Palpation of edema
To better assimilate various methodsstudies are carried out separately, but in practical activities they are often combined. So, when making a survey of a patient, simultaneously observe his behavior, mobility, facial expression, etc., ie, at the same time and examine him.
Feeling, or palpation, usually producein parallel with the examination of the patient. If a rash is found during the examination, a finger is taken along it to check whether it rises above the surface of the skin or not. To distinguish the petechia from roseola, the rash is pressed with a finger, as already mentioned, the petechia does not disappear under pressure, and the roseola disappears.
To detect subcutaneous swelling on the skinpress a finger - if there is an edema on it remains a hole. In determining the degree of obesity, except for inspection, use and palpation. To do this, the thickness of the skin fold, captured by two fingers, is determined in different places of the body, since the thickness of subcutaneous fat varies from place to place. With normal fatness, the thickness of the skin fold on the abdomen in the hypochondrium region is approximately 2 cm.
Palpation determines the elasticity (Turgor) of the skin. At the young healthy person the skin is elastic and, being seized in a fold, quickly straightens. In the elderly, as well as in persons suffering from serious diseases (cancer, tuberculosis), the skin loses its elasticity, becomes flabby and, when assembled into a fold, it does not work out for a long time.
Feeling is also determined by humidity ordry skin. In old people and exhausted patients, the skin is often flabby and dry. In people with kidney disease, sweating is reduced, the skin swollen, pale and dry.
Feel also bones, joints, muscles,The lymph nodes. Bones and joints can be thickened, uneven and painful, mobility in the joints - limited or completely absent. Muscles can be hypertrophied, atrophied, painful, flabby or, conversely, strained. Lymph nodes in a healthy person are not probed, in pathological cases they can reach huge sizes (for example, with sarcoma of lymph nodes). Most often the neck nodes (behind the sternocleidomus muscle) are probed, submandibular, axillary and inguinal. Nodes increase most often from penetration into them of infection (with tuberculosis, purulent infection, etc.). Increased lymph nodes are observed in certain diseases of the hematopoietic organs (leukemia) and malignant
When palpating lymph nodes, attention should be paid to their size, density, tenderness and mobility. In addition, the body feels all the noticeable thickening, swelling, scars.
It is extremely important to establish the density of the tumor,her mobility, unevenness and soreness. Often the nature of scars is important - whether they are only on the skin or are fused with deeper tissues, for example, with bones.
When examining the organs of respiration and circulation, palpation of the chest, cardiac shock, blood vessels (pulse) is performed.
Especially good is the nurse should master the technique of feeling the arterial blood vessels (pulse), since the work of the heart sisters should be judged mainly by the nature and quality of the pulse.
The palpation method has the greatest value atstudy of the organs of the abdomen. About palpation of the chest, blood vessels (palpation) and abdominal organs will be told in the relevant chapters of the textbook.