Ch.9: General Survey, Measurement, and Vital Signs Flashcards
a study of the whole person, covering the general health state & any obvious physical characteristics. An introduction for the physical health examination
General Survey
The General Survey includes four objective parameters
PHYSICAL APPEARANCE (age, sex, level of consciousness, skin color, facial features, overall appearance) BODY STRUCTURE ( stature, nutrition, symmetry, posture, position, body-build contour) MOBILITY(gait and range of motion) BEHAVIOR( facial expression, mood & effect, speech, dress, personal hygiene)
A healthy BMI is a level of
19 or greater to less than 25
Calculate BMI: weight (pounds)/ height (inches) x 703
NORMAL ORAL TEMPERATURE:
98.6 F (37 C) between the range of 96.4 -99.1 (37.3-37.3)
normal temperature is influenced by
diurnal cycle, menstruation, exercise, age
What is the most convenient and accurate site? and Why?
ORAL TEMPERATURE. the sublingual pocket has a rich blood supply from the carotid arteries
Rectal temperature
most accurate route; most invasive
used mostly for children 6-36 months old
preferred route when other routes are not practical
Tympanic Membrane Temperature:
senses infrared emissions of the tympanic membrane (no use for critically ill patients)
eardrum
temporal artery thermometer:
uses infrared emissions from the temporal artery
slides the probe across the forehead and behind the ears
Stroke volume:
with every beat the heart pumps an amount of blood
70 mL in adult
Pulse:
feel for the radial pulse with 2-3 fingers
count the number for 30 seconds then multiply by 2. start the count with zero
if abnormal then count for a full minute
Asses the pulse including
rate: NORMAL RATE= 50-95 ppm
rhythm: regular even tempo
force: shows the strength of the heart, three point scale ( 2+ normal)
Bradycardia
X < 50 bpm
Tachycardia
X> 95 bpm
Irregularity in heart rhythm most common in children and young adults. The heart rate varies with the respiration cycle, speeding up at the peak of inspiration and slowing to normal with expiration.
sinus arrhythmia
Respiration:
do not tell them your counting the respirations
NORMAL RANGE: 10-20 breaths per minute (adult)
the maximum pressure felt on the artery during ventricular contraction.
systolic pressure
the elastic, recoil or resting, pressure that the blood exerts constantly between each contraction
diastolic pressure
the difference between the systolic and diastolic pressures and reflects the stroke volume
pulse pressure
is the pressure forcing blood into the tissues averaged over the cardiac cycle. it is a value close to diastolic pressure plus one on third the pulse pressure
mean arterial pressure (MAP)
the average Bp in the young adult varies with many factors including
age sex race diurnal rhythm weight exercise emotions stress
The level of BP is determined by five factors:
cardiac output ( more blood= pressure increase)
peripheral vascular resistance ( direct relationship)
volume of circulating blood (direct relationship)
viscosity (thickness, direct)
elasticity of vessel walls (stiff and rigid=increase)
The cuff size is important because
using a cuff that is too narrow yields a falsely high BP, because it takes extra pressure to compress the artery
abnormally low BP
hypotension less than normal range (120/80)
