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View Full Version : CS physical exam maneuver question-URGENT



ddliang
10-23-2009, 09:18 PM
hi all,

i have my cs exam scheduled for monday. as for the physical exam, i need step by step help for the following maneuvers:

to listen to the lungs/heart on a woman - - what is the best way to 'undrape'? should i untie the back and expose her entire chest while i'm listening/auscultating?

to examine the abdomen, should i have her lie down and then drape her pelvis legs, and then pull up her gown to above her abdomen?

please respond.............

ddliang
10-24-2009, 06:49 PM
come on 26 views and no answer? please somebody answer?!?!?

michiganman
10-29-2009, 05:25 PM
I am curious as well, can anyone help?

Jay_and_the_G
11-07-2009, 11:43 AM
Hey guys, I know y'alls test might be done by now, but in case others read this...

The way you have it is fine. Untie the back, undrape her gown to the fields you need to examine and go through in the order you like (ie, heart sounds first, then lungs or vice versa). Just make sure you do all exams you need before helping her get her arms back in the gown to retie the back.

For the abdomen, the technique you describe is fine as well. Have her lay back, drape the lower extremities, adjust the gown to below the bust line so you can see the top half of the abdomen. Depending on her habitus, you can ask the patient to help you examine the lower half by having the patient readjust her shorts.

Passed CS without any problem on phys exam maneuvers, so hopefully this is legit. Best of luck to y'all

mshehorn
01-03-2010, 04:11 PM
So are all of the patients in gowns? A friend of mine said that on several of his SPs they were fully clothed or sitting in a chair like they just walked in. Are you every supposed to undress the patient?

Also to examine the chest is it necessary to remove the gown? I plan on sliding the stethoscope under the gown. Does anyone else have some advise as how to go about the encounter? This brings new dread as I will be taking the test in about 4 days.

Stlunachik
03-27-2010, 12:09 PM
Also on this, I examined my patients heart sounds with her lying down just cause i was gonna do the abdominal exam as well.. Is that wrong???

Dr. X
03-28-2010, 11:20 AM
So are all of the patients in gowns? A friend of mine said that on several of his SPs they were fully clothed or sitting in a chair like they just walked in. Are you every supposed to undress the patient?

Also to examine the chest is it necessary to remove the gown? I plan on sliding the stethoscope under the gown. Does anyone else have some advise as how to go about the encounter? This brings new dread as I will be taking the test in about 4 days.most of the pts will be in gowns.. they usually require the physical exam. my exam.. all had gowns (and required physical exam except phone case of course). There may be few cases where they will be fully clothed and in those instances.. physical exam is not required.. jus very thorough history.. eg. insurance claim paperwork case. rare but possible. The doorway information will clearly state whether physical examination should be done or not.. in either way so read properly in each case incl. name, cc, and vitals, whats expected.

never examine through gown. simple as that. even for chest.. ask permission and bring the gown down to waist (while they're sitting). even though the op's exam is done this may help others.

Dr. X
03-28-2010, 11:25 AM
Also on this, I examined my patients heart sounds with her lying down just cause i was gonna do the abdominal exam as well.. Is that wrong???

the proper cardiac exam includes auscultating the pt. sitting down and laying down. however, examining only when sitting down suffice. i doubt that listening to heart when laying down wont count as credit, it shouldnt be a problem. it is however.. up to the sp and we may never know.

i am curious as to how you did the draping.. for cardiac.. you bring the gown down and for abdominal.. you bring it up.

Stlunachik
03-28-2010, 03:00 PM
thanks for ur reply.. yes i brought the gown down for cardiac n covered back n then brought it up for abdominal....

Stlunachik
04-21-2010, 10:15 PM
Oh yes so i got my score today and I passed... I just thank Almighty God cause I was not so sure.....THANK GOD!!! PHEW....

Dr. X
04-25-2010, 09:28 AM
congrats!!

Splendid
07-03-2010, 09:40 PM
Don't be scared to untie the gown if You need to do resp/cardiac PE:ask for permission,untie,then tell that you gonna expose chest , Abdominal-cover legs with a sheet,upper level-pubic symph (upper part),then ask the Pt if you can expose abdominal area by lifting the gown (xyphoid process.)keep the sheet on patient legs if you need to examine legs (edema,varic.veins,pulses,sensations,muscle strength,rash,etc.)expose one extremity at the time unless you need to compare both of 'em.







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