Category: Palpation definition in nursing

Palpation definition in nursing

Palpitations mean that the heart is not behaving normally. It can appear to skip beats, beat rapidly, beat irregularly, or thump in the chest.

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Although palpitations are very common and often harmless, they can be frightening to the person, who is usually unaware of his or her heartbeat. Palpitations can also be a sign of serious heart trouble. Palpitations that are caused by certain types of abnormal heart rhythms arrhythmias can be serious, and even fatal if left untreated. Recognizable arrhythmias are present in a small number of patients who have palpitations.

Immediate medical attention should be sought for palpitations that feel like a very fast series of heartbeats, last more than two or three minutes, and are unrelated to strenuous physical activity, obvious fright, or anger.

Medical attention should also be sought if palpitations are accompanied by chest paindizziness, shortness of breath, or an overall feeling of weakness. Most people have experienced a skipped or missed heartbeat, which is really an early beat and not a skipped beat at all.

After a premature heartbeat, the heart rests for an instant then beats with extra force, making the person feel as if the heart has skipped a beat. This type of palpitation is nothing to worry about unless it occurs frequently. Severe palpitations feel like a thudding or fluttering sensation in the chest.

After chest pain, palpitations are the most common reason that people are referred for cardiology evaluation. Palpitations can be caused by anxietyarrhythmias, caffeine, certain medications, cocaine and other amphetamines, emotional stressovereating, panic, somatization, and vigorous exercise. There may be no other symptoms. But, anxiety, dizziness, shortness of breath, and chest pain may be signs of more severe arrhythmias.

Palpitations are diagnosed through a medical history, a physical examination, an electrocardiogram ECGand screening for psychiatric disorders. It is often difficult to distinguish palpitations from panic disordera common problem in which the person experiences frequent and unexplained "fight-or-flight" responses, which is the body's natural physical reaction to extreme danger or physical exertion, but without the obvious external stimulus. To accurately diagnose palpitations, one of the irregular heartbeats must be "captured" on an EKG, which shows the heart's activity.

Electrodes covered with a type of gel that conducts electrical impulses are placed on the patient's chest, arms, and legs. These electrodes send impulses of the heart's activity to a recorder, which traces them on paper. This electrocardiography test takes about 10 minutes and is performed in a physician's office or hospital.

Because the palpitations are unlikely to occur during a standard EKG, Holter monitoring is often performed. In this procedure, the patient wears a small, portable tape recorder that is attached to a belt or shoulder strap and connected to electrode disks on his or her chest.

The Holter monitor records the heart's rhythm during normal activities. Some medical centers are now using event recorders that the patient can carry for weeks or months. When the palpitations occur, the patient presses a button on the device, which captures the information about the palpitations for physician evaluation. Later the recording can be transmitted over the telephone line for analysis.This material must not be used for commercial purposes, or in any hospital or medical facility.

Failure to comply may result in legal action. Medically reviewed by Drugs. Last updated on Nov 16, Palpitations are fast, forceful heartbeats in an irregular rhythm. You may feel like your heart is racing, jumping, throbbing, or fluttering. You may feel extra beats, no beats for a short time, or skipped beats. You have the right to help plan your care.

Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. Some palpitations may be caused by serious heart rhythm problems. If these problems are left untreated, it can increase your chance of heart failure, heart attack, or stroke. Rarely, palpitations are caused by life-threatening health problems. Informed consent means you understand what will be done and can make decisions about what you want.

You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered. Sticky pads placed on your skin record your heart's electrical activity.

A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe.

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The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read. You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils.The physical examination of the patient begins with inspection. Unique to the sequence of the abdomen, the abdomen is then auscultated, percussed and finally, palpated.

In addition, if the patient is complaining of pain, leaving the palpation until last allows the examiner to gather other data before potentially causing the patient more discomfort.

When completing the physical examination, it is helpful to divide the abdomen into regions in order to consider which organs are involved. A four-quadrant system — left upper quadrant, left lower quadrant, right upper quadrant and right lower quadrant provides a more general overview, and is acceptable in situations when there is no abdominal complaint.

palpation definition in nursing

The nine-region system provides more specific information if the patient is complaining of discomfort or problems in a certain area. Palpation of the abdomen should include both light and deep palpation methods to detect tenderness and changes to underlying structures. If the patient is complaining of abdominal pain, assess that area last.

Begin with light palpation, pressing only. This is used to determine the characteristics of the skin and subcutaneous tissue, and to note temperature, tenderness, and large masses. Using a circular motion with your fingers, proceed slowly and methodically. Palpate the femoral pulse and the inguinal lymph nodes. Once the light palpation is complete, begin the deep palpation part of the examination. Deep palpation is used to identify normal structures and masses, and assess for tenderness.

palpation definition in nursing

During deep palpation, you will press 1. In the patient with obesity, you may not be able to feel the abdominal organs. In patients who are thin, you may be able to feel the muscular structures of the abdomen, such as the rectus muscle, the bowel and the aortic pulsations. The liver may be palpated by feeling deeply beneath the costal margin while the patient takes a deep breath.

During inspiration, the liver descends and you may be able to feel the edges against your hand. A healthy liver is firm and rubbery. It typically feels firm and smooth. Please note that the left kidney is usually not able to be palpated due to its position behind the bowel. Unless they are enlarged, all of the other structures of the abdomen, including the gall bladder and the spleen, are typically not palpable.

If a mass is discovered on palpation, its size, shape, location, consistency soft, solidsurface smooth, irregulartenderness, pulsatility, and mobility should be documented.

If the mass is small, this can be ascertained through palpation between your thumb and index finger; if it is larger, then a bi-manual evaluation should occur. A mobile mass should bounce upward and strike your fingers when you press quickly and deeply into the region.

Aging, cigarette smoking and hypertension are contributing factors. Trauma, syphilis, congenital connective tissue disorders such as Marfans syndrome, and positive history of aneurysm also increases the incidence. Characteristics include a prominent lateral pulsation.

palpation definition in nursing

This completes our series on Abdominal Assessment. Subscribe to our monthly newsletter.Palpation is the process of using one's hand or fingers to identify a disease or injury of the body or the location of pain. It is used by medical practitioners to determine the size, shape, firmness, or location of an abnormality suggestive of disease.

Palpation is commonly used for abdominal or thoracic chest exams but can be applied to any part of the body, including the mouth, vagina, and anus. By its strictest definition, taking a person's pulse may be considered a form of palpation.

The sense of touch is just as important as the sense of sight in a physical examination. As part of their training, medical practitioners learn how to recognize problems on or below the surface of the skin by touch alone.

They do so by applying general pressure with the hand or fingers to detect subtle changes that might otherwise go unnoticed by a layperson. The techniques used for palpation can vary by the body part being examined, as well as the aims of the exam i. The below are just a few of the examples. Thoracic palpation is typically used to diagnose problems of the chest or spine.

It involves the touching of superficial and deep tissues to assess the position of the vertebra, the presence of edema swelling or lymphadenopathy swollen lymph nodesor any protrusion in the ribs, sternum, or spinal column. The palpation may be performed in a seated position or when lying in a supine face-up or prone face-down position.

Palpation is also helpful in evaluating the function of the heart. The location, size, and force of the cardiac impulse on the chest wall can help determine whether the heart is working normally, and abnormal vibrations can indicate the presence of a cardiac murmur.

Deep palpation of the abdomen is performed by placing the flat of the hand on the abdominal wall and applying firm, steady pressure. Palpation may even help diagnose an abdominal aortic aneurysm.

This is done by placing both hands on the abdomen with index fingers on each side of the aorta located just above and to the right of the navel. If an abdominal aortic aneurysm is present, the fingers would separate with each heartbeat. With abdominal palpation, medical practitioners check not only for tenderness or masses, but other important characteristics that can be felt with the fingers.

Some of these include:.Palpation is an important part of the physical examination ; the sense of touch is just as important in this examination as the sense of sight is. Physicians develop great skill in palpating problems below the surface of the body, becoming able to detect things that untrained persons would not.

palpitations

Mastery of anatomy and much practice are required to achieve a high level of skill. The concept of being able to detect or notice subtle tactile signs and to recognize their significance or implications is called appreciating them just as in general vocabulary one can speak of appreciating the importance of something.

Nonetheless, some things are not palpablewhich is why additional medical testssuch as medical imaging and laboratory tests, are often needed to make a diagnosis. However, many other problems are palpable.

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Examples include pulsesabdominal distensioncardiac thrillsfremitusand various herniasjoint dislocationsbone fracturesand tumorsamong others. Palpation is used by physiciansas well as chiropractorsnursesmassage therapistsphysical therapistsosteopaths and occupational therapiststo assess the texture of a patient's tissue such as swelling or muscle toneto locate the spatial coordinates of particular anatomical landmarks e.

In summary, palpation might be used either to determine painful areas and to qualify pain felt by patients, or to locate three-dimensional coordinates of anatomical landmarks to quantify some aspects of the palpated subject. Palpation is typically used for thoracic and abdominal examinations, but can also be used to diagnose edema.

Palpation is also a simple method of examining the pulse. It is used by veterinarians to check animals for pregnancyand by midwives to determine the position of a fetus. Quantitative palpation of anatomical landmarks for measurements must occur according to strict protocols if one wishes to achieve reproducible measurements. Palpation protocols are usually based on well-described definitions for the location of anatomical, usually skeletal, landmarks.

Locating anatomical landmarks can be performed using two palpation protocols: 1 manual palpation that allows the spatial location of landmarks using hands combined or not with three-dimensional 3D digitizing, and 2 virtual palpation on 3D computer models obtained, for example, from medical imaging.

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Manual palpation of skeletal landmarks combined with 3D digitizing see text below for explanations. Manual palpation of skeletal landmarks illustrated here on a patient's shoulder, see left image.

Reflective markers are part of the scientific protocol and allow further quantified motion analysis for joint disorders follow-up. Virtual palpation of skeletal landmarks located on a 3D bone model illustrated here on a patient's knee model obtained from medical imaging, see right image. Colored spheres on bones indicate palpated skeletal landmarks. This method combined with quantified manual palpation allows subject-specific visualization of joint behavior during particular motion tasks e.

The above protocols can be used independently. Manual palpation is used in clinical activities for various aims: - identification of painful areas; - positioning of particular pieces of equipment electromyography electrodes, auscultation, external landmarks used in clinical motion analysis or body surface scanning ; or - measurements of morphological parameters e.

Virtual palpation alone is useful to quantify individual morphological parameters from medical imaging : - limb length; - limb orientation; - joint angle; or - distance between various skeletal locations.

Combining data from both manual and virtual palpation protocols allows achieving supplementary analysis: - registration protocols aiming at building reference frames for motion representation according reproducible clinical conventions; - to modelize joint kinematics accurately during musculoskeletal analysis; - to align precisely orthopedic tools according to the individual anatomy of a patient; or - to wrap and to scale surface textures to motion data when creating animation characters.

Use of standardized definitions for the above activities allows better result comparison and exchange; [2] this is a key element for patient follow-up or the elaboration of quality clinical and research databases. Such definitions also allow acceptable repeat ability by individuals with different backgrounds physiotherapists, medical doctors, nurses, engineers, etc. If applied strictly, these definitions allow better data exchange and result comparison thanks to standardization of the procedure.

Without anatomical landmark standardization, palpation is prone to error and poorly reproducible. Nowadays, the medical imaging modality of elastography can also be used to determine the stiffness of tissues.

Manual palpation suffers from several important limitations: it is limited to tissues accessible to the physician's hand, it is distorted by any intervening tissue, and it is qualitative but not quantitative. Elastography is able to overcome many these challenges and improve on the benefits of palpation.

Abdominal Assessment: Palpation

Elastography is a relatively new technology and entered the clinic primarily in the last decade. The most prominent techniques use ultrasound or magnetic resonance imaging MRI to make both the stiffness map and an anatomical image for comparison.Accessed 1 Feb.

Comments on palpation What made you want to look up palpation? Please tell us where you read or heard it including the quote, if possible. Subscribe to America's largest dictionary and get thousands more definitions and advanced search—ad free! Nothing dull about a good stroll, right? We're intent on clearing it up 'Nip it in the butt' or 'Nip it in the bud'?

We're gonna stop you right there Literally How to use a word that literally drives some pe Is Singular 'They' a Better Choice? Do you know these earlier meanings of words? Can you spell these 10 commonly misspelled words?

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Login or Register. Save Word. Learn More about palpation. Dictionary Entries near palpation palmoplantar palpable palpate palpation palpatory palpebra palpebrae See More Nearby Entries. Get Word of the Day daily email! Test Your Vocabulary. Spell words. Make bears. Love words? Need even more definitions? The awkward case of 'his or her'. Take the quiz Spell It Can you spell these 10 commonly misspelled words?It includes chest palpation described herechest percussion and chest auscultation described in parts two and three.

Chest examination should complement other investigations. The trachea should be checked to see if it is in the normal central position.

This means the distance between the trachea and the sternomastoid muscles should be equal on both sides. Tracheal deviation is indicative of mediastinal displacement to one side, which can be due to:.

Position of the apex beat can confirm or exclude mediastinal displacement Ford et al, This is not a reliable sign if there is cardiomegaly Epstein et al, Measuring the cricosternal distance can help determine if the patient is hyperventilating. Chest expansion must be assessed to determine the depth and quality of movement on each side of the chest.

Both sides should be assessed for symmetry. Unilateral decreased chest expansion, which is easier to detect, indicates pathology on that side, for example pneumothorax, pleural effusion, pneumonia and collapsed lung. Bilateral decreased chest expansion, which is more difficult to detect, is often seen in asthma and COPD.

palpation definition in nursing

The symmetry and degree of chest expansion can be more accurately evaluated by observing chest movement than by palpating the chest wall Ford et al, Tactile vocal fremitus refers to the vibrations that can be felt on the chest wall when the patient speaks.

Sound and subsequent vibrations is normally transmitted well in solid structures but poorly in air. Being able to appreciate the differences between normal and abnormal vibrations requires patience, although comparing one side to the other is often helpful. In normal lungs, the vibrations felt on the two sides of the chest should be similar except over the heart.

The mechanism and alterations of vibrations in disease are the same as for vocal resonance part three of chest examination Epstein et al, When the two sides of the chest are compared, increased vibrations can be detected in cases of lung consolidation and decreased vibrations in the presence of pneumothorax or fluid Adam and Osborne, Gentle chest-wall palpation is indicated if the patient has chest pain.


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