Definition of Auscultation – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.
Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Definition of Auscultation
Auscultation involves listening for various lung, heart, and bowel sounds with a stethoscope.
Or,
Auscultation is the process of listening to sounds produced within the body. Auscultation may be direct or indirect.
Or,
Auscultation is the act of active listening to body organs to gather information on a patient’s clinical status. Auscultation includes listening to sounds that are voluntarily and involuntarily produced by the body.
Types of Auscultation:
A. Direct auscultation: It is done by the use of the unaided ear,
- Example: To listen to a respiration wheeze or the grating of a moving joint.
B. Indirect auscultation: It is done by the use of stethoscope which amplifies the sounds and conveys them to the nurse’s ear. A stethoscope is used primarily to listen to sounds from within the body.
- Example: Heart, lungs and bowel sounds
Technique of Auscultation:
1. Provide a quiet environment.
2. Make sure the area to be auscultated is exposed (a gown or bed linens can interfere with sounds.)
3. Warm the stethoscope head in your hand.
4. Close your eyes to help focus your attention.
5. Use the diaphragm to pick up high-pitched sounds, such as first (S1) and second (S2) heart sounds. Hold the diaphragm firmly against the patient’s skin, using enough pressure to leave a slight ring on the skin afterward.
6. Use the bell to pick up low-pitched sounds, such as third (S3) and fourth (S4) heart sounds. Hold the bell lightly against the patient’s skin, just hard enough to form a seal.
7. Holding the bell too firmly causes the skin to act as a diaphragm, obliterating low-pitched sounds.
8. Listen to and try to identify the characteristics of one sound at a time.
Preparing the Environment for Physical assessment:
Before beginning a physical assessment, the nurse should make necessary arrangements to properly prepare the examination room, equipment and the patient. Poor preparation may in a haphazard examination that yields incomplete or inaccurate assessment findings, To promote the patient’s comfort and efficient examination, the examination room should have the following features:
- Privacy of the patient.
- Curtains of dividers to enclose the patient’s bed.
- A warm comfortable temperature.
- Proper examination clothing for the patient.
- Adequate lighting.
- Control of outside noises.
- Precautions to prevent interruptions by visitors or other health care personnel.
- A bed or table set at examiner’s waist level.
Articles/Equipment Needed For Performing A Physical Assessment:
The nurse uses a variety of equipment throughout the assessment process. To facilitate the examination the equipment should be readily accessible, in proper working order and warmed. The following is a list of equipment and supplies for general physical examination. There may be a need for specific instruments in special examination.
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