Inspection is the process of performing deliberate, purposeful observations in a systematic manner. The nurse closely observes visually, but also uses hearing and smell to gather data throughout the assessment. The nurse assesses details of the patient's appearance, behavior, and movement. Inspection begins with the initial patient contact and continues through the entire assessment. Adequate natural or artificial lighting is essential for distinguishing the color, texture, and moisture of body surfaces. The nurse inspects each area of the body for size, color, shape, position, movement, and symmetry, noting normal findings and any deviations from normal.

Palpation uses the sense of touch. The hands and fingers are sensitive tools that can assess skin temperature, turgor, texture, and moisture as well as vibrations within the body (e.g., the heart) and shape or structures within the body (e.g., the bones). Specific parts of the hand are more effective at assessing different qualities. The dorsum (back) surfaces of the hand and fingers are used for gross measure of temperature. The palmar (front) surfaces of the fingers and fingerpads are used to assess firmness, contour, shape, tenderness, and consistency. The fingerpads are best at fine discrimination. Use fingerpads to locate pulses, lymph nodes, and other small lumps, and to assess skin texture and edema. Vibration is palpated best with the ulnar, or outside, surface of the hand. For light palpation, apply pressure with the fingers together and lightly depressing the skin and underlying structures about 1 to 2 cm (0.5 to 0.75 inch). Light palpation is used to feel for pulses, tenderness, surface skin texture, temperature, moisture, and muscular resistance (Jarvis & Eckhardt, 2020; Jensen, 2019; Weber & Kelley, 2018). Advanced health care providers usually perform deep palpation. Deep palpation is used to assess organs, masses, structures that are covered by thick muscle, and tenderness (Jensen, 2019; Weber & Kelley, 2018). Refer to information on a health assessment text for details of this advanced assessment skill.

Percussion is the act of striking one object against another to produce sound. The fingertips are used to tap the body over body tissues to produce vibrations and sound waves. The characteristics of the sounds produced are used to assess the location, shape, size, and density of tissues. Abnormal sounds suggest alteration of tissues, such as an emphysematous lung, or the presence of a mass, such as an abdominal tumor. A quiet environment allows sounds to be heard. Advanced health care providers usually perform percussion. Refer to information on a health assessment text for details of this advanced assessment skill.

Auscultation is the act of listening with a stethoscope to sounds produced within the body. This technique is used to listen for blood pressure, and heart, lung, and bowel sounds. Four characteristics of sound are assessed by auscultation: (1) pitch (ranging from high to low); (2) loudness (ranging from soft to loud); (3) quality (e.g., gurgling or swishing); and (4) duration (short, medium, or long). When auscultating, use the proper part of the stethoscope (diaphragm or bell) for specific sounds. Use the bell of the stethoscope to detect low-pitched sounds (such as some heart murmurs). Hold the bell lightly against the body part being auscultated. Use the diaphragm of the stethoscope to detect high-pitched sounds (such as normal heart sounds, breath sounds, and bowel sounds). Hold the diaphragm firmly against the body part being auscultated.