Once you understand the patient's concerns and have elicited a careful history, you are ready to begin the physical examination. At first you may feel unsure of how the patient will relate to you. With practice, your skills in physical examination will grow, and you will gain confidence. Through study and repetition the examination will flow more smoothly, and you will soon shift your attention from technique and how to handle instruments to what you hear, see, and feel. Touching the patient's body will seem more natural, and you will learn to minimize any discomfort to the patient. You will become more responsive to the patient's reactions and provide reassurance when needed. Before long, as you gain proficiency, what once took between 1 and 2 hours will take considerably less time.
This chapter addresses skills and techniques needed for initial assessment as you begin the physical examination. Under "Anatomy and Physiology" you will find information on how to measure height, weight, and Body Mass Index (BMI), and guidelines for nutritional assessment. There is clinical information on the relevant health history, health promotion and counseling ("The General Survey"), and a preview of how to record the patient's overall appearance ("The Vital Signs"). The section on "Techniques of Examination" describes the initial steps of the physical examination: preparing for the examination, conducting the general survey, and taking the vital signs.
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