Role the Nurse in

Physical
Examination

1. Nurse plays an important role in the

program of prevention of disease not only by
encouraging the individual to have such as
examination but also by her tact and a kill in
assisting in such a way as to minimize
embarrassment to the patient.
2. Explanation as to what is to be done and
why usually facilitate the procedure both for
the doctor and the patient and will make the
patient more relaxed and more cooperative.

3. Nurse can render invaluable assistance in

expanding the examiners work and in

conserving the patients strength. Most
thorough examination is lengthy and tiring.
4. When patient is a woman, the presence of
nurse prevents embarrassment to the patient
and it protects the physician from any court
action in case patient complains.
5. Nurse is held responsible in having all
equipment and articles ready for the
examination, preparing the patient
accordingly, anticipating the physicians
needs and taking care of the used articles
after the examination.

Horizontal
Recumbent

Purpose:
General examination.
Abdominal surgery.
Surgery on head and extremities.

1. Place patient flat on back with legs extended or

slightly flexed.
2. Place bath blanket over patient lengthwise. Fan
bedding to foot of bed

Dorsal Recumbent
Purpose:
Rectal, vaginal and pelvic examinations and

treatments.
Deliveries.
1. Place patient flat on back with one pillow under
head; have knees flexed and separated and feet
flat on bed.
2. Fold blanket in half lengthwise. Lay center of
blanket over abdomen and ends over each foot.
Fan leading to foot on bed. Arrange blanket to
cover extremities and expose perineum.

Sims or Left Lateral

1. Place patient on left side somewhat obliquely
across the bed with buttocks to edge of
mattress. Incline the body forward, draw the
left arm back under patient and place the
right arm free in front. The thighs should be
flexed upon the bodythe right more than the
left.
2. Place lengthwise bath blanket over patient,
fanfold topsheet to foot of bed. Fold blanket
back exposing the area to be examined.

Knee-Chest or GenuPectoral
Purpose:
To obtain better exposure of the vagina,

cervix, and rectum.

To examine the bladder.
To help correct retroversion of the uterus.
To administer caudal and sacral anesthesia.
Vaginal and rectal examinations.
Operative procedures on the vagina, rectum
and perineum. Operative deliveries

Place patient in the prone position, then assist

her to kneel so that her weight rests on her

chest and knees. Turn head to one side and
flex her arms at the elbows extending, then to
the bed in front of her. Be sure the thighs are
perpendicular to the level of the head. Watch
pulse and general condition of the patient.

Dorsal Lithotomy or
Dorso-sacral:

Purpose:
Vaginal and rectal examination.
Operative procedures on the vagina, rectum
and perineum.
Deliveries and operative deliveries

On Examining Tables: Place patient on

dorsal position with the knees flexed and feet

in still-ups. Buttocks are brought down to edge
of examining table.
In bed:
Place the patient on her back across bed with
the buttocks slightly beyond the edge of the
mattress, then flex knees over the abdomen
and separate the knees. Support the knees by
means of long sheet folded diagonally and
passed under the knees and around the neck.
Draw up gown over abdomen. Drape as for
dorsal recumbent.

Standing or Erect
Purpose:
1. Vaginal examination for determining the

degree of prolapse of the uterus.

2. Examination of hernia

When used for vaginal examination:

Have the patient standing with the knees separated

about ten inches with one foot on a low stool.

Instruct her to place one hand on the buck of the
chair for support and the other hand on her hip.
Either remove skirts or fold about waist. Wrap a
folded sheet about the lower part of the body
stimulating skirt, with the sides overlapping in
front. Pin it to hold in place.
When use for examination of spine and
backs:
Remove patients slippers and have patient stand
on towel.
Loosen gown, place bath blanket around shoulders
with opening at the back. Pin at nape.

Prone
Purpose:

For treatment on the back.

To facilities drainage from wound.
To secure drainage of pus to front of abdomen.
To keep pus away from the spine.
1. Let patient lie on his abdomen. Turn hand to one
side. Allow pillow under the head and another
under the lower chest.
2. Draping same as in dorsal.

Jack knife or Kroaske or

Bozeman

Place patient on a prone position with the hips

directly over the band of the examining table.
Tip the table with the head lower than the
hips. Lower the foot part of the table so that
the patients feet are below the level of his
head. Place pillow under the pelvis and
abdomen to relieve the strain.
Drainage
Purpose: Operation on the rectum and
coccyx

Walchers Position
Purpose:
To increase the diagonal conjugate of the pelvis in

high forcep delivery and in breach presentation.

Relax the perineum
1. Place patient flat on her back with the sacrum
resting on the edge of the table. Lower the legs
slowly toward the floor. Elevate the buttocks
slightly if the table permits.
2. Draping is similar to that of the lithotomy
position.

Fowlers and SemiFowlers

Position

Purpose:
To obtain good drainage in the pelvis.
To localize infection in the pelvis and prevent
its spread to the peritoneum.
To prevent strain of abdominal muscles.
To facilitate breathing in patients with cardiac
or respiratory embarrassment fur postoperative nasal cases and/or thyroidectomy
cases.

Method I: Elevate head part of the bed by

means of head elevator 8-24 inches high.

Elevate knee to about 6 in.
Method II: Place patient in semi-sitting
position by backrest. Flex knees and support
with pillows

Trendelenburg
Position
Purpose:
Gynecological surgery and suprapubic

prostatectomy cases.
To prevent shocks.
To prevent or relieve post-partum
hemorrhage.

Place patient in the horizontal recumbent

position. Well-padded shoulder braces and

knees and arms restraints are adjusted. If on
the operating table. Adjust the table so that
the patients head is low the body on an
inclined phone and the knees flexed over the
adjustable lower section of the table, which is
lowered.
If no bed, rise the foot part of the bed by
means of bed elevator blocks also known as
shock blocks.