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Chapter 10

Jarvis Chapter 10 Notes - Week 5 & 6.docx

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Ryerson University

Week 5 - General Survey, Measurements and Vital Signs: Pulse and Blood Pressure (BP) 1. Integrate relevant anatomy and physiology 2. Outline subjective questions and incorporate any developmental and cultural considerations into your assessment 3. Outline the components of and conduct a general survey of your partner The General Survey (Checking for abnormalities)  Physical Appearance  Age: Appears his/her stated age  Sex: Sexual development appropriate for gender & age  Level of Consciousness (LOC): Alert & oriented, attending to your questions, responding appropriately  Skin Colour: Even colour tone, pigmentation varying w/ genetic background, intact skin w/ no obvious lesions  Facial Features: Symmetrical w/ movement (fasciculation = twitch) *No Signs of acute distress.  Body Structure  Stature: Height w/in normal range for age & genetic heritage  Nutrition: Weight w/in normal range for height & body build; even distribution of body fat  Symmetry: Body parts equal bilaterally & in relative proportion to each other  Posture: Standing comfortably erect as appropriate for age; normal “plumb line” through anterior ear, shoulder, hip, patella, & ankle o (exceptions: standing toddlers who have normally protuberant abdomen [“toddler lordosis”] & older patients who may be stooped with kyphosis)  Position: Sitting comfortably in a chair/bed/examination table; arms relaxed at sides, head turned to examiner  Body Build, Contour: Normal proportions: a.) Arm span (fingertip to fingertip) = height b.) Body length from crown to pubis approximately equal to length from pubis to sole - Obvious physical deformities: note any congenital/acquired defects  Mobility  Gait: Base width = Shoulder width; accurate foot placement; smooth, even, well-balanced walk; presence of associated movements (e.g. symmetrical arm swing)  ROM: Full mobility in each joint, & deliberate, accurate, smooth, & coordinated movement o Possible Arthritis/Parkinson’s if patient can’t lift arms over head  Behaviour  Facial expression: Maintaining eye contact w/ examiner (unless cultural consideration exists, e.g. disrespectfulness), expressions appropriate to situation (e.g. thoughtful/serious/smiling: note expressions both while the face is at rest & while patient is talking)  Mood/Affect: Comfortable & cooperative w/ examiner & interacting pleasantly (e.g. involved in convo)  Speech: Clear & understandable articulation (ability to form words) o Fluent stream of talking w/ even pace; Conveying ideas clearly; Word choice appropriate to culture & education; Communicating in native language easily by self w/ interpreter  Dress: Clothing appropriate for climate, looks clean & fits body, & appropriate for culture & age group  Personal Hygiene: o Appearance: clean & groomed appropriately for patient’s age, occupation, socioeconomic group (wide variation of dress & hygiene is “normal”) o Hair: groomed, brushed 4. Identify measurement components related to height, weight, BMI  Weight  Use standardized balance or electronic standing scale o Remove shoes & heavy outer clothing before standing on scale o Record in kilograms & pounds  Compare weight w/ recommended range for height & w/ past visits o Weight Loss ~ successful dieting; short-term illness (e.g. fever, infection, disease of mouth/throat); chronic illness (endocrine disease, malignancy, mental health dysfunction) o Weight Gain ~ excess caloric intake, unhealthy eating habits, inactivity, fluid accumulation;  Obesity = weight exceeding 120% of ideal body weight  occasionally results from endocrine disorders, drug therapy (e.g. corticosteroids), depression  Height  Use wall mounted device/measuring pole on balance scale & align extended head piece w/ top of head  Shoeless & standing straight w/ gentle traction under jaw, looking straight ahead  Feet, shoulders, b
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