Physical Examination

Overview

A routine physical examination ensures that you stay in good health. A physical can also be a preventive
step. It allows you to catch up on vaccinations or detect a serious condition, like cancer or diabetes,
before it causes problems. During a routine physical, your doctor can also check vitals, including weight,
heart rate, and blood pressure.

Definition

Physical examination is the process of evaluating objective anatomic findings through the use of
observation, palpation, percussion, and auscultation. The information obtained must be thoughtfully
integrated with the patient's history and pathophysiology. Moreover, it is a unique situation in which
both patient and physician understand that the interaction is intended to be diagnostic and therapeutic.
The physical examination, thoughtfully performed, should yield 20% of the data necessary for patient
diagnosis and management.

OR

A physical examination is an evaluation of the body and its functions using inspection, palpation 
(feeling with the hands),percussion (tapping with the fingers), and auscultation (listening). A co
mplete health assessment also includes gatheringinformation about a person's medical history an
d lifestyle, doing laboratory tests, and screening for disease.

Key points

1. A physical exam is used to check your overall health and to ensure you don’t have any
medical problems that you’re unaware of.
2. Prepare for the appointment by gathering documents relating to your medical history and
information on any medications you’ve taken or currently take.
3. This is your chance to talk about any problems or symptoms you’re experiencing and get
professional advice from your primary care provider (PCP).

A physical examination is a routine test your primary care provider (PCP) performs to check
your overall health. A PCP may be a doctor, a nurse practitioner, or a physician assistant. The
exam is also known as a wellness check. You don’t have to be sick to request an exam.
The physical exam can be a good time to ask your PCP questions about your health or discuss
any changes or problems that you have noticed.

There are different tests that can be performed during your physical examination. Depending on
your age or medical or family history, your PCP may recommend additional testing.

Purposes

A physical examination helps your PCP to determine the general status of your health. The exam
also gives you a chance to talk to them about any ongoing pain or symptoms that you’re
experiencing or any other health concerns that you might have.

A physical examination is recommended at least once a year, especially in people over the age of
50. These exams are used to:

 To check for possible diseases so they can be treated early

 To identify any issues that may become medical concerns in the future
 To update necessary immunizations
 To ensure that you are maintaining a healthy diet and exercise routine
 To build a relationship with your PCP
 To understand the physical and mental well being of the patient.
 To detect disease in its early stage.
 To determine the cause and the extent of disease
 To understand any changes in the condition of disease, any improvement .
 To determine the nature of the treatment or nursing care needed for the client.
 To contribute the medical research.
 To find out whether the person is medically fit or not for a particular task.

Points to remember
Physical assessment or the physical examination is an integral part of nursing assessment. The
physical examination is usually performed after the health history is obtained:

 It should be carried out in a well lighted, warm area

 The patient is asked to undress and draped appropriately so that only the area to be
examined is exposed
 The person’s physical and psychological comfort is considered at all time.
 Procedures and sensations to expect are described to the patient before each part of the
examination.
  The examiner’s hand are washed before and immediately after nursing assessment.
 Fingernails are kept short to avoid injuries to the patient.
 Examiners wear gloves when there is possibility of coming into contact with blood or
other body secretion during the physical examination.

Goals of physical examination

 To collect valid information regarding clients health.
 To identify clients problem.
 To plan nursing actions appropriately.
 To compare clients current health status with ideal state .

Competencies skills needed for physical examination

1. Medical personnel working in hospital must be medically fit .He must have intact
all the senses :
 Hearing
 Viewing
 Touching
 Tasting
 Smelling
2. Thoroughness: Physical examination must be done systematically and thoroughly .
Thoroughness means collect information by examimning all body systems.
3. Knowledge : Examiner must be confident . He should have upto date knowledge as
well as skill in examining client as wellas detecting the problems .
4. Concentration : Do the examination with full concentration .Dedication towards work
is very important .
5. Accurate technique : Make sure that accurate technique is used to collect
information .Follow all the stepos of procedure . It helps in avoiding errors in detecting
problems.
6. Objectivity :Avoid personal judgements , bias , clues while examining the client .
Make inference based upon findings .

TECHIQUES/OR METHOD OF PHYSICAL EXAMINATION :

A physical examination usually includes:

 Inspection (looking at the body)

 Palpation (feeling the body with fingers or hands)

 Auscultation (listening to sounds)
 Percussion (producing sounds, usually by tapping on specific areas of the body)

1. Inspection :
 It is the visual examination of the client .
 During the inspection phase of physical assessment , the nurse uses observational
skills to systematically gather data that can be seen .
 This may include noting the patients respiratory effort , observing skin color or
measuring a wound .
 It involves careful and keen observation of the clients general apperence , body size ,
shape , gait , posture .
 Inspection involves visualize the body area to maximum extent then compare it with
other sides of body .e.g. compare the width of left arm with right arm .
 Sufficient exposure of body area is important .
 Observe color , texture , mobility ,symmetry , nutritional status.
 General appearance
 State of consciousness
 Personal grooming
 Expression : anxious , comfortable , alert
 Body build : thin, fatty, moderate

2. Percussion : The technique of percussion the application of physical force into sound. It
is skill requiring practice that yields much information about disease processes in the chest
and abdomen. The principle is to set the chest wall into vibration but striking with a firm
object.
 By setting underlying tissue in motion, percussion helps in determining the density of
underlying tissue and weather it is air filled, fluid filled and solid.
 Audible sounds and palpable sounds vibration are produced, which can be
distinguished by the examiner. Five steps by percussion is important i.e. quality of
sound, pitch, duration and intensity
 The technique for percussion may be described as follows:
1. Hyperextend the middle finger of your lf hand, pressing the distal portion and
joint formally against the surface to be percussed.
2. Other finger touching the surface will damp the sound.
3. Be consistent in the degree of formness exerted by the hyper extended fingers
as you move from area to area a sound will vary
4. With a quick, sharp, relax wrist, strike the extend lf middle finger with the
flexed right middle finger, using the tip of the finger.
 3. Palpation : It is the use of tactile sensation ( use of touch , fingers , hands )to feel
texture , size , shape , consistency and location of organs . Gentle touch is used to direct
characteristics of skin and superficial tissues . It is attained by pressing 1cm in depth for
assessing skin, pulse , palpation and tenderness.Deep palpation involve use of both hands to
press 4 cm in depth to determine organ size and contour deep palpation is done to examine
deep organs and relieve pain.
,The hands , especially the finger tips are used to assess skin temperature , check
pulses, texture , moisture , masses , tenderness or pain.
4. Auscultation: It is the listening to sound within the body with the aid of a stethoscope,
fetoscope or directly with the ear placed on the body. Auscultation is the skill of listening to
sound produced within the body created by the movement of air and fluid. Example: include
breath sounds, the spoken voice, bowel sound, cardiac murmurs heart sound. Four
characteristics of sound are assessed by auscultation:
o Pitch (ranging from high to low)
o Loudness (ranging from soft to loud)
o Quality (gurgling or swishing)
o Duration (short, medium or long)

How to prepare for a physical examination

Make your appointment with the PCP of your choice. If you have a family PCP, they can provide
you with a physical examination. If you don’t already have a PCP, you can contact your health
insurance for a list of providers in your area.

Proper preparation for your physical examination can help you get the most out of your time with
your PCP. You should gather the following paperwork before your physical examination:

 list of current medications you take, including over-the-counter drugs and any herbal
supplements
 list of any symptoms or pain you are experiencing
 results from any recent or relevant tests
 medical and surgical history
 names and contact information for other doctors you may have seen recently
 if you have an implanted device such as a pacemaker or defibrillator, bring a copy of the
front and back of your device card
 any additional questions you would like answered
 You may want to dress in comfortable clothing and avoid any excess jewelry, makeup, or other
things that would prevent your PCP from fully examining your body.

How is a physical examination performed:

Before meeting with your PCP, a nurse will ask you a series of questions regarding your medical
history, including any allergies, past surgeries, or symptoms you might have. They may also ask
about your lifestyle, including if you exercise, smoke, or drink alcohol.

Your PCP will usually begin the exam by inspecting your body for unusual marks or growths.
You may sit or stand during this part of the exam.

Next, they may have you lie down and will feel your abdomen and other parts of your body.
When doing this, your PCP is inspecting the consistency, location, size, tenderness, and texture
of your individual organs.

Precautions
The patient should be comfortable and treated with respect throughout the examination. As the e
xamination procedes, theexaminer should explain what he or she is doing and share any relevant 
findings.

Description
A complete physical examination usually starts at the head and proceeds all the way to the toes. 
However, the exactprocedure will vary according to the needs of the patient and the preferences 
of the examiner. An average examinationtakes about 30 minutes. The cost of the examination wil
l depend on the charge for the professional's time and any teststhat are done. Most health plans c
over routine physical examinations including some tests.

The examination
First, the examiner will observe the patient's appearance, general health, and behavior, along wit
h measuring height andweight.

 The vital signs—including pulse, breathing rate, body temperature, and blood pressure—are 
recorded.

With the patient sitting up, the following systems are reviewed:

 Skin. The exposed areas of the skin are observed; the size and shape of any lesions are no
ted.
 Head. The hair, scalp, skull, and face are examined.
 Eyes. The external structures are observed. The internal structures can be observed using 
an ophthalmoscope (alighted instrument) in a darkened room.
 Ears. The external structures are inspected. A lighted instrument called an otoscope may 
be used to inspect internalstructures.
 Nose and sinuses. The external nose is examined. The nasal mucosa and internal structur
es can be observed withthe use of a penlight and a nasal speculum.
 Mouth and pharynx. The lips, gums, teeth, roof of the mouth, tongue, and pharynx are i
nspected.
 Neck. The lymph nodes on both sides of the neck and the thyroid gland are palpated (exa
mined by feeling with thefingers).
 Back. The spine and muscles of the back are palpated and checked for tenderness. The up
per back, where the lungsare located, is palpated on the right and left sides and a stethoscope is u
sed to listen for breath sounds.
 Breasts and armpits. A woman's breasts are inspected with the arms relaxed and then rai
sed. In both men andwomen, the lymph nodes in the armpits are felt with the examiner's hands. 
While the patient is still sitting, movementof the joints in the hands, arms, shoulders, neck, and ja
w can be checked.

Then while the patient is lying down on the examining table, the examination i
ncludes:

 Breasts. The breasts are palpated and inspected for lumps.
 Front of chest and lungs. The area is inspected with the fingers, using palpation and per
cussion. A stethoscope isused to listen to the internal breath sounds.
 Heart. A stethoscope is used to listen to the heart's rate and rhythm. The blood vessels in 
the neck are observed andpalpated.
 Abdomen. Light and deep palpation is used on the abdomen to feel the outlines of intern
al organs including the liver,spleen, kidneys, and aorta, a large blood vessel.
 Rectum and anus. With the patient lying on the left side, the outside areas are observed. 
An internal digitalexamination (using a finger), is usually done if the patient is over 40 years old. 
In men, the prostate gland is alsopalpated.
 Reproductive organs. The external sex organs are inspected and the area is examined for 
hernias. In men, thescrotum is palpated. In women, a pelvic examination is done using a speculu
m and a Papamnicolaou test (Pap test)may be taken.
 Legs. With the patient lying flat, the legs are inspected for swelling, and pulses in the kne
e, thigh, and foot area arefound. The groin area is palpated for the presence of lymph nodes. The 
joints and muscles are observed.
 Musculoskeletel system. With the patient standing, the straightness of the spine and the 
alignment of the legs and feetis noted.
 Blood vessels. The presence of any abnormally enlarged veins (varicose), usually in the l
egs, is noted.

In addition to evaluating the patient's alertness and mental ability during the initial conver
sation, additional inspection ofthe nervous system may be indicated:

 Neurologic screen. The patient's ability to take a few steps and do deep knee bends is ob
served. The strength ofthe hand grip is felt. With the patient sitting down, the reflexes in the knee
s and feet can be tested with a smallhammer. The sense of touch in the hands and feet can be eval
uated by testing reaction to pain and vibration.
 Sometimes additional time is spent examining the 12 nerves in the head (cranial) that are 
connected directly to thebrain. They control the sense of smell, strength of muscles in the head, r
eflexes in the eye, facial movements, gagreflex, and muscles in the jaw. General muscle tone and 
coordination, and the reaction of the abdominal area tostimulants like pain, temperature, and touc
h would also be evaluated.

An average physical exam may include the following:

Updated health history

Your doctor may ask for an update on new developments and changes in your health history. This may
include questions about your job and relationships, medications, allergies, supplements, or any recent
surgeries.

Vital sign checks

This includes taking a blood pressure reading and checking your heart rate and respiratory rate.
Your blood pressure should be checked at least once every year to once every three years,
depending on your history.

Visual exam

Your doctor will review your appearance for signs of any potential conditions. They’ll check the
parts of your body that could visually indicate any existing health issues. This includes
examining the following:

 head
 eyes
  chest
 abdomen
 musculoskeletal system, such as your hands and wrists
 nervous system functions, such as speech and walking

Physical exams

As the physical exam continues, the doctor will use tools to look in your eyes, ears, nose, and
throat. They’ll listen to your heart and lungs. This exam also includes:

 touching, or “palpating,” parts of your body (like your abdomen) to feel for abnormalities
 checking skin, hair, and nails
 possibly examining your genitalia and rectum
 testing your motor functions and reflexes

Laboratory tests

To complete the physical, your doctor may draw blood for several laboratory tests. These can
include a complete blood count and a complete metabolic panel (also called a chemistry panel). The
panel tests your blood plasma and can indicate any issues that exist in your kidneys, liver, blood
chemistry, and immune system. This helps detect irregularities in your body that might indicate a
larger problem. Your doctor may request a diabetes screen and a thyroid screen. If you have an
increased risk of heart attack, heart disease, or stroke, they may also request a lipid panel
(cholesterol test).

What screening tests might be performed

Your doctor might request screening tests. These can differ based on your biological sex.

Women:

 Mammogram: In women with low or average risk for breast cancer, a mammogram is

recommended every two years between the ages of 50 and 74. Earlier and more frequent
testing may be recommended based on your personal history and family history of breast
cancer.
 Breast exam: A breast exam can be used to check for abnormal lumps or signs of breast
cancer.
  Pap smear: The pap smear is a screening for cervical cancer. Women should begin
screening at age 21. After that, subsequent screenings are recommended every three years,
as long as the woman has a healthy immune system. After 30 years old, pap smears are
recommended once every five years, until the age of 65. After age 65, the majority of
women no longer require a pap smear.
 Pelvic exam: This can be done with or without a pap smear. A pelvic exam includes
examining the vagina, cervix, and vulva for signs of a sexually transmitted infection (STI)
or other conditions.
 Cholesterol test: Most women should begin regular cholesterol checks at age 45. If you
have a history of or genetic predisposition to diabetes or heart disease, you may need to
begin cholesterol checks as early as age 20.
 Osteoporosis screening: Bone density scans should begin around age 65. They may begin
sooner in certain medical conditions.

Men:

 Cholesterol test: Most men are advised to begin regular cholesterol checks at age 35. If
you have a history of or genetic predisposition to diabetes or heart disease, you may need
to begin cholesterol checks as early as age 20.
 Prostate cancer screening: In general, using the prostate-specific antigen test and digital
rectal exam for prostate cancer screening is not recommended, so talk to your doctor.
Screening may be advised for some men starting at age 50. It may start as early as age 40
for those with a strong family history.
 Testicular exam: Your doctor may wish to check each testicle for signs of a problem,
including lumps, changes in size, and tenderness.
 Abdominal Aortic Aneurysm screening: This is a one-time screening test done with an
ultrasound. It is recommended for all men ages 65-75 who have ever smoked.

Both men and women:

 Colon (colorectal) cancer test: Tests for this cancer usually begin at age 50. It may be
sooner based on personal health conditions and family history.
 Lung cancer screening: An annual low-dose CT scan of the lungs is recommended for
both men and women ages 55-80 who have smoked for a significant period of time or who
are currently smoking. Talk to your doctor to see if your smoking history warrants a lung
cancer screen.
  Depression: Many people aren’t aware of possible symptoms of depression because they
can be easily attributed to other things. However, a depression screening at each checkup
can help your doctor to see if your symptoms are a result of depression.
 Diabetes: If you have a family history or risk factors for diabetes — such as being
overweight or having high blood pressure or high cholesterol — you should be screened
for diabetes. Your doctor may use the fasting blood sugar test or the A1C test.
 Hepatitis C: All individuals born between 1945 and 1965 are recommended to have a
one-time blood test to screen for hepatitis C.
 Vaccinations: All adults continue to need vaccinations throughout their lifetime. Talk to
your doctor about which vaccinations are recommended based on your age.
 STI screening: Based on your personal sexual history, regular STI screenings during each
routine physical exam may be suggested. This can include HIV and syphilis testing.
 HIV test: Your doctor may recommend taking a one-time HIV test for preventive
purposes, or having it done more than once if you regularly have unprotected sex.
 Syphilis test: You may need to take this test if you’re pregnant or at risk for syphilis.

Head to toe examination

General appearance
Nourishment Well nourished or under nourished
Body build Thin or obese
Health Healthy or unhealthy
Activity Active or dull (tried)
Mental status
Consciousness Conscious, unconscious, delirious, talking,
incoherently.
Look Anxious or worried, depressed etc.
Posture
Body curves Lordosis, kyphosis, scoliosis.
Movement Any limp.
Height and weight
Skin conditions
Color Pallor, jaundice, cyanosis, flushing etc.
Texture Dryness, flaking, wrinkling, or excessive
moisture.
Temperature Warm, cold, and clammy
Lesions Macules, papules, vesicles, wounds etc.
Head and face
Shape of the skull and fontennels (noted in the
newborns.
Scalp Cleanliness, condition of the hair, dandruff,
pedicles, infections like ringworm.
Face Pale, flushed, puffiness, fatigue, pain, fear,
anxiety, etc.
Eyes
Eyebrows Normal or absent
Eye lashes Infection, sty
Eyelids Oedema, lesions, ectropion(eversion),
entropion (inversion)
Eyeballs Sunken or protruded

Conjunctiva Pale, red, purulent.

Sclera Jaundiced
Cornea and iris Irregularities and abrasion
Pupils Dilated, constricted, reaction to light
Lens Opaque or transparent
Fundus Congestion, hemorrhagic spots.
Eye muscles Strabismus
Vision Normal, myopia(short sight ), hyperopia(long
sight)
Ears
External ears Discharge, cerumen, obstructing the ear
passage.
Tympanic membrane Perforations, lesion, bulging.
Hearing Hearing acuity
Nose
External nares Crusts or discharges
Nostrils Inflammation of the mucus membrane, septal
deviation
Mouth and pharynx
Lips Redness, swelling crusts, cyanosis, angular
stomatitis
Odour of the mouth Foul smelling
Teeth Discoloration, and dental caries
Mucus membrane and gums Ulceration and bleeding swelling, pus
formation
Tongue Pale, dry, lesion, sord, furrows tongue
Throat and pharynx Enlarged tonsils, redness and pus
Neck
Lymph nodes Enlarge, palpable
Thyroid gland Enlarge
Range of motion Flexion, extension and rotation
Chest
Thorax Shape, symmetry of expansion, posture
Breath sound Sigh, swish, rustle, wheezing, crepitations,
pleural rub etc.
Heart Size and location, cardiac murmurs
Breasts Enlarge lymph nodes
Abdomen
Observation Skin rashes, scar, hernia, ascites, distension,
pregnancy etc
Auscultation Bowel sounds, fetal heart sounds
Palpation Liver margin, spleen, tenderness at the area of
appendix, inguinal hernia
Percussion Presence of gas, fluid or masses
Extremities
Movement of joints, tremors, clubbing of
fingers ,ankle, oedema, varicose veins, reflexes
etc
Back
Spina bifida, curves
Genitals and Rectum
Inguinal lymph glands Enlarged, palpable.
Patency of urinary meatus and rectum (in
infants)
Descent of the tests (in infants)
Vaginal discharge presence of sexually
transmitted diseases
Hemorrhoids
Enlargement of the prostate gland
Pelvic masses
Neurological Test
Coordination tests Reflexes
Equilibrium test Test for sensations

ARTICLES REQUIRED PURPOSES

Sphygmomanometer To measure B.P.
Stethoscope To listen to the body sound.
Fetoscope To listen F.H.S.
T.P.R tray To assess the vital signs.
Tongue depressor To examine the mouth and throat
Pharyngeal retractor To examine the pharynx
Laryngoscope To examine the larynx
 Tape measure To measure height, circumference of the
head and abdomen
Flash light To visualize any part
Weighing machine To check the weight
Ophthalmoscope To examine the inner part of the eyeball
Otoscope To examine the ear
Tuning fork To test hearing
Nasal speculum To examine the nostrils
Percussion hammer, safety pins, cotton To test reflexes
wool, cold and hot water in test tubes
Vaginal speculum To examine the genitals in women
Proctoscope To examine the rectum
Gloves To examine the pelvis internally
Sterile specimen bottles, slides, cotton To collect the specimen if necessary
applicators

After care
Once the physical examination has been completed, the patient and the examiner should review 
what laboratory testshave been ordered and how the results will be shared with the patient. The 
medical professional should discuss anyrecommendations for treatment and follow-up visits. Spe
cial instructions should be put in writing. This is also anopportunity for the patient to ask any re
maining questions about his or her own health concerns.

Normal results
Normal results of a physical examination correspond to the healthy appearance and normal functi
oning of the body. Forexample, appropriate reflexes will be present, no suspicious lumps or lesio
ns will be found, and vital signs will be normal.

Abnormal results
Abnormal results of a physical examination include any findings that indicated the presence of a 
disorder, disease, orunderlying condition. For example, the presence of lumps or lesions, fever, 
muscle weakness or lack of tone, poor reflexresponse, heart arhythmia or swelling of lymph node
s will point to a possible health problem.

ROLE OF THE NURSE IN PHYSICAL EXAMINATION

 Maintenance of privacy: A separate examination room is needed. Keep the doors closed.
The relatives are not allowed. Drape the client according to the parts that are exposed.
  Lighting: As far as possible, natural light should be available in the examination room
because if a client is jaundiced, it may not be detected in the artificial light. There should
be adequate lighting.

Comfortable bed or examination table :The client should be placed comfortably throughout the
examination. There should be provision for the maintenance of a suitable position e.g. a

Conclusion
The physical examination is a key part of a continuum that extends from the history of the
present illness to the therapeutic outcome. If the history and physical examination are linked
properly by the physician's reasoning capabilities, laboratory tests should in large measure be
confirmatory. The physical examination, however, can be the weak link in this chain if it is
performed in a perfunctory and superficial manner. Understanding the pathophysiologic
mechanism of a physical abnormality is essential for correct diagnosis and management. For
instance, the failure to discriminate between and know the origin of carotid bruits and
transmitted sounds of valvular origin can have critical significance.

As knowledge of disease changes, the techniques of physical examination become augmented.

The astute physician constantly reviews and adds to the repertoire of techniques for physical
examination.

Evaluation of the physical examination in terms of sensitivity and specificity is difficult.

Interpretation of isolated physical findings is often influenced by the presence or absence of
historical information and coexisting physical findings. For instance, the assessment of whether
clubbing of the fingers is present or absent has significant interobserver variability and has been
demonstrated to be influenced by the clinical appearance of the patient.

A number of studies have attempted to look at the validity of the physical exam as a diagnostic
tool. The concept of interobserver and intraobserver variability has been introduced when
looking at specific isolated findings. For example, judging the presence or absence of râles is
more likely to be agreed upon by several observers and on repeated exams by a single blinded
observer, than is the graded intensity of breath sounds. The presence or absence of ascites in
patients with known liver disease has been shown to be difficult to determine when using
physical exam techniques alone. The bedside measurement of forced expiratory time by
auscultation however, has been shown to have a small interobserver variability in trained
observers and to have clinical value in following the degree of airway obstruction.

Because of the large degree of variability in observing many physical signs, the following
recommendations can be made when reporting and interpreting physical findings.

1. Emphasis should be placed on dichotomous variables (i.e., presence or absence of râles)

rather than on graded variables (i.e., intensity of breath sounds).
 2. Some physical signs (i.e., clubbing of the fingers) represent a continuum from obviously
normal to obviously abnormal. Emphasis should be placed on those findings which
represent the extremes rather than the "borderline" cases.

3. Recognition of those physical findings which have a high degree of interobserver

variability is important. Good examples of this include detection of moderate or small
amounts of ascitic fluid and detection of diaphragmatic movement by percussion. These
findings should be deemphasized in favor of those with better reproducibility.

4. It is beneficial to use the body's "symmetry" to advantage. Differences auscultated in

breath sounds between similar area of the right and left lung are far more clinically
important than an overall decrease in breath sounds.

If these points are kept in mind, the physical exam will fill its proper role in the care of the
patient. That is as an adjunct to a thorough history and as a way for the physician to interact
physically with the patient.

BIBLIOGRAPHY
 Brunner & Suddarth. Textbook of Medical Surgical Nursing, 12th edition, Wolters
Kluwer Publishers, page no. 64-73.
  Lindh Q. Wilburta, Poolar S.Marilyn, Tamparo D.Carol, Cerrato U.Joanne.
Comprehensive Medical Assisting, Delmar Publishers, Page no. 447-470.
 Chintamani. Medical Surgical Nursing, Lewis Publishers, Page no. 28-46
 https://www.healthline.com
 https://en.m.wikipedia.org

RE

CLINICAL
PRESENTATION
 SHRI GURU RAM DAS COLLEGE OF NURSING

HOSHIARPUR

TOPIC: Oxygen Administration

SUBJECT: MEDICAL SURGICAL NURSING

SUBMITTED ON 21STJULY, 2018

SUBMITTED TO: SUBMITTED BY:

Dr. DIMPLE MADAAN MISS. CHRISTINA

PRINCIPAL and PROF. M.Sc. NURSING 1stYear