Unit 2 - General Survey

Question 1

General Survey: what does Blue skin indicate?

Answer 1

Syanosis - decreased perfusion of the skin

Question 2

General Survey: what does Yellow skin indicate?

Answer 2

Jaundice - increase in bilireuben in blood (early signs inside mouth/eyes)

Question 3

General Survey: what does Red skin indicate?

Answer 3

Erythemia - excess blood and produced capillaries

Question 4

General Survey: what does Pale skin indicate?

Answer 4

Anemia, constricted BV

Question 5

General Survey: What are the parts of the Survey? (4)

Answer 5

1) Physical Appearance - age, sex, LOC, skin colour
2) Body Structure - stature, nutrition, Symmetry, body build
3) Mobility - Gait, ROM
4) Behaviour - facial expression, speech, dress

Question 6

What is the difference between Mood and Affect?

Answer 6

Mood - what pt. tells you

Affect - does words match the actions

Question 7

General Survey: Temperature

Answer 7

Regulated by the hypothalamus

Negative feedback b/c you fight to get it back to regulate temp.

Older Adults: decreased # of sweat glands functioning = can’t cool them down

Question 8

General Survey: How to take an Oral Temp.?

Answer 8

Between 35.8 - 37.3

Place the thermometer below the tongue and off to the side (posterior pockets)

Accurate because tongue has a branch off of carotid artery

Question 9

General Survey: How to take an Axillary Temp.?

Answer 9

~ 0.5 degrees lower than oral

Place the probe comfortably in pt. armpit

Use on unconscious pt., infants and young kids

Question 10

General Survey: How to take an Rectal Temp.?

Answer 10

~ 0.5 degrees higher than oral

Use if need a core temp

Do a rectal temp. if Hyper/Hypothermic pt. or unconscious

Insert only 1 inch into adult rectum

Question 11

General Survey: How to take an Tympanic Membrane Temp.?

Answer 11

Based on infrared emissions

Use on children and pt. unwilling to cooperate

Question 12

General Survey: How to take an Temporal Artery Temp.?

Answer 12

The sweatier the pt. the less accurate

Question 13

General Survey: What is Stroke Volume?

Answer 13

Left Ventricle- the blood pumped out with each HB

Indicates a pulse

Question 14

General Survey: What do you palpate for in a pulse?

Answer 14

1) Rate - is it regular or irregular?
- if irregular: count for 1 minute, assess bilaterally
- 60-100
2) Rhythm
- tempo of the heart
3) Force
- rate on a scale 0-3+
- subjective

Question 15

General Survey: what do you look for in Respiration?

Answer 15

Count for 1 inhale and 1 exhale

DON’T let the pt. know you’re counting their breath

Question 16

General Survey: what do you look for in O2 inspiration?

Answer 16

Measure of arterial oxygen saturation (% of oxygenated blood)

~ 97-98%

Question 17

General Survey: what do you look for in BP?

Answer 17

~ 120/80

Determined by: CO, Peripheral Vascular Resistance, volume of circulated blood, viscosity of blood and elasticity of blood vessels

Question 18

Systolic BP

Answer 18

Pressure in vessel during contraction of left ventricle

Question 19

Diastolic BP

Answer 19

Pressure in vessel during relaxation phase of the heart

Question 20

General Survey: How to measure BP?

Answer 20

1) Put arm at heart level
2) Palpate brachial artery
3) Centre cuff about 1 inch above artery
4) Inflate cuff until pulse is obliterated
5) 1st Korotkoff sound you hear after blowing up cuff = SBP
6) 2nd Korotkoff sound you hear after blowing up cuff = DBP

Question 21

Nociceptive Pain

Answer 21

Visceral - from abdominal organs

Somatic - skin, muscle, bone, joints

Cutaneous - dermis, sharp/burning

Question 22

General Survey: How is Pain assessed?

Answer 22

PQRSTU

P - palliative (what makes it start/stop?)
Q - quality (what does it feel like?)
R - radiating (localized or spread out?)
S - severity (0-10 scale?)
T - timing (when, how long, how often?)
U - understanding (do you know why you have the pain?)