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MODULE 2.0 PHYSICAL ASSESSMENT

General Objective:

Upon completion of the module, the student will demonstrate the ability to perform a physical assessment.

Specific Objectives:

2.0Collect, evaluate and discuss pertinent clinical information derived from a physical examination of the patient:

2.1Interview the patient to determine:

a.

Level of consciousness and orientation, emotional state, and ability to cooperate

b.

Level of pain

c.

Presence of dyspnea, sputum production, and exercise tolerance

d.

Social history, e.g., smoking, substance abuse

2.2Assess patient’s overall cardiopulmonary status by inspection to determine:

a.

General appearance e.g.,

Venous distention

Edema

Accessory muscle activity

Chest wall movement

Diaphoresis

Cyanosis

Breathing pattern

b.

Airway assessment e.g., macroglossia, neck range of motion

c.

Cough, sputum amount and character

2.3Assess patient’s overall cardiopulmonary status by palpation

a.

Pulse, rhythm, force

b.

Asymmetrical chest movements, tactile fremitus, crepitus, tenderness, secretions in the airway, and tracheal deviation

2.4Assess a patient’s overall cardiopulmonary status by percussion

2.5Assess patient’s overall cardiopulmonary status by auscultation

a.

Breath sounds

b.

Heart sounds and rhythm

c.

Blood pressure

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