Collecting

Objective Data
Marina Gharibian PhD RN
NURS 202
Spring 2022-2023
Collecting Objective
Data (Data directly
observed by the examiner)

 Affect is the patient's immediate

expression of emotion;  
facial expressions, gestures and 
body language
 Mood refers to the more sustained
emotional makeup of the patient's
personality.
3. Performance of 4
assessment
techniques: IPPS
Preparing Oneself/ Standard Precautions

 Hand hygiene
 Gloves
 Mask, eye protection, face shield
 Gown
 Patient care equipment
 Establish Establish nurse-client relationship

Client Explain
Explain that the physical assessment will
follow
Approach
and Respect Respect client’s desire and request
Preparation
Begin examination with less intrusive
Begin
procedure
Equipment needed for physical exam

Coin or key
Cotton ball
Ophthalmoscope
Otoscope
Penlight
Hammer
Snellen chart
Tongue depressor
Tuning fork
Watch with second hand
Snellen Chart
 Physical
Examination
Techniques
Four Assessment Techniques
Inspection (1)

Involves using the sense of smell,

vision, and hearing.
Note the following: color, patterns,
size, location, behavior, sounds.
Room at comfortable temperature
Good lighting
Look and observe before touching
Completely expose part being
examined
Note characteristics
Compare appearance
Palpation (2)
Types of palpation

 Moderate: Depress the skin

surface 1-2cm, to check for
consistency and mobility.
 Deep: Place dominant hand
on the skin surface to apply
pressure.
Percussion (3)

Uses of percussion:
 Determine location,
size and shape
 Detecting abnormal
masses
 Eliciting pain
 Eliciting reflexes
Percussion  There are three approaches to percussion, but the
most widely used is indirect percussion. 
 Indirect percussion is often used to assess the lungs
and the abdomen (e.g., bowels, bladder, liver). The
steps of this technique are as follows:
1. Non-dominant hand: With your hand parallel to the
body, place the distal interphalangeal joint of the
pleximeter (middle) finger of your non-dominant
hand firmly on the body region to percuss. Ensure
that only your interphalangeal joint is touching the
body (and not the rest of the hand) and that the finger
is fully extended.
2. Dominant hand: Flex (bend) the pleximeter finger of
your dominant hand and with the tip of your finger,
tap twice on the distal interphalangeal joint of your
non dominant hand.
Percussion produces sounds that vary according to the tissue being percussed. This chart shows important
percussion sounds along with their characteristics and typical locations.

SOUND INTENSITY PITCH DURATION QUALITY SOURCE

Resonance Moderate to Low Moderate to Hollow Normal lung
loud long
Tympany Loud High Moderate Drum like Gastric air
bubble or
intestinal air
Dullness Soft to High Long Thudlike Liver, full
moderate bladder, pregnant
uterus, or spleen
Hyperresonance Very loud Very low Long Booming Hyperinflated
lung (as in
emphysema)
Flatness Soft High Short Flat Muscle, bone, or
tumor
Pitch
 The pitch of sound is determined by
the frequency of vibration of the
sound waves that produce them. A
high frequency (e.g., 880 Hz) is seen as
a high pitch, while a low frequency
(e.g., 55 Hz) is regarded as a low pitch.
Low-frequency sounds include a bass
drum, thunder, and a man's deep voice.
 For example, on a guitar a big
heavy string will vibrate slowly
and create a low sound or pitch.
A thinner lighter string will vibrate
faster and create a high sound or
pitch.
https://www.youtube.com/watch?v=wEL87lznGrg
Auscultation (4)

The assessment technique of

auscultation involves listening
to the body.
typically performed with a
stethoscope.
Use of the stethoscope
Proper use of a stethoscope involves several
steps:
1. Begin by explaining the procedure and
asking permission to touch.
2. Next, create a quiet environment.
3. Cleanse the stethoscope.
4. Place the earpieces in your ears so that they
are pointing toward your nose.
5. Last, open or close the diaphragm or bell
depending on which end piece you want to
use. It is important to tap on the diaphragm
to ensure sounds are heard if using the
diaphragm or not heard if using the bell.
 Do’s and Don’ts
Using a Stethoscope

 Warm diaphragm and bell before

use
 Explain what you are listening to
and answer any questions
 Avoid listening through clothes