| |
Back
ASSESSING THE PATIENT’S CONDITION | Up
Hospital Corpsman 3 & 2 - Intro Navy Nursing manual for hospital training purposes | Next
DEVELOPING THE MEDICAL HISTORY |
b. Gently palpate for
(1) Lumps
(2) Depressions
(3) Pain on compression of skull
(Do not compress if patient is
noncommunicative!)
2. Eyes
a. Inspect for
(1) Laceration to lid or globe
(2) Foreign matter in eye
(3) Unequal pupils (anisocoria)
(4) Eye movements
(5) Pupillary reaction
b. Palpate for
(1) Swelling in orbital or periorbital
area
(2) Failure to sense touch in supra-
orbital and infraorbital areas if
patient is communicative
3. Ear—inspect for
a. Discharge from external auditory
canal
b. Ecchymosis over mastoid (Battle’s
sign)
c. Lacerations
d. Bleeding
4. Nose—inspect for
a. Rhinorrhea
b. Patent nostrils
c. Bleeding
d. Flaring of anterior nares on
inspiration
5. Mouth
a. Inspect for
(1) Potential airway obstruction
(2) Edema or hemotoma
(3) Bleeding
(4) Teeth or dentures lodged in
pharynx
(5) Misalignment of teeth
(6) Pain when biting teeth together
b. Palpate for fractures
(1) Zygomatic
(2) Mandible
(3) Maxilla
6. Neck
a. Inspect for
(1) Retraction
bones
at suprasternal notch
on inspiration
(2) Deviation of trachea from
midline
b. Auscultate for air sounds in trachea
7. Skin—inspect for
a. Jaundice
b. Cyanosis
c. Diaphoresis
d. Temperature
e. Moistness
f. Pallor
8. Thorax
a. Inspect for
(1) Respiration
(a) Rate—tachypnea
(b) Depth
1 Hyperpnea
2 Hypopnea
(c) Retraction of intercostal
spaces
(2) Chest elevation symmetry—flail
chest
(3) Lacerations, puncture, or
ecchymosis
b. Palpate (unless there is a suspected
spinal injury)
(1) Vertebrae and ribs for sym-
metry and tenderness
(2) Anterior to posterior compres-
sion of thorax
(3) Lateral-to-lateral compression
of thorax
(4) Compression of clavicle
(5) Cranial to chordal compression
(6) Pressure of costochondral
junction
(7) Compression on costovertebral
angles
c. Auscultate for lung and heart
sounds
(1) Lung sounds
(a) Absent or unequal breath
(b) Characteristics
1 Rales
2 Rhonchi
3 Wheezes
4 Strider
(2) Heart sounds
d. Percussion
(1) Fluid in thorax
(2) Pneumothorax or collapsed
lung
9. Abdomen
a. Inspect for
(1) Lacerations, ecchymosis, burns,
etc.
(2) Hematoma
(3) Flexion of hips to relieve pain
b. Auscultate bowel sounds
4-3
|
