Health Assessment

1
Health Assessment

• Chapters 9,10,11
• Techniques, General survey, VS

2
SKIN

• According to Weird facts
• Each square inch of human skin consists of twenty
  feet of blood vessels.
  
• Each square inch of human skin contains
  seventy-two feet of nerves.
  

3
Inspection

• Always first
• Look for symmetry
• Use good lighting
• Use good exposure

4
Palpation

• Touch - warm
• Texture use fingertips
• Temperature use back of hand
• Moisture
• Organ location and size
• Slow and systematic
• Light to deep

5
Percussion

• Tapping
• Size, location, density
• Direct
• One hand
• Sinuses
• Indirect
• 2 hands
• 5 sounds

6
Auscultation

• Listening
• Stethoscope
• Ear pieces point toward nose
• Tubing 12-14 inches
• Diaphragm high-pitched sounds
• Bell - soft, low-pitched sounds
• Eliminate artifact

7
Techniques

• Setting
• Safe environment
• Standard precautions
• Clean field

• General approach
• Wash hands
• Less invasive to more invasive
• Include teaching

8
General survey - Inspection

• Physical appearance
• Body structure
• Mobility
• Behavior

9
Measurement

• Weight
• Height

10
Vital signs - Temperature

• Know the normals!
• Define hyperthermia and hypothermia
• Accuracy
• Thermometer types
• Routes

11
Vital signs - pulse

• Stroke volume, pulse strength
• Rate, rhythm
• Tachycardia, bradycardia
• Arrhythmia, dysrhythmia
• Know adult normals
• 30 seconds x 2
• Full minute if irregular

12
Vital signs - respirations

• Rate and pattern
• Know adult normals
• 30 seconds x 2
• Full minute if irregular

13
Vital signs blood pressure

• Systolic maximum pressure
• Diastolic resting, elastic recoil
• Pulse pressure Systolic-Diastolic
• Mean arterial pressure average over the cardiac
  cycle DP 1/3 pulse pressure

14
Vital signs blood pressure

• Know adult normals
• Know factor affecting BP
• BP determined by
• Cardiac output
• PVR
• Blood volume
• Viscosity
• Elasticity

15
Vital signs blood pressure

• Technique
• Cuff size most common error
• Arm at heart level
• Use bell
• Deflate 2 mmHg per beat
• Korotkoffs sounds
• 1st, muffling, disappearance

16
Vital signs blood pressure

• Hypotension
• Hypertension
• Orthostatic (postural) vital signs
• Systolic BP drops 20 mmHg
• HR rises 20 bpm

17
Promoting health - education

• Lifestyle modifications
• Page 199

18
Application p. 200