ASSESSMENT TECHNIQUES:

“IPPA” – Inspection, Palpation, Percussion, Auscultation

1. Inspection
• use of sense of sight
• visual inspection/examination
• WHAT TO INSPECT: color, tone, and texture, as well as scars, lesions, abrasions, and rashes
(skin); movement, motor dexterity, contour and symmetry of the body, and deformities.

2. Palpation
• use of sense of touch
• WHAT TO PALPATE: size, position, and consistency of various body parts, such as lymph
nodes and breast
tissue
NURSING ALERT: Finger pads and the back of the hand are the most sensitive body parts used
for palpation!!!
• Types of palpation:
(a) Light palpation – detects superficial mass ( 1 “ depth )
(b) Deep palpation – palpates organ enlargement like liver, mass and pulsations ( 3 – 4” in
depth)

3. Percussion
• assess for vibration with the use of fingers
• The finger of one hand taps the finger of the other hand to generate vibration which can be
used to determine
a diagnostic sound.

TONE QUALITY PITCH EXAMPLE

Resonance Hollow Low Healthy Lungs

Hyperresonance Booming Very Loud Emphysema
Tympany Drum – like High GI Bubbling, empty
stomach
or large intestine
Dullness Thud – like High Kidney, full bladder,
feces, filled intestine
Flatness Very Dull Soft - moderate Bones and muscles
(very dense tissues),
heart, spleen, liver

Table 5.0 Percussion Sounds and Tones

4.Auscultation
• use of sense of hearing with the use of the unaided ear or a stethoscope
• frequently assessed organs: heart, lungs, abdomen, and blood vessels
HEALTH HISTORY:
• Biographic information
• Chief complaint
• Present health status
• Health history
• Family history
• Psychosocial factors
• Nutrition

History of Present illness includes:

• Statement of general health before illness
• Date of onset
• Characteristics at onset
• Severity of symptoms
• Course since onset
• Associated signs and symptoms
• Aggravating or relieving factors
• Effect on activities
• Treatments tried and results

Past Health History – any diseases and illness experienced in the past which includes childhood
illnesses and
immunization status, any recent surgeries, admission, or recurrent illnesses.

Family Health History – any hereditary condition which makes the client susceptible of
developing a disease.