The nurse is caring for a client who has smoked for many years and documents that "clubbing is present.". Which of the following techniques is the best way for the nurse to determine the presence of clubbing?

1. Place two thumbs touching side-by-side.
2. Place two of the same fingers from each hand together.
3. Place two index fingers together tip-to-tip.
4. Place the hands out straight with the palm sides down.


2
Rationale 1: Placing the thumbs together side-by-side is not an appropriate way to determine the presence of clubbing.
Rationale 2: To assess for clubbing, the nurse can use the Schamroth technique in which the nurse asks the client to bring the dorsal aspect of corresponding fingers together and if there is clubbing, a diamond is not formed and the distance increases at the fingertip.
Rationale 3: Placing the index finger tip-to-tip is not an appropriate way to determine the presence of clubbing.
Rationale 4: Placing the hands straight out with the palms facing downward is not an appropriate way to determine the presence of clubbing.

Nursing

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