General Survey

Question 1

When does general survey begin?

Answer 1

upon entering the room

guides the rest of the assessment

Question 2

Observations include?

Answer 2

see
hear
smell

Question 3

What should be the first assessment made upon seeing a patient?

Answer 3

physical appearance
A-airway
B-breathing
C-circulation

Question 4

4 categories of assessment to the general survey?

Answer 4

1. physical appearance
2. mental status
3. behaviour
4. mobility

(age related considerations must be taken into account)

Question 5

Physical Appearance? (age)

Answer 5

stated age vs apparent age

factors that affect appearance:

• substance abuse
• stress
• depression
• turner’s syndrom
• dwarfism

Question 6

physical appearance? (facial features)

Answer 6

eyes
symmetrical face
anything there that shouldn’t be

Question 7

physical appearance? (skin pigmentation/tone)

Answer 7

-changes in pigmentation

Question 8

physical appearance? (body shape & build)

Answer 8

• deformities
• symmetry & proportion

(limbs should be proportionate to trunk

Question 9

physical appearance? (height & weight)

Answer 9

overall approximate height & weight

body shapes:

• apple
• rectangle
• pear
• inverted triangle
• hourglass

if you carry your weight in your hip, body fat will be distributed evenly

Question 10

Mental Status?

Answer 10

assess during interview/interactions

Observe:
LOC (awake, alert)
Orientation (P,P,T) (year,season, date)
Speech (should be coherent, no slurring, mumbling)
Responses (is response appropriate)
Memory (immediate, recent, long term)
Attention span
Perceptions or ability to interpret the environment
Judgment, abstract reasoning	
Ability to problem solve
Ability to learn

Question 11

physical appearance? (behaviour)

Answer 11

Observe/assess:
Dress and Grooming
Body odours
Breath odours
Eye contact
Facial expressions
Level of distress
Mood

(anesthetic is secreted through pores; can smell it)

flat affect: no emotions

Question 12

physical appearance? (mobility)

Answer 12

Posture
Gait
ROM

posture should be erect, shoulders back & even with hips, head up & midline with body, arms hanging freely at side, fluid even steps heel to toe

Question 13

Height & weight?

Answer 13

Why do we measure height and weight?

-indicates health issues/risk of health issues

Height: stand as straight as possible & look straight ahead

Weight: try to use same scale & same clothing

Question 14

BMI?

Answer 14

Purpose?

-indicates obesity & risk of serious health problems

How?

-height-weight comparison

Formula:

-BMI = wt (kg) = 65 kg = 65 kg = 23.9
ht (m2) (1.63m)2 2.72m

*Assumes everyone is same (not reliable source)

Question 15

Waist-hip ratio?

Answer 15

takes ethnicity into account

Used to indicate body fat distribution, obesity and the risk of developing serious health conditions. E.g. diabetes, high cholesterol and cardiovascular disease

measure waist at smallest point (navel) and hips at largest point (butt)

Question 16

Landmarking waist?

Answer 16

Superior border of iliac crest

Below the floating ribs

Question 17

Vital Signs?

Purpose?

Answer 17

Purpose?

• to provide baseline data
• to detect/monitor any changes in patient’s health status
• to monitor anyone at risk for changes in health status

Always ensure you assess ABC’s
   ***What does this mean?
airway
breathing
circulation

Question 18

VS ranges?

Answer 18

Temperature (C)
range? 36-38
average? 37
factors that influence? food, liquids, smoking

Pulse (P)
range? 60-100
characteristics? regular, strong, weak, threading, bounding
factors that influence? stress

Respirations (RR)
range? 12-20
average?
characteristics? regular, eupnic, shallow, effortless
factors that influence?

Question 19

VS include?

Answer 19

Blood Pressure (BP) force of blood exerted on arterial wall
systolic pressure? ventricular contraction
diastolic pressure? ventricular relaxation
range? 120-139/80-89
factors that influence?

Oxygen Saturation (O2 sat)
measures? % of blood cells that have oxygen bound to them
range? 95-100%
COPD pt can be <92%

Question 20

Pain Assessment?

Answer 20

OPPQRRSTU

onset
precipitated/provoked
paliation
quality
radiation
region
severity (0-10)
time
understanding