NURS 680B DQ What Is a Physical Exam?
NURS 680B DQ What Is a Physical Exam?
Select one of the following case studies to address. In the subject line of your post, please identify which prompt you are responding to, for example, choice #2 19-year old male.
A 28-year old female presents with a “severe headache” for the past 9 hours. She states the pain is over the left temporal area and is “throbbing” in nature. These symptoms have occurred before but not as bad.
A 54-year old woman complain of left side drooling and facial drooping since earlier this morning.
A 64-year old diabetic man reports he has numbness and burning sensations in his toes for the past 6 months.
For the case you have chosen, post to the discussion:
Discuss what questions you would ask the patient, what physical exam elements you would include, and what further testing you would want to have performed.
In SOAP format, list:
Pertinent positive and negative information
Differential and working diagnosis
Treatment plan, including: pharmacotherapy with complementary and OTC therapy, diagnostics (labs and testing), health education and lifestyle changes, age-appropriate preventive care, and follow-up to this visit.
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
In your peer replies, please reply to at least one peer who chose a different case study.
You likely already know that exercise and a healthy diet are critical to proactive good health, but you might not realize how critical a routine physical examination is to your overall preventive medicine plan.
One study published in the American Journal of Medicine revealed that inadequate physical examination is a significant source of medical errors and subsequent adverse effects. Meanwhile, a Critical Methods study says a “thoughtfully performed” exam yields roughly 20 percent of the data your physician needs to diagnose and manage symptoms.
What Is a Physical Exam?
A physical exam can be general or specific to a particular problem. Your primary care physician conducts an overall physical exam at least once annually; this may be more frequent if specific health issues are being managed. A cardiologist’s examination, on the other hand, may focus on heart-related health markers, some of which are included in a general physical.
All physicals integrate your medical history. Health questions about you, your parents, your grandparents, your siblings, and your children become part of the diagnostic picture. Be prepared by researching this information beforehand. Other information you’ll provide includes medications you take — both prescribed and over-the-counter — as well as any previous medical procedures, tests, doctors, and treatments.
Elements of a Physical Exam
When asking, “What is a physical exam?” health care consumers should know its essential elements. A thorough physical examination covers head to toe and usually lasts about 30 minutes. It measures important vital signs — temperature, blood pressure, and heart rate — and evaluates your body using observation, palpitation, percussion, and auscultation.
- Observation includes using instruments to look into your eyes, ears, nose, and throat. Your doctor will look at skin color, lesions, and note any hygienic issues. He or she may examine other parts of your body if symptoms or medical history indicates the need.
- Your doctor will palpitate — touch — certain parts of your body, feeling for unusual lumps, checking organ size and shape, and checking responses.
- By placing one hand over your abdomen and tapping it with the other, the doctor is relying on percussion to determine organ location, identify blockages, and pinpoint any problem areas. Reflexes are checked with the use of a small rubber hammer.
- Auscultation involves the use of a stethoscope to listen to your heart, lungs, and bowels.
Tests You Might Encounter
Your doctor may perform tests specific to something revealed from your medical history, your symptoms, or the physical examination. He or she should explain what the test is looking for and what will be done with the information.
Common laboratory tests that make up part of the physical examination may include having blood drawn to test for body chemistry, the presence of pathogens, or body functions. A urine specimen checks for kidney and urinary tract health, and gender-specific issues. Certain symptoms may require taking stool and sputum cultures.
Imaging studies may include X-rays, computer tomography (CT), or magnetic resonance (MRI) scans. An electrocardiogram (EKG) measures heart activity.
Your doctor may also rely on more specialized and in-depth diagnostics. In this case, sleep studies, home monitoring devices, and any number of other tools could become essential after you leave the office.
Physical Examination Is Teamwork
There are things you can do to help ensure a thorough exam. Your physician needs honest and complete information, and having all your medications and medical records on hand saves time and paints a clearer picture.
A growing diagnostic trend relies more on technology than hands-on care. If you go for a physical examination, your doctor may touch less and test more. While physicians debate the impact of this trend, patients still expect physician contact from a physical examination. It all comes down to trust; what matters is whether you believe your doctor knows what he or she is doing, however they’re doing it.
Though your doctor conducts the examination, you’re in charge. You can refuse any part of the exam, tests, or treatments ordered. Just be sure you fully understand the consequences of such a decision. Expect politeness, but respect the doctor’s need to control the examination. Take notes, and have questions prepared in advance.
A physical examination can save your life and is often the only way you or your doctor become aware of a problem. What the doctor learns from the exam helps determine the best treatment options. Yet the doctor is only part of the team. Take charge of your future by staying active, eating right, and being proactive about your health.