- Okay, welcome back to part 2 of the physical assessment
video, next we are going to assess the lower extremities and
then the patient's back.
If you are worried about your patient rolling out of bed,
for safety you do want to go ahead and raise the side rail
back up.
And then we are going to lower the sheets and make
sure her gown is lowered.
So, in general I'm looking at the legs, I am looking for
any edema, so I do not note any edema.
I am also feeling for color change and temperature changes.
So, her feet and legs feel nice and warm.
I am gonna go ahead and assess the pedal pulses, and we are
doing that bilaterally and that is equal and 2+.
We also want to assess the patient's strength and range of
motion so we are looking at the hip and the knees.
So I'm gonna lift up this leg and I'm just gonna bend that.
Okay.
Lift up the other leg, perfect, and can you do that with
this leg for me as well? And the next leg? Perfect.
So then also looking at her feet, I wanna take a look at
her toenails and at her toes.
If the patient has toenail polish on you can check
cap refill just above the nails.
So less than 2 seconds.
You do want to go ahead and check the bottom of the
patient's feet so the bottom of the ankles, remember all
bony prominences you are looking for any skin break down or
wounds and I do not see any wounds or break down, can you
go ahead and lift up with your feet against my hands?
Perfect. And push down against my hands, good job.
Okay, so the patient has full strength and range of motion
in the lower extremities. So since I touched the patient's
feet I am gonna go ahead and sanitize my hands again.
And if you had gloves on you would want to go ahead and
change your gloves, I am actually gonna go ahead and put
gloves on because I am gonna assess her back, but then I am
going to look at her buttocks and if you ever are concerned
that you might come into contact with any body fluid or body
substances you would want to have gloves on for protection.
So I am gonna put gloves on because I am looking at your
back and then your bottom okay?
- [Patient] Okay.
- And what I am looking for is just any
breakdown in your skin.
Okay, can you go ahead, I am going to lower the bed
just a little bit.
And if your patient needed assistance rolling over,
depending on their size you could either assist them
yourself or you'd have another person assist you.
Can you go ahead and bend this knee for me please?
Okay and then I am gonna have you rollover and hold on to
that side rail please.
Oops, so I am gonna go ahead and first listen to the
patient's lung sounds and just keep taking deep breaths
in and out.
Okay, so when you are listening to posterior breath sounds
you want to make sure that you are not listening over the
patient's scapula so you start kind of close to the spine,
and for a full inspiratory and expiratory cycle,
in each spot and as you go down the patient's back...
you would widen out and then always make sure that you
listen underneath the patient's arm.
Okay, your lungs sound nice and clear and then I am just
looking at your skin I can reassess the back of the
patient's head, and I do not see any hair loss or skin
breakdown, if the patient had a trach you would want to
make sure you specifically pay attention to the back of the
neck, I do not see any skin breakdown on the
bony prominences and then I am looking at the patient's back
at the coccyx and I do not see any skin breakdown.
This is another time that you can look at the back of the
feet to make sure that you have assessed them correctly.
Okay perfect Miss Greago you can go ahead and
lay back down.
How are you feeling?
- Good.
- Okay, is there anything I can get for you?
- No.
- No, okay. I want to make sure that you have your
call light and you know how to use that, correct?
- Mhmmm.
- Okay and your IV is still intact, okay well thank you
very much Miss Greago...
- So that concludes the end of part 2 of physical assessment
and I hope to see you next time.