NURS 1660 Lecture Notes - Lecture 1: Median Plane, Hand Washing, Paper Towel
10 Jun 2018
School
Department
Course
Professor
Week One (Sept. 11 - 15, 2017)
11-63-166
Pgs. 52 - 67
Health Assessment I
CHAPTER FOUR: Techniques of Physical Examination and Equipment
There are four basic physical examination modes:
Inspection - use of visual, auditory, olfactory senses.
Population - use of fingers and hands on body.
Percussion - tapping movement that produces sounds to be interpreted about body area
being observed.
Auscultation - use of a stethoscope to detect sounds produced by movements of air or
fluid in the body.
Overview of Anatomical Position
Anatomical Position
Used to promote clear and accurate communication in
both verbal and written documentation.
- Posture is erect
- Big/great toes and heels are touching another
- Palms are facing forward (anteriorly)
- Arms are at sides
- Head, eyes, and toes facing anteriorly
Anatomical Surfaces
To describe location (eg. medial, lateral) or direction
(anteroposterior) of objective data.
- Anterior (ventral) - Extensor
- Posterior (dorsal) - Flexor
- Inferior (lower) - Plantar
- Superior (upper) - Palmer
- Lateral - Medial
Anatomical Quadrants
To communicate findings in the abdomen and breasts.
Abdomen: Upper right and left quadrant, lower left and right quadrant.
Breasts: Upper outer and inner quadrant, lower outer quadrant or inner
lower quadrant. It
also has a Tail of
Spence.
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Anatomical Regions
Mainly used to observe and communicate findings in the abdomen, which has
nine abdominal regions. Consists of two vertical and two horizontal lines.
Anatomical Terms of Comparison and Movement
Term of Comparison
Description
Opposite Term
Proximal
Nearest to the trunk of the body
Distal
Distal
Farthest from the trunk of the body
Proximal
Ipsilateral
The structure/surface/function on the
same side of the median plane as
something else being described.
Contralateral
Contralateral
Something being on the opposite
side of the median plan as
something else being described.
Ipsilateral
Superficial
Proximity to the surface of the body.
Deep
Deep
Distance from the surface of the
body.
Superficial
Interior
Location of structure within another
structure or the location with respect
to the body surface.
Exterior
Exterior
Location of a peripheral structure of
the structure closer or nearer to the
surface of the body.
Interior
Superior
Closer to the head than another
structure.
Inferior
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Inferior
Closer to the feet than another
structure.
Superior
Planes:
Routine Practices and Additional Precautions
Hand Hygiene: is the most important action to prevent an infection. It includes the use of
alcohol-based hand rubs (sanitizers), hand washing with warm running water and soap
and the use of gloves.
Sanitizers: Start with dry hands, apply at least two pumps of the gel to palm of
one hand, rub hands together, covering all surfaces of hands until dry.
Hand-Washing: Remove jewellery, wet hands with warm water, apply liquid soap,
scrub hands vigorously for 15 seconds (or sing Happy Birthday), rinse hands,
turn off faucet with a paper towel. Nails must be trimmed to 0.6cm or shorter;
artificial nails is not acceptable.
Gloves: Nurses wear gloves when when handling body fluids or anticipating
contact with body fluids. Gloves must be changed when going from a
contaminated area to a cleaner area (in environment and on patient)
Patient-to-patient transmission of pathogens depends on five sequential steps:
1. Organisms are present on the patient’s skin or immediate environment.
2. Organisms are transferred from patient to nurse’s hands or environment
3. Organisms survive on nurse’s hands for at least several minutes.
4. Nurse omits or performs inadequate hand hygiene.
5. Contaminated hands of nurse come in direct contact with patient of
patient’s environment.
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Document Summary
Chapter four: techniques of physical examination and equipment. Inspection - use of visual, auditory, olfactory senses. Population - use of fingers and hands on body. Percussion - tapping movement that produces sounds to be interpreted about body area being observed. Auscultation - use of a stethoscope to detect sounds produced by movements of air or fluid in the body. Used to promote clear and accurate communication in both verbal and written documentation. Big/great toes and heels are touching another. To describe location (eg. medial, lateral) or direction (anteroposterior) of objective data. To communicate findings in the abdomen and breasts. Abdomen: upper right and left quadrant, lower left and right quadrant. Breasts: upper outer and inner quadrant, lower outer quadrant or inner lower quadrant. Mainly used to observe and communicate findings in the abdomen, which has nine abdominal regions. Consists of two vertical and two horizontal lines.
