general survey and management Flashcards
what is a general survey
the general study is a study of the whole person
general characteristics of a general survey
- Covers general health state and any obvious
physical characteristics - Provides an overall impression
- Includes objective parameters that apply to the
whole body - Includes areas of physical appearance, body
structure, mobility, and behavior
objective data - age
does the person appear his or her stated age
objective data - sex
is their sexual development appropriate for their gender and age
objective data - level of consciousness
is the person alert and oriented, and attends to your questions and responds appropriately
objective data - skin color
is their color tone even, their pigmentation varying with genetic background, and the skin intact with no obvious lesions
objective data - facial features
is their face symmetric with movement
objective data - overall appearance
can they/are they provide general statement r/t presence or absence of distress
objective data - body structure (stature) (Exam)
height appears within the normal range for age, genetic heritage
objective data - body structure (nutrition) (Exam)
their weight appears within normal range for height and body fluid; their body fat distribution is even
objective data - body structure (symmetry)
their body parts look bilaterally equal and are relative in proportion
objective data - body structure - posture
the person stands comfortably erect as appropriate for their age
objective data - Body structure (body, build, contour)
proportions and note deformities
objective data: mobility and gait
Gait: normally base is as wide as shoulder
width
- Foot placement: accurate; walk smooth, even, and well-balanced; and associated movements, such as symmetric arm swing, are present
- Range of motion: note full mobility for each joint, and that movement is deliberate, accurate, smooth, and coordinated
- No involuntary movement
objective data - Behavior (facial expression)
Facial expression: person maintains eye contact (if culturally appropriate), with expressions appropriate to situation
- Note expressions both while face is at rest and while person is talking
objective data - behavior (mood and affect)
the person comfortably and cooperative with examiner and interacts pleasingly
objective data - behavior (speech)
Speech: articulation (ability to form words) clear and understandable
- Speech pattern: Stream of talking is fluent, with an even pace
- Conveys ideas clearly
- Word choice appropriate to culture and education
- Person communicates in prevailing language easily by himself or herself or with interpreter.
objective data - behavior (dress)
Dress: appropriate to climate, looks clean and fits body, and is appropriate to person’s culture and age group; for example, normally:
- Amish women wear clothing from nineteenth century.
- Indian women may wear saris.
- Culturally determined dress should not be labeled as bizarre by Western standards or by adult expectations.
objective data - measurements in weight
- Use a standardized balance or electronic standing scale.
- Instruct person to remove his or her shoes and heavy
outer clothing before standing on scale. - When sequence of repeated weights is necessary, aim for approximately same time of day and same type of clothing worn each time.
- Record weight in kilograms and pounds.
- Show person how his or her weight matches up to
recommended range for height. - Compare person’s current weight with previous visit.
- Recent weight loss may be explained by successful dieting.
- Weight gain usually reflects overabundant caloric intake, unhealthy eating habits, and sedentary lifestyle.
the two most important things to weight
- when the sequence of repeated weights is necessary, aim for approximately the same time of day and same type of clothing worn each time
- compare the person’s current weight with their previous visit
the nurse is conducting a general survey which is a part that matters?
observing the patient’s body stature and nutritional status right when walking into the room
objective data - measurements (height)
- Use wall-mounted device or measuring pole on scale.
- Align extended headpiece with top of the head.
- Person should be shoeless, standing straight, looking straight ahead, with feet and shoulders on hard surface.
objective data - measurements (body mass index)
Body mass index is practical marker of optimal
weight for height and an indicator of obesity or protein-calorie malnutrition.
objective data - waist circumference
Assesses body fat distribution as indicator of health risk.
Excess abdominal fat is an independent risk factor for disease, over and above that of body mass index (BMI).
Waist circumference measured in inches at smallest circumference below rib cage and above iliac crest
Hip circumference measured in inches at largest circumference of buttocks
Note the measurement at end of normal expiration.
developmental competence - general survey r/t infants and children
Interpret based on age and developmental ability
Behavior and caregiver bonding
Measurement—weight and length (height)
Physical growth based on CDC growth charts
* Head circumference and chest circumference
developmental competence - general survey r/t aging adults (exam)
Normal consequence of aging changes r/t posture and gait
Measurement—weight and height
dwarfism
- hypopituitary dwarfism
- achondroplastic dwarfism
gigantism versus acromegaly
hyperpituitarism
acromegaly (Exam)
- is caused by an excess of the growth hormone after the growth plates have closed
- causes excessive growth of certain parts of the human body
Cushing’s syndrome (Exam)
- occurs when the body produces too much cortisol, and causes things like, facial roundness, weight gain around the middle area and back, thinning of the limbs, easy bruising, stretch marks, and overall increase of inflammation
