A. What Is a Physical Examination?

Highlights
1. A physical exam is used to check your overall health and make sure you dont have
any medical problems that you are unaware of.
2. Make sure to tell your Primary Care Provider about any medications you are currently
taking or have in the past. Its helpful to prepare for the appointment by gathering any
documents relating to your medical history.
3. This is your chance to talk about any problems or symptoms you are experiencing and
get professional advice from your PCP. Dont hesitate to ask any questions.
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 dont 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.
B. The Purpose of an Annual Physical Exam
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 are 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:

check for possible diseases so they can be treated early

identify any issues that may become medical concerns in the future

update necessary immunizations

ensure that you are maintaining a healthy diet and exercise routine

build a relationship with your PCP

These exams are also a good way to check cholesterol, blood pressure, and blood sugar
levels. These levels may be high without you ever showing any signs or symptoms. Regular
screening allows your PCP to treat these conditions before they become severe.
Your PCP may also perform a physical exam before a surgery or before beginning your
treatment for a medical condition.

C. 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 dont 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.
D. 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 any 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.
Your PCP will use a stethoscope the listening device doctors typically keep around
their necks to listen to various parts of your body. This could include listening to your
lungs while you take deep breaths and listening to your intestines.
Your PCP will also use the stethoscope to listen your heart to make sure there are no
abnormal sounds. Your PCP can evaluate your heart and valve function and hear your hearts
rhythm during the exam.

Your PCP will also use a technique known as percussion, tapping the body like it is a
drum. This technique helps your PCP discover fluid in areas where it shouldnt be, as well as
locate the borders, consistency, and size of organs.
Your PCP will also check your height, weight, and pulse.
Be sure to communicate with your PCP if you have any concerns throughout the exam.
While you can always contact your PCP as needed, your physical examination is your private
time set up to ask questions about anything health-related. If you dont understand any test
that your PCP is doing, dont hesitate to ask questions.
E. Following Up After a Physical Examination
After the appointment, you are free to go about your day. Your PCP may be in touch with
you after the exam. They will generally provide you with a copy of your test results and
carefully go over the report. Your PCP will point out any problem areas and tell you anything
that you should be doing. Depending on what your PCP finds, you may need other tests or
screenings at a later date.
If no additional tests are needed and no health problems arise, you are set until next year.

DIALOGUE PHYSICAL ASSESSMENT

Nurse

: Good Morning. What is your name?

Patient : Good Morning nurse. My name is Mr Jhon.

Nurse

: Mr Jhon., my name is Nurse Budi, Im the nurse as a duty in this morning. How is
your condition today Mr Jhon.?

Patient : I am still feel the fever and dizzy nurse.

Nurse

: Have you got your breakfast today?

Patient : Yes nurse, I got my breakfast. I was ate a quarter plate of rice and side dishes. I was
drunk a glass of water before.
Nurse

: Mr Jhon., now I will do physical examination to you and measure your vital sign.

Patient : Yes, please nurse.

Nurse

: For the first, I will measure your vital sign. I will take this termometer in your armpit,
please clip this. And I will fold your sleeve to easy I take the manset of
sphygmomanometer in your arm. And I will check now.

Patient : Why is measure vital sign necessary nurse?

Nurse

: Yes, because by measuring the vital sign, we will know your condition and assess the
function of your body today.

Patient : How is the result nurse?

Nurse

: Well, the result of your vital sign are your blood pressure is 130/80 mmHg, your pulse
82 bpm, and your temperature 38 degrees celcius.

Patient : Thats sound not good nurse.

Nurse

: Now, I will continued to do physical esamination to you.

Patient : Why you do physical assessment to me nurse? Is it a necessary?

Nurse

: Yes, of course Mr Jhon.. Do the physical assessment is necessary. The purpose is to

find out how your current physical condition.

Patient : Yes, please nurse.

Nurse

: For the first, I will check on your conjunctiva. Could you open your mouth please! I
will saw condition of your mouth.

Patient : Yes, of course nurse.

Nurse

: Your lips mucosa look pale and dry. I suggest you drink a lot of water, because is also
important for you and for fluid balance your body.

Patient : Thank you for your suggest nurse.

Nurse

: Youre welcome Mr Jhon.. Now I will palpate your stomach. Do you feel pain?

Patient : No nurse.
Nurse

: do you feel difficulty in breathing Mr Jhon.?

Patient : Yes nurse, I feel little difficult when I breathing.

Nurse

: Okay, to make you easy to breathing I will change your position to semi fowler
position and set oxygen to your. do you feel more comfortable?

Patient : Yes, nurse I felt more comfortable and easy to breathing.

Nurse

: Now I will give you a paracetamol, to help decrease your fever. We will monitor your
fluid balance and vital sign.

Patient : Thank you for your suggest nurse.

Nurse

: Youre welcome Mr Jhon.. Now I will leave you, before I leave do you still have any
question or complaints?

Patient : No nurse.

Nurse

: If you have a complaint, you can call me on nursing station and 30 minutes again,
doctor will come here to check your condition. I hope you get well son. Excuse me Mr
Jhon.

Patient : Thank you nurse.