Florida University : NUR 3125 Health Assessment Exam 2 /Chapter 9-17,100% CORRECT
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NUR 3125
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NUR 3125
Florida University : NUR 3125 Health Assessment Exam 2 /Chapter 9-17
Chapter 9: General Survey and Measurement
General Survey: the study of the whole person, covering the general health state and any physical characteristics; begins when you meet a person
● Components
○ Physical Appea...
florida university nur 3125 health assessment exam 2 chapter 9 17
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Florida University : NUR 3125 Health Assessment Exam 2 /Chapter 9-
17
Chapter 9: General Survey and Measurement
General Survey: the study of the whole person, covering the general health state and any
physical characteristics; begins when you meet a person
● Components
○ Physical Appearance
■ Age: the person appears his or her age
● Some people may appear older because of chronic illness or chronic
alcoholism
■ Sex: sexual development is appropriate for their age
● If the individual is transgender, note the stage of transformation
● Some individuals experience delayed or precocious puberty
■ Level of Consciousness: alert and oriented to person, place, time,
and situation, responds appropriately to questions
● Some may be confused, drowsy, lethargic due to illness
■ Skin Color: tone should be even, appropriate to genetic background;
skin is intact, no obvious lesions
● Note any tattoos or piercings, stage of healing
● Note deviations such as pallor, cyanosis, jaundice, erythema
■ Facial features: symmetric with movement
● Abnormal findings include immobile, asymmetric, masklike, drooping
■ Overall appearance: no signs of acute distress
● Cardiac or respiratory signs (diaphoresis, SOB, wheezing, pain
signs like clutching chest, grimacing)
○ Body Structure
■ Stature: normal range for age and genetic heritage
● Abnormally short or tall, abnormal proportions
● Table 9.2 abnormalities in body height and proportion
○ Hypopituitary dwarfism: deficiency in growth hormone
results: in growth below 3rd percentile; delayed puberty
onset; hypothyroidism; adrenal insufficiency
○ Achondroplastic dwarfism: genetic disorder resulting in
cartilage becoming bone, results in: normal trunk size, short
arms and legs, large head with frontal bossing, midface
hypoplasia; sometimes thoracic kyphosis, lumbar lordosis,
and abdominal protrusion; men around 4’4” and women
around 4’1”
○ Acromegaly: excessive growth hormone secretion in adults
after normal body growth, causes overgrowth of bone in
face, head, hands, and feet with no change in height;
internal organs can enlarge (cardiomegaly example),
metabolic disorders can be present
○ Anorexia nervosa
○ Endogenous Obesity: excessive ACTH stimulates secretion of
, cortisol or administration of adrenocorticotropin; cervical
obesity, moon face (round, fat); weight gain in central trunk,
cervical obesity, muscle wasting, weakness, think extremities,
reduced height, thin fragile skin with purple abdominal striae,
bruising, and acne
○ Gigantism: excessive secretion of growth hormone during
childhood, results of overgrowth of entire body; when it
occurs before cone epiphyses close it causes increased
height, weight, and delayed sexual development
○ Marfan syndrome: inherited connective tissue disorder
characterized by tall, thin stature (>95%), arachnodactyly,
hyperextending joints, arm span greater than height, flat feet
(pes planus), sternal deformity such as pectus excavatum,
narrow face, high-arched and narrow palate, and more;
cardiovascular complications can cause early morbidity and
mortality
■ Symmetry: body parts look equal bilaterally and are in relative proportion to
each other
, ● Asymmetry or unilateral hypertrophy/atrophy
■ Nutrition: normal weight and height, body fat evenly distributed
● Cushing's obesity is different than normal obesity
■ Posture: person sits comfortably with arms relaxed at sides and head
turned to the examiner
● Tripod: leaning forward with arms braced on chair arms, occurs
with chronic pulmonary disease, asthma
● Sitting up straight and resisting lying down- heart failure
● Fetal position- pain, usually abdominal
■ Body build and contour
● Proportions: arm span = height; crown to pubis = pubis to sole
(roughly)
● Elongated arms could be from marfans, hypogonadism
■ Obvious physical deformities: not any congenital or acquired defects
such as missing extremities, webbed digits, shortened limb
○ Mobility
■ Gait: smooth walk, no assistance, symmetry, feet about shoulder width
apart
● Propulsion- difficulty stopping
■ Range of motion: rom for each joint and movements are deliberate,
accurate, smooth, and coordinated
■ Involuntary movements: tics, tremors, seizures, abnormal muscle
movements
○ Behavior
■ Facial expression: culturally appropriate eye contact, expressions
appropriate to situation, note face at rest and while talking
● Anxiety is common in ill people, some people smile when they are
anxious
● Abnormalities can include flat, depressed, angry, sad, anxious, etc
■ Mood and affect: comfortable and cooperative
■ Speech: articulation is clear and understandable
■ Speech pattern: fluent, even pace, word choice is appropriate, conveys
ideas clearly, communicates easily on their own or with interpreter
■ Dress: appropriate, clean, fits properly
■ Personal hygiene: clean, well groomed, “normal”
○ Measurements
■ Weight: remove heavy outer clothing and shoes, aim for weighing at
same day with same type of clothing, record in kg and lbs; before
breakfast, after void
● Look for weight loss and gain
● Example: patient with initial weight in undergarments and
gown should be repeated in gown
● Unexplained loss: from short term or chronic illness
(malignancy, endocrine disease, depression, anorexia, bulimia)
○ Person treated for pneumonia for several weeks may have
some weight loss
● Unexplained gain: fluid retention
■ Height: measured with a wall-mounted device or pole on balance scale;
align extended headpiece with top of head, person should be shoeless,
standing straight and looking straight ahead, slight traction under jaw;
feet, shoulders, butt should be in contact with the wall or measuring pole
, ■ BMI: there are two tables, one for inches, and one for meters. Look at it
● BMI is a practical marker for optimal healthy weight for height,
indication of obesity or malnutrition. Should be used with other
measures such as weight circumference
● Review the classifications. You should already know them
● Formula: Weight (kg) divided by height^2 (m^2) OR [(lbs)/(in^2)]*703
■ Waist circumference: should be <40in men, <35in women, measured at
iliac crest; larger increases risk for T2D, heart disease, dyslipidemia, CVD,
hypertension, etc
○ Developmental competence
■ Infants and children
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