procedure to patient procedure t Esplamatient in optimal position for assessment
ID: 138684 • Letter: P
Question
procedure to patient procedure t Esplamatient in optimal position for assessment cal Examination XXXxX A Inspection Note if patient relaxed & position in bed -xxxxx- nescribe contour &symmetry of abdomen 2. 3. Describe condition of skin of abdomen e any skin lesions or discoloration Not 5 S. Note and describe any vascular pulsation or movement 6. Describe umbilicus 7. Identifies one organ found at each quadrant B.Auscultation 1. Auscultates abdomen in all four quadrants in correct order 2. Describes normal bowel sounds 3. Explains how to document "silent" bowel sounds 4. Auscultate abdominal vascular sounds-Aorta 5. Describe sounds of bruits C. Percussion 1. Percusses abdomen in correct order and describe sounds 2. Defines the sound of "tympany" 3. Describes sound heard over liver D. Palpation 1. Palpates all 4 quadrants in correct order E. Proper pronunciation and use of medical terminology TOTAL POINTS 75Explanation / Answer
1) explaining the procedure to the patient : explaining the procedure to the patient is often inculded in objective structured clinical examinations and inform the patient and allow to involve in the procedure so that the patient will be cooperative. 2)place patient in optimal postion for assessment:for assessing different parts of the body the patient should be postioned in different position for correct assessment of the patient like for examination of the abdominal organs lying flat on the table with legs together, hands at sides of the body. lll. physical examination: A.Inspection:1)The physician has to make the patient to empty the urinary bladder and then patient is made comfortable in a supine position with the pillow for the head and perhaps another under the knee, the patient should keep arms at the sides or folded across the chest. 2) contour and symmetry of abdomen: the contour describes nutritional state and normally ranges from flat and rounded, symmetry of the abdomen should be symmetric bilaterally, if any localized bulging , e smooth and symmetry, 3)skin of the abdomen: generally the skin should be smooth with homogenous color, any lesion, scars is seen then the scar location is drawn its location in persons record , and also check for scar, striae, dilated veins, rashes and lesions and any other abnormalities. 4)skin lesion or discoloration: normally the abdomen skin should be homogenous or if any lesion and discoloration or any abnormalities are there it has to be noted for further investigations, 5)vascular pulsations or movement:mormally there are no pulsation seen bet in aortic aneurysm there is increased pulsation and dilated veins seen in the hepatic cirrohosis or inferior vena ceva. etc, 6) umbilicus: normally it is the centre of the abdomen inverted or protruding and should be clean and free of drainage, if abnormallity it should be recorded, 7)identifies one organ in each quardant: the abdomen is divided into 4 quardants they are right upper and lower quardant and left upper and lower quardant, and each quarant has respective organs and it is assessed, B.Auscultation : 1)in the four quardants:use diaphragm of stethscope lightly placed first on the right lower quardant, and then the right uper and then left upper and left lower, 2)bowel sounds : normal bowl sounds:these are produced by the movement of the fluids and air in the bowel and noraml peristatic movement creates normal bowel sounds and are heards as clicks and gurgets and bowel sounds are absent if there are no peristasis. 3)when sounds are not heard for 3-5 minutes of asculations in each quardant,4)abdominal aorta : blood flow in an artery is turbulent or obstructed makes a whooshing sound, it is a aneurysm or renal arterial stenosis. 5)sounds of burits: it is a low pitched vascular sounds resembling murmur it is caused by partially obstructed artery turbulence. C:1) Percussion in correct order:it is perrformed by knocking the middle finger against the phalanx of the middle of the opposite hand which rest against the surface of the abdomen in each of the nine areas percussion the 4 quardants of the abdomin to determine the amount of tympany and dullness, 2)sounds of tympany : it is a loud hollow sound should be obtained in the 4 quardants and they are loudest over the gastric bubble and intestine. ( given time is over so iam not able to complete the other questions)
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