse is preparing to perform the physical examination.
1. How does the nurso prevent the spread of infection and implement infection control measures?
2. What physical examination techniques should the nurse use for inspection?
3. What physical examination techniques should the nurse use for palpation?
4. What physical examination techniques should the nurse use for percussion?
5. What physical examination techniques should the nurse use for auscultation?

Answer:

1.)

Most important thing to prevent from infection is hand-washing after physical contact with patients.

2.)

Inspection is critical observation of the patient in a systematic, deliberate manner that begins as a general survey the moment the practitioner meets the patient. It is the first technique used in the performance of a physical assessment. Good lighting, adequate exposure, and, at times, the use of special instruments aid in the completion of a good inspection.

3.)

Palpitation uses fingertips, grasping actions, and the dorsa of the fingers and hands as well as the base of the fingers.

Palpation applies the sense of touch to assess texture, temperature, moisture, organ location and size, as well as any swelling, vibration or pulsation, rigidity or opacity, crepitation, presences of lumps or masses, and presence of tenderness or pain.

4.)

Percussion is the technique of striking a part of the body with short, sharp taps of the fingers. The location, size, position, and density of the underlying organs can be assessed by the change in percussion sounds elicited. The sounds are assessed for amplitude, pitch, quality, and duration. To elicit the best tones and to avoid pain, short fingernails are a must.

5.)

Auscultation (listening to sounds produced by the body) is done with both the unassisted sense of hearing and with special instruments, usually a stethoscope. Sounds heard with the ear alone include speech, percussion tones, difficult breathing, coughing, and loud abdominal sounds. The stethoscope should always be put on bare skin, not over clothing.

A detailed study of a specific subject like a person, place, group, and others is termed as a case study. In the study generally the qualitative methods are used, however, at certain cases quantitative methods are also used.

The following are the solutions of the given questions based on the case study given:

1. In the given case, the spread of the infection can be prevented by the nurse by using protective barriers like gowns, gloves, protective eyewear, face shield, and by following certain hygiene measures like washing hands, environmental hygiene to reduce the threat of occupational transmission of diseases from the patient to the health care workers and from the health care center to the patient.

2. A close observation of the details of the appearance, movement, and behavior of the client is termed as inspection. The technique for inspection comprise accurate observation of the physical features and behaviors of the client.

3. The use of tactile pressure from the fingers to evaluate temperature, texture, shape, size, moisture, tenderness, pain, and edema is termed as palpation. The examination technique for palpitation comprises light palpation technique that determines surface traits and to accustom the patient of being touched. It is done by placing the middle finger of one hand on the surface of the body and striking with the other middle finger.

4. A medical technique, which is done to elicit sound or impart tenderness by tapping the part of the body with hands, fingers, or small instruments as part of a physical examination is termed as percussion. Percussion can be directly performed by the nurse by directly tapping the fingers on the skin of the client or patient.

5. The use of a stethoscope to hear sound within the organs of the body is termed as auscultation. It is used by the nurse to evaluate the lub-dub sounds of the heart.

Thus, case study is generally used in hospitals and health care centers, which helps in diagnosing and treating the condition of the patient.

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