Published Mar 26, 2011
noyesno, MSN, APRN, NP
834 Posts
I could not hear my patient's apical pulse through her breast tissue and my preceptor told me you had to lift the breast to be able to hear it. Okay, that makes sense and all but how do you go about lifting breast?
My patient was sitting in the bedside chair and her breast was sagging pretty low. The only way I could imagine elevating the breast would be through a whole hand grasp, squeeze, and lift but I thought that might make her uncomfortable.
Any other ways to get the breast up and out of the way without making the little old lady feel violated?
noahsmama
827 Posts
If she's capable, you can ask her to lift it herself.
LPNweezy
188 Posts
What you do is you lift the breast using the back of your hand in a lifting motion. Here is a good photo of how to lift a breast to clean underneath during a bed bath. same concept. :)
This way there is no grabbing and groping. lol
MidnightAzalea
58 Posts
I use the back of my wrist (or arm, depending on the size of the breast) to move it out of the way. Seems a little less "personal" than using my hand!
tainted1972, ASN, RN
271 Posts
I have been able to slip the stethoscope under the breast without having to lift it.
Or Simply say " I need to listen under your breast" some people will move it for you.
If I have to do it, I use my left hand, flattened, slide it under the breast and then lift it up. No big deal at all, pretty soon you will see breasts, testicles, abdomens and other body parts that may be obstructing something.. as just that; an obstacle, and you will not even think twice about moving it. :)
hiddencatRN, BSN, RN
3,408 Posts
I also state what I am doing: "I am lifting your breast to be able to hear your heart" or "Please lift your breast so I can listen to your heart".
If I'm lifting I do the back of the hand.
mehitabela
79 Posts
Just whatever you do...the nipple is not there for your convenience! Yeah, silly, I know...this thread just called to mind the physician in ICU that, instead of sternal rubs...you guess what he pinched to gauge alertness!!
These ideas are great. Thanks everyone.
For some reason, I kind of froze and couldn't get my brain to problem solve around the boob. I just kind of stared, perplexed (I bet that made her feel real comfortable, booo).
noahsmama, she was kind of out of it. I'll try that with an alert/oriented person though.
Thanks for the picture LPNweezy, very helpful for this visual learner.
MidnightAzalea, I definitely would have needed to use an arm. Great idea.
I also state what I am doing: "I am lifting your breast to be able to hear your heart" or "Please lift your breast so I can listen to your heart".If I'm lifting I do the back of the hand.
Good call on explaining what you're doing. I'm usually really good about this but I froze for some reason.
Back of the hand/arm it is.
Thanks hiddencatRN!
Omg, yikes! Probably pretty effective though.
CathyLew
463 Posts
wait till you come to the situation where you need to lift both sagging breasts to listen to bowel sounds! I should not joke..... I am one of those ones that someday I will be in a nursing home and they will have to ask me to lift my breast so they can feel piedal pulses! Gravity is hell!!!!
:lol2::lol2: OMG I think you made me pee a little!!
In the nursing news section of all nurses there is an article called "Manual Lifting Led to Paraplegia"...would this apply? Roflmao!