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Discussion

Assessment

I just finished my first semester of nursing school. We learned a lot about assessments and I don't think I truly ever understood what I was supposed to be doing. I get confused on percussion and auscultation and what I'm supposed to be hearing where. Does anyone have any advise to figure this stuff out?

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What you are asking is pretty broad. Auscultation is listening/hearing with a stethoscope . Percussion is tapping with your fingers to hear a sound.

On the chest it's lung sounds on the abdomen it's bowel sounds....what are you looking for...what do you need?

Didn't they give you a lab book on physical assessment? You need a resource on this.

Here's the link to a bunch of them at Amazon. Jarvis is well-regarded. http://www.amazon.com/s/ref=nb_sb_ss_c_0_16?url=search-alias%3Dstripbooks&field-keywords=physical+assessment&sprefix=physical+assessm%2Caps%2C212

Percussion: Think about the percussion section in the orchestra. Think about the hollow sound you get when you thump on a ripe watermelon-- that's the sort of hollow sound you'll hear when you thump on a belly full of gas or a chest full of air. Think about the dull sound you'd get if you thump on something solid, like, oh, a roast of beef. That's the sound you'd get thumping on a lung that was solidly full of inflammation and secretions.

Auscultation: Means "listening." (Doesn't anybody ever take Latin any more? aus, ear; auscultare, to listen). Another word describing a way to hear what's going on inside a body. You can say "Listen to breath sounds" or you can say "Auscultate breath sounds," same thing.

I have to be honest- I think that knowing what you are listening to/for is the most difficult concepts in the assessment. In fundamentals, my friends and I practiced on that dang mannequin all the live long day. Then when I finally heard wheezes, crackles, and other sounds I realized they sound NOTHING like the mannequin. Practice makes perfect- once you start listening to normal lung sounds, the first time you hear an abnormality you will notice it! Then get your RN or instructor to determine what the sound is. I at first used to mistake sounds, but now in my final semester of RN school thought I finally had it down- but I ended up assessing a patient's lung sounds differently than my RN. I went back and listened again and finally heard it, but it was faint. You just have to keep trying- eventually you will get better at it. I still have trouble identifying the S3 sounds in children- if anyone has any tips, please let us know!

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