Best way to lift a sagging breast for apical pulse

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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?

Specializes in Family Medicine.
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. :)

I think that's what my preceptor did, she slipped it under some how.

I'll go with that or do the flat hand/arm lift next time.

I guess I was so hesitant because she was kind of out of it and I thought she might get the wrong idea. Probably would have because I was considering a grasp, squeeze, and lift. Omg, so glad I didn't do that.

Thanks so much for the tips! :)

Specializes in Family Medicine.
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!!!!

Omg, hope they don't get that low CathyLew! Would definitely put you as a falls risk. :)

I had some really great learning experiences in nursing school but I did not get a whole lot of experience with sagging breasts. Listening to bowel sounds might become a two person job?

Specializes in LTC, Med-Surg.

I have had bladder scanning be a three person job...two to hold stuff out of the way and one to work the Doppler.:eek:

Specializes in OR; Telemetry; PACU.
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 explain what I'm doing whether they are alert and oriented or not. For me it's respectful.

Specializes in Family Medicine.
I explain what I'm doing whether they are alert and oriented or not. For me it's respectful.

Me too! I talk to everyone. :)

noahsmama was suggesting I ask her to assist. My response was to that.

Specializes in Family Medicine.
I have had bladder scanning be a three person job...two to hold stuff out of the way and one to work the Doppler.:eek:

Wow, I feel so naive.

I have a lot to look forward to in nursing, figuring out how to maneuver assessments and personally, with my own breasts.

Putting on a push up bra...

i ask my saggy breasted pts, to stand on their heads.

voila! no need to touch at all.

leslie:D

Omg, yikes! Probably pretty effective though.

Pretty effective until someone responds with a kick to the family jewels.

Specializes in LTC, Med-Surg.
i ask my saggy breasted pts, to stand on their heads.

voila! no need to touch at all.

leslie:D

Holy hanging baskets, batman!! Yes but the flesh might obstruct their breathing...and we all know how important the A in ABC is! :lol2:

Noyesno, you have yet another hurdle to hop. It's the realization that no matter what you shove out of the way, you are going to have to go ask for help because.... wait for it.... you cannot find the member!!

Specializes in ER.

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).

This just tickles me. Your preceptor/coworkers would be proud! Of course, some men have a little seizure whenever they see a bare breast unexpectedly- we know you can't help it.

Specializes in Family Medicine.
Noyesno, you have yet another hurdle to hop. It's the realization that no matter what you shove out of the way, you are going to have to go ask for help because.... wait for it.... you cannot find the member!!

There should definitely be a code for this to keep the man's ego intact.

Code turtle?

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