General Survey, Measurement, Vital Signs Ch. 9,10 Flashcards by Aniya Loren

What is a General Survey

Looking/Inspecting the General State of Health and Obvious Physical Characteristics of the whole Person

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Dysarthria

Difficulty w/ speech due to muscle problem

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Dysphonia

Difficulty w/ speech due to physical disorder or vocal cord (structural damage)

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Aphasia

loss ability to understand or express speech caused by brain injury

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Dysphagia

difficulty swallowing

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Global Aphasia

Affects both receptive (stringing meaningless words, vs Expressive (short phrases and often leads out connecting words)

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Expressive Aphasia

Difficulty with speech production, short phrases and often leads out connecting words

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Receptive Aphasia

Fluent but speech may be nonsensical, also trouble with reading and writing.

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What are the 4 components of a General Survey?

1.Physical Appearance
2. Body Structure
3. Mobility
4. Behavior

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What are the components of Physical Appearance of the General Survey?

-Age
-Sex
-level of Consciousness (LOC)
-Skin Color
-Facial Features
-Overall Apperance

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What are the components of Body Structure of the General Survey?
(BNPPSS)

-Stature
-Nutrition
-Symmetry
-Posture
-Position
-Body Build, Contour

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What are the components of Mobility of the General Survey?

-Gait
-Foot placement
-Range of Motion (ROM)
-Note any involuntary movement

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What are the components of Behavior of the General Survey?

-Facial Expression
-Mood and Affect
-Speech
-Dress
-Personal Hygiene

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What are some Abnormalities in Body height Proportion?

-Dwarfism
-Gigantism vs Acromegaly (Hyperpituitarism)
-Anorexia nervosa vs Bulimia Nervosa
-Endogenous Obesity-Cushing’s Syndrome (endocrine disorder, steroids can induce overproduction of cortisol by adrenal glands, moon face)
-Marfan Syndrome(long arms, long legs)

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What are Vital Signs?

Objective Data that includes:
-Temperature
-Pulse
-Respiratory Rate
-Blood Pressure
-Pain
-SPO2 and FIO2

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What affects Temperature?

-Circadian/Diurnal cycle(peak in late afternoon)
-Age
-Menstrual Cycle
-Medications
-Where it was taken
-Environment
-Exercise
-Hot or Cold drinks

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Where can Temperature by Assessed?

-Oral
-Axillary
-Rectal
-Temple

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Adult Normal Temperature Readings

35.8-37.3 degrees C /96.4-99.1 degrees F

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Pulse

palpable flow felt in the periphery as a result of pressure wave generation from stroke volume

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Adult Normal Pulse Rate

50-95 or 60-100 bpm

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Bradycardia

Slower heart rate, <50/bpm

Tachycardia

fast heart rate, >95-100/bpm

What affects the pulse rate, rhythm and force?

-Fever
-Medication
-Anxiety
-Cardiac History
-Athlete
-Exercise

Respirations

number of breaths per minute, 1 inhale and 1 exhale is one respiratory cycle, never let the patient know you are counting respirations.

What can affect Respirations?

Narcotics- decrease Head Injury- increase or decrease Heart Failure w/ activity intolerance- increase Anesthesia- decrease Exercise- increase Sleep-decrease

Adult Normal for Respirations

10-20/min

Pulse Oximetry (SPO2 and FIO2)

Tool used to measure the saturation of oxygen by applying a sensor with a light that measures the relative amount of light absorbed by oxyhemoglobin.

Adult Normal for Pulse Oximetry

>95% in Normal Adult >92% in Older adult w/ disease

What affects Pulse Oximetry?

-Anemia -Lung Disease -Heart Disease -Inadequate O2 given or method of delivery

Blood Pressure

is force of blood pushing against side of its container, vessel wall.

Systolic Pressure

Maximum pressure felt on artery during ventricular contraction or systole

Diastolic Pressure

elastic recoil, or resting pressure that blood exerts constantly between each contraction.

Pulse Pressure

Difference between systolic and diastolic( reflects stroke volume) 120/80 120-80=40

What affects Blood Pressure?

-Age -Race -Weight -Emotions -Sex -Exercise -Stress -Medication (steroids can cause hypertension, beta-blockers can cause hypotension)

What 5 factors determine Blood Pressure Level?

1. Cardiac Output 2. Peripheral Vascular Resistance 3. Volume circulating Blood 4. Viscosity 5. Elasticity

Adult Normal for Blood Pressure

<120/80

Elevated BP

120-129/<80

Stage 1 Hypertension

130-139/80-89

Stage 2 Hypertension

>140/90

Hypertensive Crisis

>180/120

Hypertensive Emergency

>200/140

Hypotension

>90/60 with signs and symptoms

Orthostatic Hypotension

Person experiences a sharp drop in blood pressure (systolic >20mmHg/ diastolic >10 mmHg) when sitting up or standing, can be dizzy and prone to falls. Increased in Elderly due to vascular changes. (No vascular tone)

What are common causes of Orthostatic Hypotension

-Fluid Loss -Aging -Bedrest -Changes in BP medication

Where can Blood Pressure be Measured?

upper arm/brachial artery-most common site -Lower arm/radial artery -lower leg/tibial artery site -upper leg/popliteal artery site -B/P can be auscultated or palpated depending on situation

What are some common errors w/ Blood Pressure assessment?

-Arm Placement -Patient Hold up arm -legs crossed -Examiner eyes are not level with manometer or meniscus -incorrect cuff size -Failure to palpate for level of inflation -deflate too fast or too slow -Stopping during descent and then reinflating -Failure to wait 1-2 minutes between readings -Subconscious Bias -Diminished hearing ability of examiner -Defective equipment -Number preferences

Which patient would be most likely to present with a pulse rate that is lower than normal? A. A 70-year-old telephone salesman presenting with dehydration. B. A 20-year-old runner who had surgery 4 days ago for a fractured leg. C. A 67-year-old who presented with an exacerbation of his COPD D. A 80-year old male who was admitted with dyspnea and myocardial infarction

B. A 20-year-old runner who had surgery 4 days ago for a fractured leg.

What three things may increase body temperature? A. Illness, fasting, mouth breathing B. Illness, infection, environment C. Sleep, cold, malnutrition D. Exercise, cold water, eating

B. Illness, infection, environment

A pulse rate of 42 bpm in considered: A. Bradycardia B. Tachycardia C. Bradypnea D. Apnea

A. Bradycardia

If your patient’s radial pulse is regular, you may count it for: A. 30 seconds B. Always 60 seconds C. 30 seconds and multiply by 2 D. 15 seconds and multiply by 2

C. 30 seconds and multiply by 2

Respirations are usually counted: A. In the evening B. After the patient exercised C. After taking a pulse D. While taking a blood pressure

C. After taking a pulse

All the following factors tend to increase blood pressure except: A. Pain B. Stress C. Sleeping D. Exercise

C. Sleeping