When studying HA you must know how to properly perform the assessment, understand abnormal situations and diseases, recall anatomy and physiology, understand elderly abnormals and cultural implications.
A good way to critically think about HA is to ask yourself questions.
- What am I observing?
- What are the normal findings?
- What position should the patient be in?
- What could I see abnormally?
- How would I know if it is an abnormal finding?
- What would I do if there was an abnormal finding?
- What would I do in an emergency situation?
For example: When testing for symmetry of the chest using the chest expansion test you would give your partner instructions, "I observed my thumbs moving apart symmetrically."
What position should the patient be in? At least 30 degrees at all times with lung problems
What position should the patient be in? At least 30 degrees at all times with lung problems
If this did not happen then ask why not? If your thumbs did not move apart symmetrically this could indicate atelectasis, rib fracture, pneumonia, pleural effusion or collapsed lung.
How would you know if it is a rib fracture vs. collapsed lung? Understand the signs and symptoms of the possible causes.
Is this an emergency situation? A fractured rib and a collapsed lung are both emergency situations but the pneumothorax would need to be addressed first (always think critically because not every situation is alike). With a collapsed lung or pneumothorax you will see signs of shortness of breath, tachycardia, tracheal deviation to the opposite side (one of the main signs) and cyanosis.
What would the nurse do? The nurse would give oxygen if ordered, put the pt. in a high fowlers position, monitor the chest tube, monitor for subcutaneous emphysema.
When practicing your head to toe assessment it could be helpful to speak out loud to your partner giving instructions and saying normal and abnormal findings.
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