General Survey Flashcards
Overall impression
physical appearance, behavior, COLDSPA/focused assessment for abnormalities, height, weight, BMI, waist circumference
Physical appearance includes
skin color, dress, hygiene, posture, gait, development, body build, appears stated age, LOC
Behavior includes
body movement, affect, facial expression
How do you take height?
no shoes, standing straight w/ feet/shoulders/bottom against hard surface
BMI
optimal healthy weight for height. obesity/nutrition risk assessor. normal = 18-24.9, obese >30
Why is waist circumference important?
if carried around waist vs hips = higher risk for heart disease/diabetes II
How do you get the height of infants?
straighten legs/mark on paper. get height/weight each visit to determine normal growth patterns/compare w/ general population
Measure head circumference
2cm more than chest newborns, same 6mos-2, less >2
vital signs
temp, pulse, respirations, bp, o2 sat
sites for temperature
oral, axillary, rectal, temporal, tympanic, lowest in morning, peaks med afternoon, older people may have a lower temp.
Oral temp
easiest, sublingual pocket
Axillary temp
degree lower than oral
Rectal temp
degree higher than oral, most accurate, wear gloves/lubricate
Temporal and tympanic temp
temporal slide across forehead/behind ear - maybe accurate. tympanic accurate
Pulse is
feeling amount of blood pumped with each beat = stroke volume
What do you report with pulse?
rate - number, amplitude - 0 absent, 1+ weak, 2+ normal, 3+ bounding. rhythm - regular/irregular
Pulse sites
apical (count minute), radial, carotid, brachial, femoral, dorsalis pedis, posterial tibial
Respirations
normal = relaxed, regular, automatic, silent, don’t let pt know counting (during pulse), can put hand on chest to help feel (especially in newborns). faster in kids (try to get when quiet)
What do you report with respirations?
rate - number, rhythm - regular/irregular, depth - shallow, regular, deep
Systolic
ventricles contracted
Diastolic
ventricles relaxed
Pulse Pressure
systolic - diastolic
What can influence BP?
age, race, weight, emotions, stress
Tips for BP
right size cuff, if must retake wait 1-2 min, validate electronic with manual
Orthostatic
serial measurements of pulse/bp. read lying, sitting, standing - normal <10mm/Hg decrease in systolic
orthostatic hypotension
drop in systolic of >20mm/Hg or pulse increase >20 with quick position change - caused by peripheral vasodilation w/o compensatory increase in cardiac output
Sites for bp
upper arm, forearm, leg
O2 sat
measures light absorbed by unoxygenated hemoglobin, use fingers toes or earlobes, needs to be unpolished nail
Developmental considerations
infant - auscultate while sleeping, exam table or parent’s lap.
toddler - tell what’s next asking, can demonstrate on parent or stuffed animal.
adolescent - provide feedback that body is healthy, what to expect next.
elderly - plan for few position changes
What age do you check bp?
3
Things to know about older adults
kyphosis, muscle shrinkage 80s/90s, shorter b/c thinning vertebral disks/knee/hip flexion, less sweat glands, stiff arteries, shallow respirations/decreased inspiratory volume, less sq fat - lower body temp (infection w/o fever), higher bp
best O2 sat
93-100%
What causes low O2 sat?
low hemoglobin which carries O2
What is oxygen saturation?
non-invasive measurement of arterial oxygen saturation (SpO2)
Kyphosis
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