General appearance and skin exam Flashcards
Describe the Glasgow coma scale
Used to measure alertness/consciousness
3 categories: eye opening (1-4), best verbal response (1-5), best motor response (1-6)
Scoring: Best response= 15, comatose client = 8 or less, totally unresponsive= 3
Scored responses for Eye opening response
4= spontaneously 3= to speech 2= to pain 1= no response
Scored responses for Best verbal response
5= oriented to time, place, person 4= confused 3= inappropriate words 2= incomprehensible sounds 1= no response
Scored responses to best motor response
6= obeys commands 5= moves to localized pain 4= flexion withdrawal from paon 3=abnormal flexion 2= abnormal extension 1= no response
What to look for in general appearance exam?
alertness/consciousness, orientation, apparent state of health (healthy/sick, obese/frail), Pain assessment (wincing), apparent age, special considerations (race, tattoos, scars), hygiene, odors
How can CHF patients present?
patients are leaning forward to breath easier
How can hemiparesis (stroke) patients present
paralysis on one side of body
How can parkinson’s patients present?
shuffling feet
Components of skin exam
SCALDA
size, color, arrangement, lesion, distribution, adjacent structures
Jaundice
yellowing of skin affecting the sclera
Peripheral cyanosis
Blue finger tips
Erythema
Redness, associated with a rash
What is a maculopapular rash?
means it has flat and raised lesions coalesced together
Screening for melanoma
ABCDE
Asymmetry, border irregularity, color change, diameter (>6 mm), evolution (changes in last 6 months)
Koilonychia
refers to abnormally thing nails that have lost their convexity. can be result of hypo chromic anemia
