Ch.9: General Survey, Measurement, and Vital Signs

Question 1

a study of the whole person, covering the general health state & any obvious physical characteristics. An introduction for the physical health examination

Answer 1

General Survey

Question 2

The General Survey includes four objective parameters

Answer 2

PHYSICAL APPEARANCE (age, sex, level of consciousness, skin color, facial features, overall appearance)
BODY STRUCTURE ( stature, nutrition, symmetry, posture, position, body-build contour)
MOBILITY(gait and range of motion)
BEHAVIOR( facial expression, mood & effect, speech, dress, personal hygiene)

Question 3

A healthy BMI is a level of

Answer 3

19 or greater to less than 25

Calculate BMI: weight (pounds)/ height (inches) x 703

Question 4

NORMAL ORAL TEMPERATURE:

Answer 4

98.6 F (37 C) between the range of 96.4 -99.1 (37.3-37.3)

Question 5

normal temperature is influenced by

Answer 5

diurnal cycle, menstruation, exercise, age

Question 6

What is the most convenient and accurate site? and Why?

Answer 6

ORAL TEMPERATURE. the sublingual pocket has a rich blood supply from the carotid arteries

Question 7

Rectal temperature

Answer 7

most accurate route; most invasive
used mostly for children 6-36 months old
preferred route when other routes are not practical

Question 8

Tympanic Membrane Temperature:

Answer 8

senses infrared emissions of the tympanic membrane (no use for critically ill patients)
eardrum

Question 9

temporal artery thermometer:

Answer 9

uses infrared emissions from the temporal artery

slides the probe across the forehead and behind the ears

Question 10

Stroke volume:

Answer 10

with every beat the heart pumps an amount of blood

70 mL in adult

Question 11

Pulse:

Answer 11

feel for the radial pulse with 2-3 fingers
count the number for 30 seconds then multiply by 2. start the count with zero
if abnormal then count for a full minute

Question 12

Asses the pulse including

Answer 12

rate: NORMAL RATE= 50-95 ppm
rhythm: regular even tempo
force: shows the strength of the heart, three point scale ( 2+ normal)

Question 13

Bradycardia

Answer 13

X < 50 bpm

Question 14

Tachycardia

Answer 14

X> 95 bpm

Question 15

Irregularity in heart rhythm most common in children and young adults. The heart rate varies with the respiration cycle, speeding up at the peak of inspiration and slowing to normal with expiration.

Answer 15

sinus arrhythmia

Question 16

Respiration:

Answer 16

do not tell them your counting the respirations

NORMAL RANGE: 10-20 breaths per minute (adult)

Question 17

the maximum pressure felt on the artery during ventricular contraction.

Answer 17

systolic pressure

Question 18

the elastic, recoil or resting, pressure that the blood exerts constantly between each contraction

Answer 18

diastolic pressure

Question 19

the difference between the systolic and diastolic pressures and reflects the stroke volume

Answer 19

pulse pressure

Question 20

is the pressure forcing blood into the tissues averaged over the cardiac cycle. it is a value close to diastolic pressure plus one on third the pulse pressure

Answer 20

mean arterial pressure (MAP)

Question 21

the average Bp in the young adult varies with many factors including

Answer 21

age
sex
race
diurnal rhythm
weight
exercise
emotions
stress

Question 22

The level of BP is determined by five factors:

Answer 22

cardiac output ( more blood= pressure increase)
peripheral vascular resistance ( direct relationship)
volume of circulating blood (direct relationship)
viscosity (thickness, direct)
elasticity of vessel walls (stiff and rigid=increase)

Question 23

The cuff size is important because

Answer 23

using a cuff that is too narrow yields a falsely high BP, because it takes extra pressure to compress the artery

Question 24

abnormally low BP

Answer 24

hypotension less than normal range (120/80)

Question 25

abnormally high BP

Answer 25

hypertension Systole:140-159 Diastole: 90-99

Question 26

take serial measurement of pulse and BP when

Answer 26

suspect volume depletion
hypertension/hypertensive medications
reports of fainting or syncope

( supine, seating, standing BP & pulse)

Question 27

Thigh pressure

Answer 27

check for coarctation of the aorta (congenital form of narrowing) when the arm pressure is too high. NORMALLY THE THIGH PRESSURE IS HIGHER THAN IN THE ARM.

Question 28

Normal range of BP

Answer 28

systole: <120
Diastole: <80

Question 29

prehypertension:

Answer 29

systole: 120-139
Diastole: 80-89

Question 30

Blood pressure is measured with

Answer 30

stethoscope and sphygmomanometer

Question 31

normal O2 range

Answer 31

97-99

Question 32

Older adult vitals:

Answer 32

Temp: less likely to have fever, more at risk for hypothermia
pulse: 50-95 beats/min
Respiration: shallow breaths, and increase rate
BP: arteries tend to Harden, increase in systole. widened pulse pressure. BP INCREASE

Question 33

noninvasive method to assess arterial oxygen saturation

Answer 33

pulse oximeter