General Survey: Ch. 9

Question 1

When is the general survey done?

Answer 1

During the interview

Question 2

6 observations to note for Physical Appearance during the general survey?

Answer 2

• Age: pt. looks stated age (older appearance could mean chronic illness)
• Sex: sexual development is app. for age. Note transgender & what stage
• Skin: even tone, color, app. for genetic background, intact, tattoo & piercing
• Facial Features: symmetrical w/ movement
• Level of Consciousnesses (LOC): place, time, situation
• Overall appearance: no acute distress

Question 3

characteristics of Centripetal Obesity

Answer 3

Obesity concentrated in the face, neck & trunk. Thin extremities.

Question 4

what is Cachexia

Answer 4

Wasting

Question 5

3 observations to note when assessing Mobility

Answer 5

• Gait: feet shoulder width, symmetrical arm swing, smooth walk, even, maintain balance
• ROM: mobility of joints, deliberate, accurate, smooth, coordinated
• No involuntary movement

Question 6

7 observations to note when assessing Body Structure

Answer 6

• Stature: height
• Nutrition: weight
• Symmetry: body equal bilaterally, normal proportions
• Posture: plum line through ear, shoulder, hip, knee, ankle
• Position: sits comfortably
• Body Build, Contour: arm span = height, crown to pubis = pubis to sole of feet
• Obviously physical deformities: congenital, acquired defect (amputation)

Question 7

Lordosis

Answer 7

Excessive inward curve of lumbar vertebrae

Question 8

Kyphosis

Answer 8

Humpback appearance common in the very old and in those with osteoporosis.

Question 9

6 observations to note for Behavior

Answer 9

• Facial Expression: app. eye contact, app. expression
• Mood & Affect: pt. is comfortable & cooperative
• Speech: articulation
• Speech pattern: fluent w/ even pace, conveys ideas clearly, communicates easily on their own or through an interpreter
• Dress: app. for weather
• Personal hygiene: clean, groomed

Question 10

What would nurse obtain during a general survey?

PBBM

Answer 10

Begins when you first meet the patient, observation of general health state and any obvious physical characteristics. It is an introduction for the physical examination that will follow.

(objective data)

Physical appearance
Behavior
Body structure
Mobility

Question 11

what do you do to measure Height

Answer 11

Shoe-less

Children <2y use measuring board

Question 12

what do you do to measure Weight

Answer 12

Record in kg (1 kg = 2.2 lbs)
Shoe-less & remove heavy outer clothing
Infants use platform scale

Question 13

what is BMI? what are its drawbacks?

Answer 13

Indicates healthy weight for height
Useful in obesity risk assessment

Drawbacks: muscle weighs more than fat

Question 14

how do you take Body Measurements for an adult & an infant

Answer 14

Taken in cm

• Adult
  head: around temporal & occiptal
  waist: just above illiac crest (risk for DM: >40” in men & >35” in women)

-Infant
head: around temporal & occiptal (32 to 38 cm)
chest: around nipple line
newborn’s head is about 2cm larger than chest, Between 6mo. and 2y head and chest should be equal

Question 15

Hypopituitary Dwarfism

Answer 15

Deficiency in growth hormone in childhood results in retardation of growth.
Delayed puberty, hypothyroidism, and adrenal insufficiency

Question 16

Gigantism

Answer 16

Excessive secretion of growth hormone by the anterior pituitary.
Overgrowth of the entire body.
When this occurs during childhood before closure of bone epiphyses, it causes increased height, as well as increased weight and delayed sexual development.

Question 17

Acromegaly (Hyperpituitarism)

Answer 17

Excessive secretion of growth hormone in adulthood after normal completion of body growth.
Overgrowth of bone in face, head, hands, and feet but no change in height.
Internal organs also enlarge, and metabolic disorders (e.g., diabetes mellitus) may be present

Question 18

Achondroplastic Dwarfism

Answer 18

A genetic disorder in converting cartilage to bone.
Normal trunk size, short arms and legs, and short stature.

It is characterized by a relatively large head with frontal bossing; midface hypoplasia (small); and often thoracic kyphosis, prominent lumbar lordosis, and abdominal protrusion.
The mean adult height in men is about 131.5 cm (4 ft 4 in) and in women about 125 cm (4 ft 1 in).

Question 19

Amenorrhea (uh-men-o-REE-uh)

Answer 19

The absence of menstruation — one or more missed menstrual periods

Question 20

Endogenous Obesity—Cushing Syndrome

Answer 20

adrenal cortex secretes excess cortisol.

Weight gain and edema
central trunk and cervical obesity, round, plethoric face, muscle wasting; weakness; thin arms and legs; reduced height; and thin, fragile skin with purple abdominal striae, bruising, and acne.

Question 21

Marfan Syndrome

Answer 21

Inherited connective tissue disorder is characterized by tall, thin stature

arachnodactyly (long, thin fingers), hyperextensible joints

arm span > height, pubis to sole > crown to pubis

sternal deformity (note pectus excavatum), high-arched narrow palate, narrow face, and pes planus (flat feet).

Early morbidity and mortality occur s aa result of cardiovascular complications