Edited by
Carol Lynn Cox
PhD, MSc, MA (Theology), MA (Education), PG Dip Education, BSc (Hons), RN, ENB 254, FHEA
Professor Emeritus, School of Health Sciences, City, University of London, London, UK and Clinical Manager and Director of Nursing, Health and Hope Clinics, Pensacola, FL, USA
Adapted from Lecture Notes on Clinical Skills (Third Edition) by:
The late Robert Turner MD, FRCP
Professor of Medicine and Honorary Consultant Physician
Nuffield Department of Clinical Medicine
Radcliffe Infirmary, Oxford, UK
Roger Blackwood MA, FRCP
Consultant Physician, Wexham Park Hospital, Slough, and Honorary Consultant Physician at Hammersmith Hospital, London, UK
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Library of Congress Cataloging‐in‐Publication Data
Names: Cox, Carol Lynn, editor. | Adaptation of (expression): Turner, Robert, 1938–1999. Lecture notes on clinical skills. 3rd edition.
Title: Pocket guide to physical assessment / edited by Carol Lynn Cox.
Description: Hoboken, NJ : Wiley‐Blackwell, 2019. | Adapted from Lecture notes on clinical skills / Robert Turner, Roger Blackwood. 3rd ed. 1997. | Includes bibliographical references and index. |
Identifiers: LCCN 2019003275 (print) | LCCN 2019004179 (ebook) | ISBN 9781119108931 (Adobe PDF) | ISBN 9781119108948 (ePub) | ISBN 9781119108924 (pbk.)
Subjects: | MESH: Physical Examination–methods | Diagnostic Techniques and Procedures | Handbook
Classification: LCC RC78.7.D53 (ebook) | LCC RC78.7.D53 (print) | NLM WB 39 | DDC 616.07/54–dc23
LC record available at https://lccn.loc.gov/2019003275
Cover Design: Wiley
Cover Images: © George Doyle/Getty Images, © Seth Joel/Getty Images, © Jeffrey Coolidge/Getty Images, © kokouu/Getty Images
Graham M. Boswell, DEd, MA Ed, BA (Hons), BSc (Hons) RGN, FHEA
Senior Lecturer, Department of Adult Nursing and Paramedic Science, Faculty of Education and Health, University of Greenwich, London, UK
Carol Lynn Cox, PhD, MSc, MA (Theology), MA (Education), PG Dip Education, BSc (Hons), RN, ENB 254, FHEA
Professor Emeritus, School of Health Sciences, City, University of London, London, UK and Clinical Manager and Director of Nursing, Health and Hope Clinics, Pensacola, FL, USA
Helen Gibbons MSc, PG Cert (Medical Education), ENB (Ophthalmic Practice), BA (Hons), RN
Clinical Nursing Lead (Education and Research), Moorfields Eye Hospital NHS Foundation Trust and Course Director, University College London, London, UK
Victoria Lack, MSN, PG Dip (Academic Practice), BN (Hons), Family Nurse Practitioner, Non‐Medical Prescriber, DN (Cert), RN
Lecturer in Primary Care, Department of Health Sciences, University of York, York, UK, and Advanced Nurse Practitioner, Beech House Surgery, Knaresborough, North Yorkshire, UK
Anthony McGrath, PhD, MSc, PGCE, BA (Hons) RMN, RGN, FHEA
Principal Lecturer, Head of Adult Nursing and Midwifery, London South Bank University, London, UK
Nicola L. Whiteing, PhD, MSc, PG Dip HE, BSc (Hons), RN, RNT, ANP
Lecturer in Nursing, Southern Cross University, New South Wales, Australia
Underpinning the appropriate delivery of healthcare is the Physical Assessment. This structured physical examination allows the healthcare professional to obtain a comprehensive assessment of the patient and is critically important in that it leads to clinical decisions that are crucial for the patients' care.
This Pocket Book, Pocket Guide to Physical Assessment, provides a clear and easy‐to‐use reference guide for achieving the Physical Assessment. It is specifically intended for those embarking on a career in healthcare and contains the techniques used by specialist/advanced practitioners.
In this Pocket Guide, the need for a thorough approach to the Physical Assessment is excellently presented by Professor Cox. Professor Cox shows how important it is to develop a rapport with the patient in order to carefully assess their perceptions and how this relationship must be established from the very first meeting when information is exchanged between the healthcare professional and the patient. Fundamental to gaining this perspective is to listen. The importance of guiding the healthcare practitioner to engage in active listening cannot be underestimated and this is reflected in the fact that not being heard is an issue that is often raised as a point of criticism of healthcare professionals by patients and their families.
Careful observation and reports of subjective symptoms are the window through which healthcare professionals gain knowledge of their patients. Following the opening chapters, this Pocket Guide is structured to enable the healthcare professional to learn how to systematically gather information before moving on to an initial diagnosis and further investigations. The tools of inspection, palpation, percussion, and auscultation are key to this assessment and are excellently laid out in the chapters covering the examination of the different organs of the body.
It is key for healthcare professionals to be able to communicate the outcomes of their Physical Assessment to their professional colleagues. Professor Cox demonstrates her experience and understanding of the world of healthcare when she talks about the importance of this communication between professionals and how the Physical Assessment can bring together the disparate professional views that will underpin the diagnostic process.
In this Pocket Guide to Physical Assessment, Professor Cox has created an invaluable guide that will not only support practitioners as they begin a clinical career in healthcare but will also function as an ongoing reference book to support their careers.
Professor Stanton Newman, Pro Vice Chancellor Research, City University London, England, UK
Over the past decade many changes have occurred in relation to medical practice. What has not changed, and should not change, is the view healthcare professionals have in relation to the patient. This view sees the patient as an individual with physical as well as emotional, psychological, intellectual, social, cultural, and spiritual needs. A comprehensive assessment of the patient is the foundation upon which healthcare decisions are made. The best way to develop assessment skills is to learn them systematically. The systematic approach involves taking a full health history, physical examination, and reviewing diagnostic texts/laboratory data. Use of a systematic approach is essential in clinical decision making, which leads to the formulation of a differential diagnosis and final diagnosis.
This Pocket Guide for healthcare professionals is based on Robert Turner’s and Roger Blackwood’s Lecture Notes on Clincal Skills that was written for medical students and Carol Cox’s Physical Assessment for Nurses. It is intended to be used as a guide when examining patients in the clinical setting. The Guide includes simple instructions on examination approaches and details of diseases that are relevant to abnormal findings.
Turner and Blackwood's Lecture Notes on Clinical Skills has been used in the Oxford Clinical Medical School for over 35 years and is viewed as an essential guide in medicine. Although some doctors may use slightly different techniques in taking a history and physical examination, it is recommended that healthcare practitioners embarking on a career in healthcare use the techniques recommended in this Pocket Guide because they provide a sound approach for developing and employing clinical decision making.
Carol Lynn Cox
Special thanks are extended to Robert Turner and Roger Blackwood for granting permission for their text, Lecture Notes on Clinical Skills, to be used as a reference for this Pocket Guide. In addition, I am grateful to my students and healthcare practitioners that I have worked with over the years for encouraging me to create this Pocket Guide so that they could have an accessible tool for reference purposes in the clinical setting. This Guide has benefited from their suggestions as well as from medical colleagues with whom I currently practice. I am also grateful to Yogalakshmi Mohanakrishnan, Mitch Fitton, Copy Editor, Tom Marriott, Editorial Assistant, Vincent Rajan, Production Editor and the entire team at Wiley Publishers for their support in completing this Pocket Guide. Any faults or omissions in the text are entirely my own.