Main Body Show Palpation is the technique of using your hands/fingers to assess the client based on your sensation of touch. It provides the opportunity to use your sense of touch to assess the body and further examine cues that were identified during inspection. As you prepare to touch the client, it is important that you:
Palpation provides useful information to assess and evaluate findings related to temperature, texture, moisture, thickness, swelling, elasticity, contour, lumps/masses/deformities, consistency/density, organ location and size, vibration, , , and presence of pain. See Table 1.1 for specifics of how to conduct palpation based on what you are attempting to assess. Always compare the right side and the left side of the body when palpating, because the best standard of comparison is the client’s own anatomy. The presence of a bilateral versus a unilateral finding is of clinical significance. For example, the left ankle should be symmetrical with the right ankle. The presence of edema in one ankle versus both ankles is meaningful for making judgements about the underlying pathology. Table 1.1: Palpation techniques
Figure 1.8: Palpating for temperature with dorsa of hands Figure 1.9: Palpating with metacarpophalangeal joints Figure 1.10: Palpating with ulnar surfaces Distinguishing normal and abnormal findings comes with practice. It helps to familiarize yourself with common anatomy. Lab time is a unique opportunity to practice your skills and get a feel for human anatomy. Palpation is not just an assessment technique, it is a means of communicating with your patient through touch. Consider what message you are trying to convey through touch. With young children, try to incorporate play and involve the care partner when possible. You can incorporate a child’s toy or teddy bear into the assessment. If a child is ticklish, you can engage them by placing their hand on top of yours and ask them to move your hand to various positions to palpate. For all clients – children, adolescents, and adults – assess their readiness to touch. For example, you may begin by palpating non-invasive areas such as the hands first, and always explain what you will be doing. It is important to observe facial expression as an indicator of how the client is responding and also whether they are in pain. Which part of the hand should be used when palpating?Pain/tenderness is best assessed while palpating with your fingertips in which your hand and wrist are kept parallel to the body so that the action does not involve poking or jabbing the client with your fingertips. Always assess a painful area last.
What part of your hand do you use to assess temperature?The dorsal surface of the hand has the highest concentration of thermo-receptors, and is found by many people to provide the best sense of temperature.
Which area of the hand would the nurse use when palpating the liver?To palpate the liver, place your left hand under your patient, parallel to and supporting the right 11th and 12th ribs and your right hand lateral to the rectus muscle with your fingertips below the liver border (as identified by dullness during percussion).
Which is the best technique for palpating the skin for temperature?The dorsa (backs) of hands and fingers are best for determining temperature because the skin there is thinner than on the palms. Fingertips are best for fine, tactile discrimination; the other responses are not useful for palpation.
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