Jarvis Unit 2, Ch. 9

What is considered about appearance during a general survey?

1. Age - the person appears stated age

2. Sex - sexual development is appropriate for sex/age

3. Level of consciousness - the person is alert/oriented

4. Skin color - color tone is even, skin is intact w/ no obvious lesions

5. Facial features - symmetric @ rest & w/ movement

6. Overall appearance - no signs of acute distress are present

Level of Consciousness (LOC)

Abnormal LOC is characterized as confused, drowsy, or lethargic

What is considered about body structure during a general survey?

1. Structure - height appears w/in normal rage for age or genetic heritage

2. Nutrition - weight appears w/in norma range for height & body build; body fat distribution is even

3. Symmetry

4. Posture

5. Position - person sits comfortably w/ arms relaxed @ sides & head turned to examiner

6. Body build, contour - arm span = height, body length from crown to pubis = length from pubis to sole

7. Obvious physical deformities

What is considered about mobility during a general survey?

1. Gait

2. Range of motion

Gait

Abnormal gait is characterized by an exceptionally wide base. Staggering, stumbling, shuffling, dragging, nonfunctional leg, limping with/ injury.

Range of Motion

Abnormal range of motion is characterized as limited joint range of motion. Paralysis (absent movement). Jerky, uncoordinated movement. Tics, termors, seizures, abnormalities in muscle movement

What is considered about behavior during a general survey?

1. Facial expression - person maintains eye contact; expressions are appropriate to the situation

2. Mood & affect - person is comfortable & cooperative

3. Speech - articulation is clear & understandable

4. Speech pattern - stream of talking is fluent w/ an even pace

5. Dress - clothing is appropriate to climate, looks clean, & fits body

6. Personal hygiene - person appears clean & groomed appropriately for age, occupation, & socioeconomic group

Affect

Abnormal mood & affect are characterized as hostile, distrustful, suspicious, or crying

Body Mass Index (BMI)

A practical marker of healthy weight for height & an indicator of obesity/malnutrition

How is height measured?

- Infants (under 2 yrs old): measured supine on a horizontal board; legs are gently extended w/ feet against footplate

- Children: measured standing against a wall or ruler

- Older adults: height often ↓ due to vertebral disc thinning, postural changes, kyphosis, & slight flexion in knees/hips

How is weight measured?

- Infants (under 2 yrs): measured on a platform-type scale

- Children: measured on an upright scale

- Older adults: weight may ↓ in 80s/90s due to muscle loss, changes in fat distribution, & overall aging

Acromegaly

Excessive secretion of growth hormone in adulthood after normal completion of body growth. Causes overgrowth of bone in face, head, hands, & feet, but no change in height.

Bulimia Nervosa

Serious mental health disorder characterized by episodes of binge eating & then purging. Binge-purge cycles cause physical health problems such as electrolyte imbalances & erosion of tooth enamel

Anorexia Nervosa

Severe mental health disorder characterized by severe & life-threatening weight loss in an otherwise healthy person. Results in amenorrhea in females

Endogenous Obesity (Cushing Syndrome)

Administration of adrenocorticotropin (ACTH) or excessive production of ACTH by the pituitary will stimulate the adrenal cortex to secrete excess cortisol. Characterized by weight gain and edema, buffalo hump, & moon face

Marfan Syndrome

Inherited connective tissue disorder is characterized by tall, thin stature, arachnodactyly (long, thin fingers), hyperextensible joints, arm span greater than height, long legs, and sternal deformity