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Health Assessment > Lecture 2 - General Survey, Measurements, Mental Status, and Report > Flashcards

Lecture 2 - General Survey, Measurements, Mental Status, and Report Flashcards

1
Q

Which four categories of things are noted in a General Survey?

A

Physical appearance, body structure, mobility, and behaviour

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2
Q

What things are noted in the “Physical Appearance” category of the general survey?

A

LoC, Age, Sex, Skin colour, Facial expression(s)

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3
Q

Which things are noted in the “Body Structure” portion of a general survey?

A

Stature, nutrition, symmetry, posture, and position

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4
Q

What kinds of things are noted in the “Mobility” portion of a general survey?

A

Gait and RoM

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5
Q

What kinds of things are noted in the “Behaviour” portion of a general survey?

A

Facial expression, mood and affect, speech, dress, personal hygiene

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6
Q

what is a general survey and why is it important?

A

A General Survey is a whole person view that establishes objective parameters of the individual.

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7
Q

What are some warning signs for a patient’s physical appearance?

A

Drowsiness or lethargy might indicate brain injury.
Appearing older than stated may indicate alcoholism or eating disorder.
Jaundice may indicate liver failure, respiratory illness may cause pallor.
Asymmetrical or drooping face may indicate stroke.
Delayed puberty for age may indicate problems.

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8
Q

What three things should be recorded when assessing a patient’s LoC?

A
  1. The level of stimulus used
  2. Patients response
  3. What the patient does on cessation of stimulus
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9
Q

What is an obtunded person?

A

One who is in transitional phase between stupor and lethargy. Sleeps most of the time and is difficult to arouse. Requires constant vigorous stimulus for even marginal cooperation.

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10
Q

What is Stupor or semicoma?

A

A person who is spontaneously unconscious and has an appropriate motor response to pain, but can otherwise only groan mumble or move restlessly. Reflex activity persists.

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11
Q

What is an Acute Confusional State (or Delirium)?

A

A cloudy state of consciousness with impaired recent memory. May include agitation or visual hallucinations and disorientation. May be worse at night.

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12
Q

How would a Glasgow Coma Scale be conducted?

A

Eye Opening Response:
Spontaneous (4)
To speech or direction (3)
To pain (2)
No response (1)

Motor Response:
Obeys verbal command (6)
Localizes pain (5)
Withdrawal from pain (4)
Abnormal flexion (3)
Abnormal extension (2)
No response (1)

Verbal Response:
Oriented (5)
Confused (4)
Inappropriate response (3)
Incomprehensible (2)
No response (1)

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13
Q

How might the results of a Glasgow coma scale be interpreted?

A

13-15 –> mild
9-12 –> moderate
3-8 –> severe

Seven or less reflects a coma

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14
Q

What are the limitations of the Glasgow Coma Scale?

A

Cannot be used on a patient who is inutbated

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15
Q

How might a GCS score of 9 be interpreted?

A

This indicated moderate injury, could signify a concussion. Patient absolutely needs more tests, such as a CT.

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16
Q

How is someone’s height measured?

A

Arrow must be aligned with top of head. Shoes should be removed. Feet, shoulders, and buttocks must be in contact with the board.

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17
Q

What precautions should be taken when measuring repetitive weights?

A

Should be measured with same type of clothing, at the same time of day, and by the same person. Weights should be input in both kg and pounds.

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18
Q

What is the conversion between pounds and kg?

A

lb / 2.2 = weight in kilograms

kg x 2.2 = weight in lb

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19
Q

What is cachexia?

A

Extreme wasting or atrophy due to chronic illness.

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20
Q

What might explain sudden weight loss?

A

Short term or chronic illness

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21
Q

What might explain sudden weight gain?

A

Fluid retention could be associated to heart failure.

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22
Q

What might centropedal obesity indicate?

A

Could be a sign of Cushing’s Syndrome

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23
Q

How is BMI calculated

A

kg / m^2 = BMI
(lbs / in^2) x703 = BMI

24
Q

How might different BMI calculations be interpreted?

A

<18.5 –> underweight
18.5-24.9 –> Normal weight
25-29.9 –> Overweight
30-34.9 –> Obese (Class I)
35-39.9 –> Obese (Class II)
>40 –> Obese (Class III)

25
Q

When should a BMI not be calculated?

A

In a pregnant individual. BMI should also be not shared with someone who has an ED.

26
Q

What is important to note when measuring the growth of children?

A

Healthy growth will be continuous but uneven, so results can be analyzed more reliable when compared over time.

27
Q

What is important to note when measuring the height and weight of older adults?

A

Decreases in height and weight are normal in the eighties and nineties. Height changes may be due to intervertebral disk shortening or because of flexion in the knees and hips.

28
Q

What might tripod sitting indicate?

A

Could be a chronic respiratory issue, as this position drops the diaphragm and allows for greater lung volume

29
Q

What might fetal position indicate?

A

Abdominal pain or depression

30
Q

When assessing body build and contour during a general assessment, what should be noted?

A

Arm span should be equal to height, crown to pubis should be equal to pubis to sole. Note all physical deformities, acquired or genetic.

31
Q

Disproportionately long legs or arms might indicate what?

A

Marfan Syndrome

32
Q

What should be noted in a mobility assessment during general survey?

A

RoM and gait. Also not any tics or tremors.

33
Q

What should you be aware of when assessing the facial expression of children?

A

Developmentally healthy children under five tend to avoid eye contact. This is normal

34
Q

What is flat affect?

A

A flat expression and tone when speaking. Neutrality is not necessarily appropriate for every situation.

35
Q

What is Lability or a Labile affect?

A

Rapid shift in moods and expressions

36
Q

What is dysarthria?

A

Difficulty articulating or speaking language that is otherwise normal

37
Q

Inappropriate dress for the season might indicate what?

A

Those with schizophrenia in crisis might dress for the wrong season

38
Q

Which four categories are assessed during a Mental Status Examination?

A

Appearance, Behaviour, Cognition, and Thinking

39
Q

When should a Mental Status Examination be done?

A

If a patient exhibits aphasia, brain lesions, any psychiatric illness, or when the patient or a relative makes note of issues.

40
Q

Which leading question can be asked to asses a person’s mood and affect?

A

How are you feeling today?
How do you feel most days?

41
Q

In what order do people lose their orientation?

A

Time, place, and person (or self) are lost in that order.

42
Q

What is gnosia?

A

The ability to recognize objects and their function

43
Q

What things should be checked in a cognitive assessment?

A

Orientation, gnosia, attention/concentration, memory (immediate, recent, and remote), and comprehension or abstract reasoning.

44
Q

What kinds of things are examined in an assessment of thinking?

A

Thought processes & content, perceptions, and insight and judgement.

45
Q

What score on an MMSE (Mini-Mental State Examination) indicates abnormality?

A

Anything 24 or below indicates an abnormality that should be evaluated.

46
Q

What score on a MOCA (Montreal Cognitive Assessment) indicate abnormality?

A

Any score of 25 of lower

47
Q

What is a Mini-Cog Test and when should it be used?

A

A short test used to screen for memory abnormalities in older adults. Used to screen for symptoms of Alzheimer’s and related dementias.

48
Q

What is a MOCA test and when should it be used?

A

A test used to determine mild cognitive impairment. Does not necessarily indicate dementia.

49
Q

What is the Confusion Assessment Method

A

A tool used to determine is a patient is experiencing delirium. Patient must:
Have acute onset change and and fluctuating course + inattention.
And be experiencing: disorganized thinking OR Altered level of consciousness

50
Q

What risks must all patients undergoing a mental status examination be assessed for

A

Suicidal thoughts, assaultive/homocidal ideation, or elopement risk.

51
Q

What are some warning signs for suicidal thoughts?

A

–> sadness, hopelessness
–> flat affect or sadness
–> slumped posture
–> prior attempts
–> Self harm
–>Anorexia

52
Q

What questions could you ask someone to screen for assaultive or homicidal ideation?

A

Do you have any thoughts of wanting to hurt anyone?
Do you have any feelings or thoughts that you wish someone were dead?

53
Q

How can you avoid the risk of patient elopement?

A

–> Checking patients off unit privileges + locking doors if absolutely necessary
–> Make sure patient has an adequate understanding of their need for hospitalization

54
Q

How should narrative paper report be structured?

A

Include everything that has been completed. List assessment, interventions, and outcomes in that order.

55
Q

According who the WHO, characteristics indicate positive mental health?

A

A sense of emotional and spiritual well-being - reflects importance of culture, equity, social justice, interconnections, and personal dignity.

56
Q

What is the difference between recent and remote memory?

A

Recent Memory
–> Last 24 hours

Remote Memory
–> Memory about distant past (could be months or a few years)

Health Assessment (14 decks)

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