UNIVERSITY OF SOUTHERN MINDANAO

BASIC PHYSICAL
ASSESSMENT
PROCEDURES/
PREPARATION
Prepared by:

SHERYNA M. MAMALANGKAP, RN
 Topic Outline
A. Physical Examination
B. Draping during Physical Assessment
C. Techniques necessary for an accurate physical examination
D. Preparation for physical examination
E. Positioning for physical examination
F. Instruments, Equipments and Supplies needed for physical
examination

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION 2

 Intended Learning Outcomes
• Describe the components of a Physical Examination
• Use appropriate equipment while performing a head-to-toe
physical assessment.
• Assist in positioning the patient in the correct position to
perform the head-to-toe physical assessment.
• Verbalize the appropriate rationale for performing the specific
head-to-toe assessment techniques.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Physical Examination
Purposes:
• Routine screening.
• Eligibility for employment, school activities, physical
activities, medical insurance, military service.
• Hospital Admission.
• Establishing a data base for the patient.
• Identifying patient problems requiring intervention.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

• Evaluating the effectiveness of care.
• Developing credibility for promoting nurse- patient
relationship.
a) Nurse in all health care settings typically
perform complete physical examinations.
b) In all settings the physical examination should
be integrated into the nurses’ routine care.
c) The nurse must first learn to identify normal
characteristics before attempting to distinguish
abnormal findings.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Draping during the Physical Assessment

Purposes:
• To prevent unnecessary exposure.
• To provide privacy.
• To keep the client warm.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Considerations:
1) The method of draping varies with the position
of the patient, examination being done and the
room temperature.
2) As the examination is conducted, only those
body parts being assessed are exposed.
3) Draping should be loose enough to allow quick
change of position but anchored securely t
prevent unnecessary exposure

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Techniques necessary for an accurate physical
examination

1. Observation, measurement and history taking.

2. INSPECTION- visual and olfactory inspection to
observe color, odor, size, shape symmetry and
movement.
3. PALPATION- using the sense of touch
simultaneously with inspection to identify
softness, rigidity, temperature and to determine
position, size, texture, consistency and moisture.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

• PERCUSSION- striking body surfaces, producing
sounds to determine if underlying tissues are air-
filled, fluid filled, or solid.
Percussion sounds include:
Flat : non-resonant; soft tissues
Dull : thudlike; solid organs
Resonant : hollow
Hyperresonant : booming
Tympanic : over gas- filled
organs; drumlike
• AUSCULTATION- listening to sounds (usually with
stethoscope) produced as to their frequency,
intensity, quality and duration. Low pitched sounds.
BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION
Preparation for Examination
The environment must be suitable and all
equipments must be completed before the
examination begins.
1. Preparation of the environment
a)The examination is performed in privacy.
b)Adequate lighting is required for proper
illumination of body parts, observation, and
inspection.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

c.) The examination room should be
soundproof if possible; if not, all
extraneous noise should be eliminated.
d.) The examination table should be
comfortable for the patient.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

2. Preparation of the equipment.

a) Equipment and hands should be clean and be

kept warm.
b) All equipment should function properly.
c) All equipment should be gathered prior to the
beginning of the examination and should be kept
within easy reach of the examiner.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

3. Physical preparation of the patient.

a) The patient should be asked to void prior to the

examination.
b) The reason for the specimen collection should
be explained to the patient.
c) The patient should be properly positioned and
draped for examination.
d) The patient should be kept warm and out of
drafts; seriously ill patients are more susceptible
to chills.
e) The patient should be provided with privacy and
adequate time to dress and undress.
BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION
4. Psychological preparation of the patient.

a) Provide reassurance and support to decrease

patient anxiety and embarrassment.
b) Explain actions clearly and in details using simple
explanations.
c) Acquire a third person to be in the examination
room when the patient and examiner are of the
opposite sex.
d) Monitor the patient’s emotional responses
throughout the examination.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

 Positioning for Physical Examination

Considerations:
1. It is important to consider the client’s energy level
and privacy.
2. Clients who are weak may require assistance with
positioning.
3. Uncomfortable or embarrassing positions should
not be maintained for long periods.
4. The examination should be organized so that
several body systems can be assessed with the
client in one position.
BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION
SITTING POSITION

Purposes:
1. Sitting upright provides
good visualization of the
symmetry of the upper
body.
2. Allows full lung expansion.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Areas used to assess include:
1.Head and neck
2.Anterior and posterior thorax and lungs
3.Breast
4. Axilla
5.Heart
6.Upper extremities
7.To take vital signs

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Considerations:
1.The client may sit upright in a chair, on the side
of an examining table or bed.
2.Physically weak patients may not be able to sit. A
supine position with the head of the bed elevated
can be used instead.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Procedure:
1.Position the buttocks against the back of the
chair. Hips and knees are flexed at the right angle
to the trunk.
2.Keep the trunk and head as in standing position.
3.Place feet flat on the floor at 90° angle to the
lower legs.
4.If the chair has arms, flex the elbows and place
the forearms on the armrest to avoid shoulder
strain.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

 SUPINE POSITION

The supine position is normally the most relaxed

position.
Purposes:
1)Prevents contracture of the abdominal muscles.
2)Provide easy access to pulse points.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Areas used to assess includes:
1.Head and neck
2.Anterior thorax and lungs
3.Breast
4.Axilla
5.Heart
6.Abdomen
7.Extremities
8.Peripheral pulses

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Considerations:
1) This position allows relaxation of abdominal
muscles.
2) The supine position may be difficult for patients
experiencing shortness of breath.
Procedures:
3) The patient lies flat on the back with legs
together but extended and slightly flexed at the
knees.
4) The head may be supported with a small pillow.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

DORSAL RECUMBENT POSITION

Purposes:
1)Vaginal examination
2)Digital examination of rectum
3)Pelvic examination
4)Catheterization

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Areas used to assess includes:
1.Head and neck
2.Anterior thorax and lungs
3.Breast and axilla
4.Heart
5.Extremities
6.Peripheral pulses

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Considerations:
1)Bending the knees in the dorsal recumbent
position may be more comfortable for patients
with painful disorders
2)This position cannot be used to assess the
abdomen since it promotes contracture of the
abdominal muscles.
Procedures:
3)The patient lies on the back with legs separated,
knees bent, and soles of the feet flat on bed.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

2.) On the Internal Examination table:
a)Bring buttocks of the client to extreme edge of the
examining table and place the feet on extension.
b)Drape is placed diagonally over the patient with
opposite corners in place between the legs.
c)Place Kelly or disposable pad under patient’s buttocks
d)The corner of the drape between the patient’s legs is
raised on folded back on the abdomen to expose the
part being examined.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

 SIMS POSITION

Purpose:
1)Used to assess the rectum or the vagina
Consideration:
2)Joint deformities may prevent the patient from
assuming this position.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Procedure:
1)Place top sheet.
2)The client lies on either the right or the left side.
3)The lower arm is behind the body and the upper
arm is flexed at the shoulder and elbow.
4)The knees are both flexed, with the uppermost
leg more accurately flexed.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

PRONE POSITION

Purposes:
1)It is used to assess the hip joint.
2)Can be used to assess the posterior thorax.
Consideration:
3)This position is difficult to assume for many
clients.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Procedure:
1)Place top sheet.
2)The client lies on the abdomen, flat on bed, with
the head turned to one side.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

LITHOTOMY POSITION

Purposes:
1)Examination of the rectum and female genitalia
2)Delivery of the newborn
3)Cystoscopic examination.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Considerations:
1)It is uncomfortable for the older clients.
2)It is often embarrassing, so time spent in this
position should be minimized.
3)Lithotomy position provides the greatest exposure
of genitalia and allows insertion of vaginal speculum.
Procedures:
4)Place top sheet.
5)The client is in dorsal recumbent position with the
buttocks at the edge of the examining table and the
feet supported in stirrups.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

KNEE-CHEST OR GENU-PECTORAL POSITION

Purpose:
1)The position is used for the examination of rectal
area.
Consideration:The same precautions should be used
as with the lithotomy position.

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Instruments, equipments and supplies needed for
Physical Examination
Instruments:
1)Blood pressure

2)Stethoscope

3)Ophthalmoscope

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

4.) Otoscope

5.) Snellen’s chart

6.)Nasal speculum

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

7.) Weighing scale

8.) Vaginal speculum

9.)Tuning fork

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

10.) Percussion hammer

11.)Neurologic hammer

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION

Equipments and Supplies:

1. Alcohol swabs
2. Cotton applicators
3. Disposable pad
4. Cotton balls with antiseptic solution
5. Gauze dressing (4x4)
6. Drape
7. Gloves (sterile and non-sterile/ clean)
8. Lubricant
9. Penlight
10. Safety pins
11. Cologne or perfume (testing sense of smell)
12. Tape measure
13. Thermometer
14. Tongue depressor
15. Kidney basin
16. Tissue paper
17. Lab slides or test tubes
18. Clean white towel
BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION
 Summary
• Physical assessment is the systematic collection of objective
data that are directly observed or are elicited through
examination techniques, such as inspection, palpation,
percussion, and auscultation .Performing a physical
examination requires knowledge of anatomy and physiology,
the equipment being used, and proper patient positioning and
draping

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION 39

 References
• Lynn, P., (2011). Health Assessment. Taylors Clinical Nursing
Skills 3rd Edition. 45-51.
• Manual of Clinical Nursing Procedures (2020 Edition)

BASIC PHYSICAL ASSESSMENT PROCEDURES AND PREPARATION 40

God Bless us all….