General Survey Flashcards
When does general survey begin?
upon entering the room
guides the rest of the assessment
Observations include?
see
hear
smell
What should be the first assessment made upon seeing a patient?
physical appearance
A-airway
B-breathing
C-circulation
4 categories of assessment to the general survey?
- physical appearance
- mental status
- behaviour
- mobility
(age related considerations must be taken into account)
Physical Appearance? (age)
stated age vs apparent age
factors that affect appearance:
- substance abuse
- stress
- depression
- turner’s syndrom
- dwarfism
physical appearance? (facial features)
eyes
symmetrical face
anything there that shouldn’t be
physical appearance? (skin pigmentation/tone)
-changes in pigmentation
physical appearance? (body shape & build)
- deformities
- symmetry & proportion
(limbs should be proportionate to trunk
physical appearance? (height & weight)
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
Mental Status?
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
physical appearance? (behaviour)
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
physical appearance? (mobility)
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
Height & weight?
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
BMI?
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)
Waist-hip ratio?
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)
Landmarking waist?
Superior border of iliac crest
Below the floating ribs
Vital Signs?
Purpose?
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
VS ranges?
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?
VS include?
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%
Pain Assessment?
OPPQRRSTU
onset precipitated/provoked paliation quality radiation region severity (0-10) time understanding
