Reflective Essay on Physical Assessment Techniques

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Running head: REFLECTIVE ESSAY
REFLECTIVE ESSAY
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2REFLECTIVE ESSAY
Description
Physical assessment like inspection, palpation, percussion and palpation. These
assessments are generally the important steps of airway assessment or cardiac assessment
(Ashcheulova, Kovalyova & Demydenko, 2017). Being an airway nurse, I was instructed to
perform this assessment in one of my colleagues, whose name is tracy.
At first I entered the room and greeted my collegue and explained her about the
procedure and the importance of doing this examination. I asked for the consent before
touching the patient. Before examining the patient, I washed my hands thoroughly with the
soap or an antibacterial wash. Handwashing is an important step to prevent infection (Longtin
et al., 2013). I requested the patient to sit in the examination table and assisted her to lie down
on the examination table. I generally observed my concerned patient to look for any signs of
distress. I asked the patient to hold her hands up and I pressed the thumbnail with the help of
my first finger while holding the other side of the finger with the help of my thumb. This is
how I noted the pheripheral circulation. Clubbing should be noticed, which can be reerred to
as the decrease in the angle between the nail bed and the nail (Ashcheulova, Kovalyova &
Demydenko, 2017). Then I performed auscultation by placing the stethoscope above Tracy’s
chest and tried to listen to the lund sounds. Airflow normally sounded differently in case of
blocked airways or wheezing can be heard (Sarkar, Madabhavi, Niranjan & Dogra, 2015).
The radial pulse is palpated with the help of the middle finger and the index finger and the
rhythm, regularity, rate per minute, rhythms and the volumes are measured (Estes, 2013). I
tried to assess the apex beat, corresponding to the lower left borer of the heart. Next I
palpated for the heaves and thrills. I inspected the head of the patient for signs of any cardiac
diseases like bobbing head movement, that is linked to aortic regurgitation or flushing skin
(Lehrer, 2018). I made it sure to inspect the skin around the eyes for any yellow coloration.

3REFLECTIVE ESSAY
Then I performed percussion by placing my hand firmly over the chest wall along the
intercostal space and tapped over the distal interphalageal joint. I was mindful about the
positioning of my fingers as the tapping should be done with the wrist and the percussion
finger would not be left in the chest, as that would dampen the sound.
I inspected that patient’s chest anteriorly for searching evidence of any median sternotomy
scar.
Feelings
I was a bit nervous about the assessment, although I have performed this assessment
for a number of times, but this time I had to perform this in front of the supervisor, hence I
was tensed, whether, I was performing all the steps correctly. I considered if the patient is
uncomfortable with the examination or whether she was hurt at the time I was performing the
percussion. However, my nurse supervisor had assured ne in the beginning that he would be
assisting me throughout the procedure and so I felt a bit relived.
Evaluation
There were few mistakes that I did during the procedure. I did not position my patient
at an angle of 45 degree or 30 degree, which is an important step at the time of inspecting my
patient (Estes, 2013). I was also forgetful about the inspection of cornea for the presence of
corneal arcus to inspect for any hyperlipidaemia or even did not check the colour of the
tongue to inspect for the central cyanosis. However, I was mindful about the rest of the
procedures and the patient also expressed that she had been comfortable throughout the
procedure. However, my supervisor also confirmed that I have performed the procedure
excellently, except that I could have been more prompt and confident during the procedure.