The General Survey

Question 1

Observations of the General Survey

Answer 1

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

Question 2

Physical Appearance

Answer 2

• age
• sex
• level of consciousness
• skin colour/ condition (even, rash, pallor, jaundice)
• facial expressions (symmetry with movement)

Question 3

Level of Consciousness

Answer 3

Alert and Oriented x 3
1. Who they are
2. Where they are
3. When they are (season, date, month)

Consciousness is lost in the reverse order: when –> where –> who

Question 4

LOC: Alert

Answer 4

awake, readily aroused, oriented, fully aware of external and internal stimuli, responds appropriately

full range of controlled movement

Question 5

LOC: Lethargic

Answer 5

not fully alert, drifts off to sleep when not stimulated, can be aroused when touched or name is called (in a normal tone of voice), responds appropriately but seems slow, inattentive

spontaneous movement decreased

Question 6

LOC: Obtunded

Answer 6

transitional state between lethargy and stupor

difficult to arouse (needs a vigorus shake or loud shout), otherwise will only groan, mumble, or move restlessly

Question 7

LOC: Stupor or Semicoma

Answer 7

spontaneously unconscious, responds only to persistent, vigorous shakes or pain

confused when aroused, mumbles, incoherent speech, moves restlessly

still responds to painful stimuli, moves reflexively

Question 8

LOC: Coma

Answer 8

completely unconscious, no response to pain or other internal/ external stimuli

light coma: some reflex activity, but no strong movements

deep coma: no reflex activity and no motor response

Question 9

LOC: Acute Confessional State (delirium)

Answer 9

clouding of consciousness, inattentive, incoherent, impaired recent memory

worse at night when visual stimulation decreases (less stimuli to provoke consciousness)

Question 10

Glasgow Coma Scale

Answer 10

used to assess patients suspected of a brain injury –> 3 areas:
1. Eye opening response
2. Motor response
3. Verbal response

Max score of 15 points
13-15 = mild
9-12 = moderate
3-8 = severe

Question 11

GCS Score: 13-15

Answer 11

mild brain injury

Question 12

GCS Score: 9-12

Answer 12

moderate brain injury

Question 13

GCS Score: 3-8

Answer 13

severe brain injury

Question 14

Body Structure

Answer 14

1. stature
2. nutrition (healthy, cachectic, obese)
3. symmetry (bilateral, proportional)
4. posture (plumb line)
5. position (tripod, resisting laying down, fetal)
6. body build, cntour,

Question 15

Nutritional Assessment

Answer 15

assessments used to determine a patient’s nutritional status

Question 16

Posture

Answer 16

• tripod sitting
• fetal position
• slumped shoulders
• closed off, reserved
• anxious
• sitting tall

Question 17

Position

Question 18

Body Max Index (BMI)

Answer 18

an indicator of optimal weight according to height –> may indicate obesity or malnutrition

BMI = weight/ height (squared)

Question 19

BMI of <18.5

Answer 19

under weight

Question 20

BMI 18.5-24.9

Answer 20

normal

Question 21

BMI 25.0 - 29.9

Answer 21

over weight

Question 22

BMI 30+

Answer 22

obese

Question 23

What number can be used to best predict health outcomes?

Answer 23

waist circumference

Question 24

Height and Weight of Older Adults

Answer 24

• shorten in stature due to compressed/ shortened vertebral discs
• postural changes due to changes in knee and hip flexion
• decrease in weight, bony prominences more visible

Question 25

Mobility

Answer 25

1. Gait (stable, shuffling, uneven, dragging feet) 2. Range of Movement (fully mobility of joints, smooth, coordinated)

Question 26

Behaviour

Answer 26

1. Facial Expression 2. Mood and Affect 3. Speech 4. Dress and Personal Hygiene