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Health Assessment Practical Final

Assessing the Thorax and Lungs


Instructions: Please indicate how much you agree or disagree with each of the following statements by circling the number in the appropriate box. For example, if you strongly agree (SA) that the student performed the behavior described in the statement during the health assessment practical final correctly, skillfully, smoothly, dexterously, and efficiently, circle the box with a 5. If you strongly disagree (SD) that the student performed the behavior described in the statement during the health assessment practical final correctly, skillfully, smoothly, dexterously, and efficiently, circle the box with a 1. At the end of the health assessment practical final, add the total points obtained on the tool and divide that number by the total points possible to obtain on the tool to determine a % score for the student on the health assessment practical final.

Student's Name: ____________________

Student's Score: _____ out of 915 points possible (183 x 5) or _____% for a grade of _____

Prepared self and the patient for the examination
SA
A
U
D
SD
  • washed hands
5
4
3
2
1
  • gathered all the necessary equipment (stethoscope, skin marking pen, small centimeter ruler)
5 4 3 2 1
  • greeted the patient and established rapport
5
4
3
2
1
  • explained the procedure to the patient in simple terms what will be done, what he/she should expect, and how he/she could cooperate during the examination
5
4
3
2
1
  • assisted the patient in assuming a position of sitting up straight with his/her legs dangling over an examining table and then lying supine on an examining table with his/her head elevated 30 degrees on a small pillow and his/her arms at his/her sides
5 4 3 2 1
  • encouraged the patient to ask questions and mention any discomfort he/she felt during the examination
5
4
3
2
1
Comments:

Inspected the rate, rhythm, pattern, depth, sound, and effort of respirations of the posterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5
4
3
2
1
  • observed the rate, rhythm, pattern, depth, sound, and effort of respirations of the posterior thorax from all angles
5
4
3
2
1
Comments:

Inspected the shape and configuration of the posterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5
4
3
2
1
  • observed the shape and configuration of the posterior thorax from all angles
5
4
3
2
1
Comments:

Inspected the respiratory movement of the posterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5
4
3
2
1
  • stood directly behind the patient
5 4 3 2 1
  • observed the respiratory movement of the patient's anterior thorax from all angles
5
4
3
2
1
Comments:

Inspected the skin over the posterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • observed the skin over the patient's posterior thorax from all angles
5 4 3 2 1
Comments:

Inspected the spinal alignment of the posterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • observed the spinal alignment of the patient's posterior thorax from all angles
5 4 3 2 1
Comments:

Inspected the accessory muscles of the posterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • observed the accessory muscles (sternocleidomastoid, scalenus, trapezius) of the patient's posterior thorax from all angles
5 4 3 2 1
Comments:

Inspected the intercostal spaces of the posterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • observed the intercostal spaces of the patient's anterior thorax from all angles
5 4 3 2 1
Comments:

Palpated the posterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5
4
3
2
1
  • stood directly behind the patient
5
4
3
2
1
  • placed the pads of the first four fingers of your right hand over the right apice of patient's posterior thorax
5
4
3
2
1
  • pressed the pads of the first four fingers of your right hand 1 centimeter (1/2 inch) into the right apice of the patient's posterior thorax
5 4 3 2 1
  • moved the pads of the first four fingers of your right hand in a circle over the right apice of the patient's posterior thorax
5 4 3 2 1
  • continued to palpate in a zig-zag pattern and compare symmetrical areas of the patient's posterior thorax
5
4
3
2
1
Comments:

Palpated the posterior thorax for respiratory expansion
SA
A
U
D
SD
  • explained the procedure to the patient
5
4
3
2
1
  • stood directly behind the patient
5 4 3 2 1
  • placed the thumb of your right hand to the left of the patient's xyphoid process
5 4 3 2 1
  • spread the fingers of your right hand lightly over the patient's left costal margin
5 4 3 2 1
  • placed the thumb of your left hand to the right of the patient's xyphoid process
5 4 3 2 1
  • spread the fingers of your left hand lightly over patient's right costal margin
5 4 3 2 1
  • instructed the patient to inhale deeply and exhale fully
5 4 3 2 1
  • observed the separation of your thumbs during the patient's inspiration
5
4
3
2
1
Comments:

Palpated the posterior thorax for tactile (vocal) fremitus
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • placed the ball (the bony part of the palm at the base of the fingers) or ulnar edge of one hand on the right apice of the patient's posterior thorax
5 4 3 2 1
  • instructed the patient to say "ninety-nine", "one-one-one", or "blue moon"
5 4 3 2 1
  • felt for the vibration on the ball (the bony part of the palm at the base of the fingers) or ulnar edge of your right hand
5 4 3 2 1
  • continued to palpate in a zig-zag pattern and compare symmetrical areas of the patient's posterior thorax for tactile (vocal) fremitus
5 4 3 2 1
Comments:

Percussed the posterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • placed your hands in the correct position for percussion over the right apice of the patient's posterior thorax
5 4 3 2 1
  • percussed on a point over the right apice of the patient's posterior thorax
5 4 3 2 1
  • listened for the percussion note obtained during percussion over the right apice of the patient's posterior thorax
5 4 3 2 1
  • continued to percuss in a zig-zag pattern and compare symmetrical areas of the patient's posterior thorax for percussion notes
5 4 3 2 1
Comments:

Percussed the posterior thorax to determine the level of diagphagmatic dullness
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • gathered a skin-marking pen and ruler
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • instructed the patient to cross his/her arms across his/her chest
5 4 3 2 1
  • placing your hands in the correct position for percussion on the 7th intercostal space (ICS) in the right scapular line (RSL) in an area of lung resonance of the patient's posterior thorax
5 4 3 2 1
  • instructed the patient to exhale fully and hold it
5 4 3 2 1
  • percussed downward in progressive steps from the 7th ICS in the RSL in the area of lung resonance of the patient's posterior thorax to the level of diaphragmatic dullness in the RSL of the patient's posterior thorax
5 4 3 2 1
  • marked the point of diaphragmatic dullness on the RSL of the patient's posterior thorax with a skin marking pen
5 4 3 2 1
  • instructed the patient to breath normally
5 4 3 2 1
  • placed your hands in the correct position for percussion on the 7th intercostal space (ICS) in the left scapular line (LSL) in an area of lung resonance of the patient's posterior thorax
5 4 3 2 1
  • instructed the patient to exhale fully and hold it
5 4 3 2 1
  • percussed downward in progressive steps from the 7th ICS in the LSL in the area of lung resonance of the patient's posterior thorax to the level of diaphragmatic dullness in the LSL of the patient's posterior thorax
5 4 3 2 1
  • marked the point of diaphragmatic dullness on the LSL of the patient's posterior thorax with a skin marking pen
5 4 3 2 1
  • instructed the patient to breath normally
5 4 3 2 1
Comments:

Percussed the posterior thorax to determine the level of diagphagmatic excursion
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • gathered a skin-marking pen and ruler
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • instructed the patient to cross his/her arms across his/her chest
5 4 3 2 1
  • placing your hands in the correct position for percussion on the mark you made in the RSL that coincided with the level of diaphragmatic dullness
5 4 3 2 1
  • instructed the patient to exhale fully and hold it
5 4 3 2 1
  • percussed downward in progressive steps from the the mark you made in the RSL that coincided with the level of diaphragmatic dullness to the new level of diaphragmatic dullness in the RSL of the patient's posterior thorax
5 4 3 2 1
  • marked the new level of diaphragmatic dullness on the RSL of the patient's posterior thorax with a skin marking pen
5 4 3 2 1
  • instructed the patient to breath normally
5 4 3 2 1
  • measured the distance between the two points of diaphragmatic dullness in the RSL of the patient's posterior thorax
5 4 3 2 1
  • placed your hands in the correct position for percussion on the mark you made in the LSL that coincided with the level of diaphragmatic dullness in the LSL of the patient's posterior thorax
5 4 3 2 1
  • instructed the patient to exhale fully and hold it
5 4 3 2 1
  • percussed downward in progressive steps from the markyou made in the LSL that coincided with the level of diaphragmatic dullness to the new level of diaphragmatic dullness in the LSL of the patient's posterior thorax
5 4 3 2 1
  • marked the new level of diaphragmatic dullness on the LSL of the patient's posterior thorax with a skin marking pen
5 4 3 2 1
  • instructed the patient to breath normally
5 4 3 2 1
  • measured the distance between the two points of diaphragmatic dullness in the LSL of the patient's posterior thorax
5 4 3 2 1
Comments:

Auscultated the posterior thorax for normal and adventitious breath sounds
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • gathered a stethoscope
5 4 3 2 1
  • placed the diaphragm of your stethoscope over the right apice of the patient's posterior thorax
5 4 3 2 1
  • instructed the patient to take a deep breath through this/her mouth
5 4 3 2 1
  • listened for the breath sound obtained during auscultation over the right apice of the patient's posterior thorax
5 4 3 2 1
  • continued to auscultate in a zig-zag pattern and compare symmetrical areas of the patient's posterior thorax for normal and adventitious breath sounds
5 4 3 2 1
Comments:

Auscultated the posterior thorax for bronchophony
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • gathered a stethoscope
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • placed the diaphragm of your stethoscope over the questionable area of the patient's posterior thorax
5 4 3 2 1
  • instructed the patient to say "99"
5 4 3 2 1
  • listened to the "99" obtained during auscultation over the questionable area on patient's posterior thorax
5 4 3 2 1
  • continued to auscultate any other questionable areas over the patient's posterior thorax for bronchophony
5 4 3 2 1
Comments:

Auscultated the posterior thorax for egophony
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • gathered a stethoscope
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • placed the diaphragm of your stethoscope over the questionable area of the patient's posterior thorax
5 4 3 2 1
  • instructed the patient to say "e"
5 4 3 2 1
  • listened to the "e" obtained during auscultation over the questionable area on patient's posterior thorax
5 4 3 2 1
  • continued to auscultate any other questionable areas over the patient's posterior thorax for egophony
5 4 3 2 1
Comments:

Auscultated the posterior thorax for whispered pectoriloquy
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • gathered a stethoscope
5 4 3 2 1
  • stood directly behind the patient
5 4 3 2 1
  • placed the diaphragm of your stethoscope over the questionable area of the patient's posterior thorax
5 4 3 2 1
  • instructed the patient to whisper "1 - 2 - 3"
5 4 3 2 1
  • listened to the whispered "1 - 2 - 3" obtained during auscultation over the questionable area on patient's posterior thorax
5 4 3 2 1
  • continued to auscultate any other questionable areas over the patient's posterior anterior thorax for whispered pectoriloquy
5 4 3 2 1
Comments:

Inspected the rate, rhythm, pattern, depth, sound, and effort of respirations of the anterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5
4
3
2
1
  • observed the rate, rhythm, pattern, depth, sound, and effort of respirations of the anterior thorax from all angles
5
4
3
2
1
Comments:

Inspected the shape and configuration of the anterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5
4
3
2
1
  • observed the shape and configuration of the anterior thorax from all angles
5
4
3
2
1
Comments:

Inspected the respiratory movement of the anterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5
4
3
2
1
  • stood on the right side of the patient
5 4 3 2 1
  • observed the respiratory movement of the patient's anterior thorax from all angles
5
4
3
2
1
Comments:

Inspected the skin over the anterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood on the right side of the patient
5 4 3 2 1
  • observed the skin over the patient's anterior thorax from all angles
5 4 3 2 1
Comments:

Inspected the accessory muscles of the anterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood on the right side of the patient
5 4 3 2 1
  • observed the accessory muscles of the patient's anterior thorax (sternocleidomastoid, scalenus, trapezius, rectus abdominis, pectoral) from all angles
5 4 3 2 1
Comments:

Inspected the intercostal spaces of the anterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood on the right side of the patient
5 4 3 2 1
  • observed the intercostal spaces of the patient's anterior thorax from all angles
5 4 3 2 1
Comments:

Inspected the supraclavicular spaces of the anterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood on the right side of the patient
5 4 3 2 1
  • observed the supraclavicular spaces of the patient's anterior thorax from all angles
5 4 3 2 1
Comments:

Inpsected the substernal area of the anterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood on the right side of the patient
5 4 3 2 1
  • observed the substernal area of the patient's anterior thorax from all angles
5 4 3 2 1
Comments:

Palpated the anterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5
4
3
2
1
  • stood on the right side of the patient
5
4
3
2
1
  • placed the pads of the first four fingers of your right hand over the right apice of patient's anterior thorax
5
4
3
2
1
  • pressed the pads of the first four fingers of your right hand 1 centimeter (1/2 inch) into the right apice of the patient's anterior thorax
5 4 3 2 1
  • moved the pads of the first four fingers of your right hand in a circle over the right apice of the patient's anterior thorax
5 4 3 2 1
  • continued to palpate in a zig-zag pattern and compare symmetrical areas of the patient's anterior thorax
5
4
3
2
1
Comments:

Palpated the anterior thorax for respiratory expansion
SA
A
U
D
SD
  • explained the procedure to the patient
5
4
3
2
1
  • stood on the right side of the patient
5 4 3 2 1
  • placed the thumb of your right hand to the left of the patient's xyphoid process
5 4 3 2 1
  • spread the fingers of your right hand lightly over the patient's left costal margin
5 4 3 2 1
  • placed the thumb of your left hand to the right of the patient's xyphoid process
5 4 3 2 1
  • spread the fingers of your left hand lightly over patient's right costal margin
5 4 3 2 1
  • instructed the patient to inhale deeply and exhale fully
5 4 3 2 1
  • observed the separation of your thumbs during the patient's inspiration
5
4
3
2
1
Comments:

Palpated the anterior thorax for tactile (vocal) fremitus
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood on the right side of the patient
5 4 3 2 1
  • placed the ball (the bony part of the palm at the base of the fingers) or ulnar edge of one hand on the right apice of the patient's anterior thorax
5 4 3 2 1
  • instructed the patient to say "ninety-nine", "one-one-one", or "blue moon"
5 4 3 2 1
  • felt for the vibration on the ball (the bony part of the palm at the base of the fingers) or ulnar edge of your right hand
5 4 3 2 1
  • continued to palpate in a zig-zag pattern and compare symmetrical areas of the patient's anterior thorax for tactile (vocal) fremitus
5 4 3 2 1
Comments:

Percussed the anterior thorax
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • stood on the right side of the patient
5 4 3 2 1
  • placed your hands in the correct position for percussion over the right apice of the patient's anterior thorax
5 4 3 2 1
  • percussed on a point over the right apice of the patient's anterior thorax
5 4 3 2 1
  • listened for the percussion note obtained during percussion over the right apice of the patient's anterior thorax
5 4 3 2 1
  • continued to percuss in a zig-zag pattern and compare symmetrical areas of the patient's anterior thorax for percussion notes
5 4 3 2 1
Comments:

Auscultated the anterior thorax for normal and adventitious breath sounds
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • gathered a stethoscope
5 4 3 2 1
  • placed the diaphragm of your stethoscope over the right apice of the patient's anterior thorax
5 4 3 2 1
  • instructed the patient to take a deep breath through this/her mouth
5 4 3 2 1
  • listened for the breath sound obtained during auscultation over the right apice of the patient's anterior thorax
5 4 3 2 1
  • continued to auscultate in a zig-zag pattern and compare symmetrical areas of the patient's anterior thorax for normal and adventitious breath sounds
5 4 3 2 1
Comments:

Auscultated the anterior thorax for bronchophony
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • gathered a stethoscope
5 4 3 2 1
  • stood on the right side of the patient
5 4 3 2 1
  • placed the diaphragm of your stethoscope over the questionable area of the patient's anterior thorax
5 4 3 2 1
  • instructed the patient to say "99"
5 4 3 2 1
  • listened to the "99" obtained during auscultation over the questionable area on patient's anterior thorax
5 4 3 2 1
  • continued to auscultate any other questionable areas over the patient's anterior thorax for bronchophony
5 4 3 2 1
Comments:

Auscultated the anterior thorax for egophony
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • gathered a stethoscope
5 4 3 2 1
  • stood on the right side of the patient
5 4 3 2 1
  • placed the diaphragm of your stethoscope over the questionable area of the patient's anterior thorax
5 4 3 2 1
  • instructed the patient to say "e"
5 4 3 2 1
  • listened to the "e" obtained during auscultation over the questionable area on patient's anterior thorax
5 4 3 2 1
  • continued to auscultate any other questionable areas over the patient's anterior thorax for egophony
5 4 3 2 1
Comments:

Auscultated the anterior thorax for whispered pectoriloquy
SA
A
U
D
SD
  • explained the procedure to the patient
5 4 3 2 1
  • gathered a stethoscope
5 4 3 2 1
  • stood on the right side of the patient
5 4 3 2 1
  • placed the diaphragm of your stethoscope over the questionable area of the patient's anterior thorax
5 4 3 2 1
  • instructed the patient to whisper "1 - 2 - 3"
5 4 3 2 1
  • listened to the whispered "1 - 2 - 3" obtained during auscultation over the questionable area on patient's anterior thorax
5 4 3 2 1
  • continued to auscultate any other questionable areas over the patient's anterior thorax for whispered pectoriloquy
5 4 3 2 1
Comments:

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This page was last modified on 1/1/02