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Nur 220 Test 1- General Survey, Measurements, Vital Signs
Terms in this set (30)
What is a general survey
-is a study of the whole person
-covers general health state state and any obvious physical characteristics
What are things to look for when you take a general survey and when does it start.
-the moment you first encounter the person
-do they state there name properly, do they look sick,
what are the four things to consider on a general survey
body structure, behavior, physical appearance,mobility
What are types of objective data that is physical appearance
level of consciousness
-no signs of acute distress
What are types of objective data is taken on the body structure?
-stature:height normal with age
-nutrition:Weight,height,body build, body fat distribution
What are types of objective data is taken on mobility?
-Gait: normally, base is as wide as shoulder width
-range of motion
- no involuntary movement
What types of objective data is taken on behavior?
- facial expression
- mood and affect
What are important factors in weighing people
- same way (shoes on or off/ same time of day )
- is it a normal weight
- loss weight my be explained by dieting
- gain weight is usually by over abundant caloric intake
What was discussed in class about measuring height?
-heels to the back of the wall
- making sure growth is regular in children
What is bmi
Body Mass index-maker of optimal weight for height and an indicator of obesity or protein mal nutrition
Why is Waist circumference
-where do you carry your weight
-measure waist and hips
- could a risk factor
How is temperature maintained?
-thermostat, or feedback mechanism, regulated in Hypothalamus
-balances metabolism, exercise, food digestion, external factors (heat production) with (heat loss) through sweat, radiation, convection, conduction
4 ways to take temp and what is the normal temperature for all 3 .
-rectal -99.9( last result, can't close mouth for breathing,tympanic equipment isn't available/lube and gloves)
-auxillary-97.9 (safe for infants
What is a normal heart rate and what is the name of a slow and fast heart beat?
(females have higher heart rate)
what person would have a slow heart beat
an athletes , strong heart
heart rate varies with respiratory cycle, speeding up at peak of inspiration / normal in exhalation
somewhat regular irregularity in pulse
an irregular irregular pulse
What is the trick with respiration s
count radial pulse and with out moving count respiration (30 sec.)
what is a normal blood pressure?
What are factors that can increase bp
age- rise through child through childhood
gender- female higher than males
What are internal factors that
-peripheral vascular resistance
- volume of circulating blood
- elasticity of vessel walls
What is used to measure bp
stethoscope/ aneriod sphygmomanometer
When do you need to take serial bp and pulse
-you suspect volume depletion
- person is know to have hypertension or taking anti-hypertension meds
-fainting or syncope
-supine to standing- normal decrease in bp
describe the orthostatic vital signs procedures
take baseline readings the repeat bp sitting then standing (supine then sitting, for patients too weak to stand
What differences where discussed with children and infants
you want to make sure that they are growing properly, make them as comfortable as possible, note parent child interaction
What is the difference in aging adults weight?
-weight decreases in the 80s and 90s
-more bony landmarks
-more fat in the abdomen and hips, less fat from face and periphery (fore arms)
Describe common characteristics with height in older adults
-80 to 90s and shorter than 70s
-this is a result of vertebral disk thinning /postural changes of kyphosis and slight hip flexion
Describe aging adults vital signs (temperature,pulse,respirations,Blood Pressure.
temp-less likely to have a fever but high risk for hypothermia, sweat gland activity diminished
pulse-rhythm may be slightly irregular, rigid arterial wall
respiration- decreased vital capacity, decreased inspiratory reserve volume / increased respiratory rate
BP-aorta and major arteries tend to harden with age increase in blood pressure
Explain Measurements of Oxygen Saturation. (how and why)
-pulse oximeter- for arterial oxygen saturation (SpO2)
- sensor attached to finger or earlobe
-lower saturations use earlobe.
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