General Survey, Measurement, Vital Signs Ch.9 Flashcards
What areas should you consider when doing a general survey?
- physical apperance
- body structure
- mobility
- behavior
redness of the skin
erythema
weakness and wasting of the body due to severe chronic illness.
cachexia; being cachectic
tripod- leaning forward with arms braced on chair arms; occurs with _____.
chronic pulmonary diease
patient sitting straight up and resist lying down indicates….
congestive heart failure
difficulty stopping with gait
propulsion
the ability to form words
articulation
a practical marker of optimal healthy weight for height and an indicator of obesity or malnutrition.
BMI
Body Structure
Stature- height normal for age & genetics
Nutrition-weight appears normal range for height
& fat evenly distributed
Symmetry-body parts equal & proportioned
Posture-stands comfortably erect for age
Position- sits comfortably arms relaxed, head
turned to examiner
Body build,contour-arm span=height,crown to
pubis roughly= pubis to sole
Obesity caused by an internal malfunction, usually hormonal (i.e. thyroid disorder).
endogenous obesity - cushings syndrome
mobility
gait- normal walking
Range of motion- full mobility of joints & well
No involuntary movement
physical apperance
Age-appears his/her stated age
Sex- sex development appropriate for gender/age
Level of Conscience-alert & oriented
Skin color-tone even,pigmentation, on lesions
Facial Features-symmetric w/movement
No signs of acute distress present
A healthy BMI is a level of ___ or greater to less than ___.
19, 25
The body maintains a steady temperature through a ______ regulated in the _____.
thermostat, or feedback mechanism
hypothalamus of the brain
The normal temperature is influenced by :
a diurnal cycle
menstration cycle
exercise
age
When taking oral temperature, wait __ mins if the person has just taken hot or ice liquids and ___ mins if he or she has just smoked.
15, 2
the __ temperature is accurate and convenient.
oral
fast and accurate, safe, unbreakable, and disposable for temperature
electronic thermometer
when other routes are not practical, coma, shock, confused, etc…
rectal
senses infrared emissions of the eardrum, which shares the vascular supply with the hypothalamus . accurate measurement of the core tempertature
tympanic membrance thermometer (TMT)
This thermometer is used with unconscious patients or with those is emergency departments, recovery rooms, labor and delivery units.
TMT ; studies do not show support in critically ill patients.
amount of blood pumped into aorta with each beat (about 70ml in adult)
stroke volume
assess the pulse, including __, __, and __.
rate, rhythm, force
abnormally slow heartbeat ( in adult less than 50 bpm, and not an athlete)
bradycardia
The pulse rate varies with gender; after puberty, females have a slightly ___ rate than males.
faster
abnormally rapid heartbeat (over 90 beats per minute)
tachycardia
The rate usually increases with inspiration and decreases with expiration (towards normal). , irregular heartbeat originating in the sinoatrial node
sinus arrhythmia
a ___ pulse reflects a decreased stroke volume ( as occurs with hemorrhagic shock)
weak, thready
a fairly constant ratio of pulse rate to respiratory rate exist, which is about ___.
4:1
maximum pressure felt on artery during left ventricle contraction, or systole
systolic pressure
occurs when the ventricles are relaxed; the lowest pressure against the walls of an artery
diastolic pressure
difference between systolic and diastolic pressure and reflects the stroke volume
pulse pressure
pressure that drives blood into the tissues averaged over the entire cardiac cycle
mean arterial pressure (MAP)
normal factors varying BP
Age- gradual rise thru childhood into adulthood
Gender- after puberty females lower;after menopause females higher
Race-black adults higher than whites
Diurnal rhythm-daily cycle- BP climbs to high in
afternoon and low in morning
Weight-higher in obese
Exercise-increased activity yields higher BP
Emotions- momentarily rises w/ fear, anger, pain
Stress-elevated w/ continual tension
BP is determined by what factors?
Cardiac output Peripheral vascular resistance Volume of circulating blood Viscosity Elasticity of vessel walls
using a cuff that is too ___ yeilds a falsely high BP because it takes extra pressure to compress the artery
narrow
Period during which sound disappears then reappears when taking a blood pressure measurement ( temporary disappearance of sound when taking a patient’s BP)
auscultatory gap
low blood pressure occurring in some people when they stand up
orthostatic hypotension
congenital narrowing of aorta
coarctation
Deficiency in growth hormone in childhood results in retardation of growth below the 3rd percentile, delayed puberty, hypothyroidism, and adrenal insufficiency.
hypopituitary dwarfism
condition of overgrowth due to hyperpituitarism occuring before puberty and during the growing years
gigantism
enlargement of the extremities (and bones of the face, head, hands, and feet caused by excessive production of the growth hormone by the pituitary gland after puberty)
acromegaly (hyperpituaitarism)
inherited condition that results in excessive cartilage formation at the growth plates, forming long arms and legs
marfans syndrome
Congenital skeletal malformation caused by a genetic disorder in converting cartilage to bone.
achondroplastic dwarfism
(psychiatry) a psychological disorder characterized by somatic delusions that you are too fat despite being emaciated
anorexia nervosa
Obesity caused by an internal malfunction, usually hormonal (i.e. thyroid disorder). (adrenal cortex to secrete excess cortisol.)
endogenous obesity- cushings syndrome p.155
Administration of Adrenocorticotropin (ACTH) or excessive production of ACTH by the pituitary that leads to stimulation of adrenal cortex to secrete excess cortisol
endogenous obesity
