Chapter 9 - General Survey & Measurement

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Questions and Answers

Which of the following is NOT a component of the general survey?

  • Medical history (correct)
  • Behavior
  • Mobility
  • Physical appearance

It is best practice to measure a patient's weight at different times of the day and with different types of clothing to get a more accurate average.

False (B)

What two units of measure should be used to record a patient's weight?

kilograms and pounds

Unexplained weight _________ can indicate fluid retention.

<p>gain</p> Signup and view all the answers

Match the following measurements with their description:

<p>Weight = Recorded in both kilograms and pounds Height = Recorded in feet, inches, and centimeters BMI = Practical marker of healthy weight for height General Survey = Study of the whole person, health state, and characteristics</p> Signup and view all the answers

What does BMI not take into consideration?

<p>Muscle mass (C)</p> Signup and view all the answers

BMI is an effective tool for measuring healthy weight in children and older adults.

<p>False (B)</p> Signup and view all the answers

In addition to BMI, what other measurement can be used to better determine the risk of developing chronic diseases?

<p>waist circumference</p> Signup and view all the answers

What is the correct anatomical landmark to use when measuring waist circumference?

<p>The iliac crest (A)</p> Signup and view all the answers

A newborn's head circumference is typically smaller than its chest circumference.

<p>False (B)</p> Signup and view all the answers

What two measurements are used to calculate Body Mass Index (BMI)?

<p>weight and height</p> Signup and view all the answers

In older adults, body weight tends to ______ along with muscle mass.

<p>decrease</p> Signup and view all the answers

Match the following conditions with their primary characteristics:

<p>Hypopituitary Dwarfism = Growth hormone deficiency in childhood Gigantism = Overgrowth of entire body due to excessive growth hormone Achondroplastic Dwarfism = Normal trunk size with short arms and legs Acromegaly = Overgrowth of bones in face, head, hands, and feet</p> Signup and view all the answers

Which of the following best describes how to measure an infant’s body length?

<p>Using a horizontal measuring board by gently stretching the spine and legs (A)</p> Signup and view all the answers

Height and weight are not good indicators of a child's general health.

<p>False (B)</p> Signup and view all the answers

What is the term for excessive fat accumulation in the trunk of the body due to excessive cortisol?

<p>Endogenous Obesity</p> Signup and view all the answers

The chest circumference after ______ years is greater than the head circumference.

<p>2</p> Signup and view all the answers

Which of the following is a common effect of aging on height?

<p>Decreased height due to vertebral disc thinning and postural changes (D)</p> Signup and view all the answers

Flashcards

General Survey

The first encounter with a patient involving a holistic assessment of their overall health, including appearance, body structure, mobility, and behavior.

Physical Appearance

A subjective parameter that encompasses various aspects of a patient's physical presentation, including age, sex, level of consciousness, skin color, facial features, and overall appearance.

Body Structure

A subjective parameter that focuses on the patient's frame, including stature, nutritional status, symmetry, posture, position, body build, contour, and visible deformities.

Mobility

A subjective parameter that assesses a patient's movement, including gait and range of motion.

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Behavior

A subjective parameter that focuses on a patient's demeanor, including facial expression, mood, affect, speech, speech pattern, dress, and personal hygiene.

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Body Mass Index (BMI)

A numerical measure that reflects the body's weight in relation to height, used to categorize individuals as healthy weight, overweight, or obese.

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Weight Measurement

The process of measuring a patient's weight while ensuring accurate and consistent measurements.

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Height Measurement

The process of measuring a patient's height while ensuring accurate and consistent measurements.

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Waist Circumference

The measurement of the circumference of the abdomen, taken at the level of the iliac crest, with the tape measure snug and at the end of normal expiration. It is an indicator of abdominal fat, which is an independent risk factor for diseases like heart disease and type 2 diabetes.

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Hypopituitary Dwarfism

A deficiency in growth hormone during childhood, resulting in stunted growth.

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Acromegaly (Hyperpituitarism)

Excessive secretion of growth hormone by the anterior pituitary in adulthood, resulting in the overgrowth of bone in the face, hands, feet, and internal organs, but no change in height.

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Bulimia Nervosa

A mental health disorder characterized by recurrent episodes of binge eating followed by purging behaviors.

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Anorexia Nervosa

A mental health disorder characterized by severe and life-threatening weight loss in an otherwise healthy person. It is often driven by an intense fear of gaining weight and a distorted body image.

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Endogenous Obesity (Cushing Syndrome)

Excessive fat accumulation in the trunk of the body, caused by the excessive secretion of cortisol.

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Marfan Syndrome

An inherited connective tissue disorder characterized by tall, thin stature, with long fingers, hyperextensible joints, and an arm span greater than height.

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Achondroplastic Dwarfism

A genetic disorder that affects the conversion of cartilage to bone, resulting in disproportionate growth with a normal trunk size but short arms and legs.

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Gigantism

Excessive secretion of growth hormone by the anterior pituitary during childhood, leading to excessive growth in the entire body.

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Study Notes

General Survey & Measurement

  • General Survey Definition: A comprehensive assessment of the entire person, encompassing physical appearance, body structure, mobility, and behavior. It begins at the initial patient encounter and informs the health history and vital sign measurement.
  • Components of General Survey:
    • Physical Appearance: Age, sex, level of consciousness, skin color, facial features, overall appearance.
    • Body Structure: Stature, nutrition, symmetry, posture, position, body build, contour, physical deformities.
    • Mobility: Gait, range of motion.
    • Behavior: Facial expression, mood, affect, speech, speech pattern, dress, personal hygiene.
  • Sequence of Measurement: Nursing observations, health history, vital signs, then patient measurements.
  • Measurement Methods & Considerations:
    • Weight:
      • Remove shoes and heavy clothing.
      • Measure at the same time of day and in the same clothing.
      • Record in kilograms and pounds.
      • Consistency in using the same scale.
      • Unexplained changes can indicate illness.
    • Height:
      • Use wall-mounted device/measuring pole.
      • Patient must be shoeless, standing straight, with gentle traction under jaw.
      • Feet, shoulders, and buttocks touching the wall/measuring pole.
      • Record in feet, inches, and centimeters.
    • Body Mass Index (BMI):
      • Practical marker of healthy weight for height; indicates obesity/malnutrition.
      • Used to identify those at risk for health problems.
      • Shows relationship between height and weight; excludes muscle mass.
      • Less effective for children and older adults.
      • Combination with other measures (waist circumference) is beneficial.
      • Compare to previous visits.
    • Waist Circumference:
      • Important independent risk factor for diseases (heart disease, type 2 diabetes).
      • Patient stands; find iliac crest.
      • Wrap measuring tape around waist, parallel to floor, at iliac crest; snug fit.
      • Measure at end of normal expiration.

BMI Calculation

  • Imperial System: BMI = 703 x Weight (lbs) / Height (in)2
  • Metric System: BMI = Weight (kg) / Height (m)2

Developmental Considerations

  • Infants & Children:

    • General Survey: Physical appearance, body structure, mobility, behavioral response to stimuli, caregiver bond.
    • Measurements:
      • Weight: Platform scale (safety).
      • Length: Horizontal measuring board (up to age 2).
      • Height: Ruler/wall scale (standing straight).
      • Head Circumference: Newborns to 6 years. Use plastic tape, aligned with eyebrows and prominent bones.
      • Chest Circumference: Measured at nipple line (for comparison with head circumference).
    • Growth Potential: Economic, nutritional, and environmental factors.

  • Aging Adults:

    • General Survey: Physical appearance, posture, gait.
    • Weight: Decreased weight, muscle loss, fat redistribution (abdomen/hips).
    • Height: Shorter stature due to vertebral disc thinning, kyphosis, flexion.

Abnormal Findings (Body Height/Proportion)

  • Hypopituitary Dwarfism: Growth hormone deficiency (childhood retardation).
  • Gigantism: Excessive growth hormone (anterior pituitary).
  • Achondroplastic Dwarfism: Genetic disorder (cartilage-to-bone conversion) - Short arms/legs.
  • Acromegaly (Hyperpituitarism): Excessive growth hormone (adulthood overgrowth of face, head, hands, feet).
  • Bulimia Nervosa: Binge eating, purging.
  • Anorexia Nervosa: Severe weight loss.
  • Endogenous Obesity (Cushing Syndrome): Fat accumulation (trunk).
  • Marfan Syndrome: Connective tissue disorder (tall, thin stature; long fingers; hyperextensible joints; arm span exceeding height).

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