Health Assessment vs Physical Examination

Physical Examination

• Positions in physical examination: • Lithotomy: Back-lying position with feet supported in stirrups • Genupectoral/Knee-Chest: Kneeling position with torso at 90 degrees angle to hips • Lateral/Side-lying position • Sim’s position/Semi prone position • Prone/Face lying position: With the head turned to side; also known as abdominal-lying position

Health Assessment

• Components of health assessment: • Age, sex, race • Body build, height, weight (in relation to client's age, lifestyle, and health) • Posture and gait • Hygiene and grooming • Body and breath odor • Signs of distress • Attitude, affect, and mood • Speech and thought process

Laboratory and Diagnosis

• Specimen used: • Urine • Stool • Blood • Other body secretions

Framework for Health Assessment

• A. Functional Health Framework: • Evaluates the effects of mind, body, and environment on a person's ability to perform daily tasks • Focuses on 11 functional patterns (Gordon): • Health perception and health management • Activity and exercise • Nutrition and metabolisms • Elimination • Sleep and rest • Cognition and perception • Self-perception and self-concept • Roles and relationships • Coping and stress tolerance • Sexuality and reproduction • Values and belief
• B. Head to Toe Framework: • Collects data from head to toe in a cephalo-caudal manner • Focuses on general health state, vital signs, weight, and nutritional status

Body Temperature

• Regulation: • Increases body temperature: progesterone, thyroxine, norepinephrine, epinephrine • Decreases body temperature: estrogen
• Abnormalities: • Pyrexia: Body temperature above normal range (hyperthermia or fever) • Hyperpyrexia: Very high fever (41°C or 105.8°F and above) • Hypothermia: Subnormal core body temperature

Types of Fever

• Intermittent fever: Temperature fluctuates between periods of fever and normal/subnormal temperature
• Remittent fever: Temperature fluctuates within a wide range over 24 hours, but remains above normal
• Relapsing fever: Temperature is elevated for a few days, then returns to normal for 1-2 days
• Constant fever: Body temperature consistently high

Decline of Fever

• Crisis of flush or defervescence stage: Sudden decline of fever, indicating impairment of hypothalamic function
• Lysis: Gradual decline of fever, indicating the body's ability to maintain homeostasis

Clinical Signs of Fever

• Onset (cold or chill stage): • Increased heart rate • Increased respiratory rate and depth • Shivering • Pale, cold skin • Cyanotic nail bed • Complaints of feeling cold • "Goose flesh" appearance of the skin • Cessation of sweating • Rise in body temperature

Health Assessment vs. Physical Examination

• Health Assessment: Collection of data about an individual's health
• Physical Examination: Head-to-toe review of each body system, offering objective information about the client

Purpose of Health Assessment

• To make a clinical judgment or diagnosis about the individual's health state or condition
• To obtain baseline data about the client's functional abilities

Purpose of Physical Examination

• For routine screening to determine client's eligibility for health insurance
• For acquiring a new job
• For client's admission to the hospital

Modes of Examination

• Inspection: Assessing using the sense of sight
• Palpation: Examining the body using the sense of touch
• Percussion: Tapping body parts to produce sounds
• Auscultation: Listening to body sounds with a stethoscope

Processes Involved in Heat Loss

• Radiation: Transfer of heat from the surface of one object to the surface of another without contact
• Conduction: Transfer of heat from one surface to another, requiring temperature difference between the two surfaces
• Convection: Dissipation of heat by air currents
• Evaporation: Continuous vaporization of moisture from the skin, oral mucus, and respiratory tract (also known as insensible heat loss)

Factors Affecting Temperature

• Age: Infants' body temperature is affected by the environment; elderly people are at risk of hypothermia
• Diurnal variations: Highest temperature between 8:00 p.m. to 12:00 noon; lowest temperature between 4:00-6:00 a.m.
• Exercise
• Hormones

Pulse

• Definition: A wave created by the contraction of the left ventricle of the heart
• Regulation: Autonomic nervous system (ANS)
• Factors affecting pulse rate: • Age • Sex/Gender • Exercise • Fever • Medications • Hemorrhage • Stress • Position changes

Pulse Sites

• Temporal
• Carotid
• Apical
• Brachial
• Radial
• Femoral
• Posterior Tibia

Learn the difference between Health Assessment and Physical Examination in the context of healthcare. Understand the purpose and dimensions of health assessment and how it contributes to clinical judgments and diagnoses.