General Survey, Measurement, Vital SignsGeneral SurveyObjective DataSlide 4Slide 5Slide 6Slide 7Slide 8Slide 9Slide 10Slide 11Slide 12Slide 13Slide 14Slide 15Slide 16Slide 17Slide 18Slide 19Slide 20Slide 21Slide 22PulseSlide 24Slide 25Peripheral Pulse Sites:Slide 27Slide 28Slide 29Slide 30Slide 31Slide 32Slide 33Factors controlling blood pressureSlide 35Slide 36BP Sounds - Korotkoff Sounds See Table 9-3 in JarvisMeasuring arm pressureSlide 39Slide 40Slide 41Objective Data Developmental CompetenceSlide 43Slide 44Slide 45Slide 46Slide 47Slide 48Slide 49Slide 50Slide 51Slide 52Slide 53Slide 54Slide 55Slide 56Slide 57Slide 58Slide 59Slide 60Slide 61Sample chartingAbnormal Findings: In Body Height and ProportionAbnormal Findings: Abnormalities in Blood PressureElsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. General Survey, General Survey, Measurement, Vital SignsMeasurement, Vital SignsChapter 9Chapter 9Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 9: General Survey, Measurement, Vital SignsChapter 9: General Survey, Measurement, Vital SignsGeneral SurveyGeneral SurveyThe general survey is a study of whole The general survey is a study of whole personpersonCovers general health state and any obvious Covers general health state and any obvious physical characteristicsphysical characteristicsLaunch a general survey at moment you first Launch a general survey at moment you first encounter personencounter personWhat leaves an immediate impression? Does What leaves an immediate impression? Does person stand promptly as his or her name called person stand promptly as his or her name called and walk easily to meet you? and walk easily to meet you? Slide 9-2Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 9: General Survey, Measurement, Vital SignsChapter 9: General Survey, Measurement, Vital SignsObjective DataObjective DataPhysical appearancePhysical appearanceAge: person appears his or her stated ageAge: person appears his or her stated ageSex: sexual development appropriate for gender Sex: sexual development appropriate for gender and ageand ageLevel of consciousness: person alert and oriented, Level of consciousness: person alert and oriented, attends to your questions and responds attends to your questions and responds appropriatelyappropriatelySkin color: color tone even, pigmentation varying Skin color: color tone even, pigmentation varying with genetic background, skin intact with no with genetic background, skin intact with no obvious lesionsobvious lesionsSlide 9-3Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 9: General Survey, Measurement, Vital SignsChapter 9: General Survey, Measurement, Vital SignsObjective DataObjective DataBody structureBody structureStature: height appears within normal range for Stature: height appears within normal range for age, genetic heritageage, genetic heritageNutrition: weight appears within normal range for Nutrition: weight appears within normal range for height and body build; body fat distribution evenheight and body build; body fat distribution evenSymmetry: body parts look equal bilaterally and Symmetry: body parts look equal bilaterally and are in relative proportionare in relative proportionPosture: person stands comfortably erect as Posture: person stands comfortably erect as appropriate for ageappropriate for age•Note normal “plumb line” through anterior ear, shoulder, Note normal “plumb line” through anterior ear, shoulder, hip, patella, anklehip, patella, ankleSlide 9-4Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 9: General Survey, Measurement, Vital SignsChapter 9: General Survey, Measurement, Vital SignsSlide 23-5Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 9: General Survey, Measurement, Vital SignsChapter 9: General Survey, Measurement, Vital SignsObjective DataObjective DataBody structure (cont.)Body structure (cont.) Position: person sits comfortably in chair or on bed Position: person sits comfortably in chair or on bed or examining table, arms relaxed at sides, head or examining table, arms relaxed at sides, head turned to examinerturned to examinerBody build, contour: proportions are correctBody build, contour: proportions are correctObvious physical deformities: note any congenital or Obvious physical deformities: note any congenital or acquired defectsacquired defectsSlide 9-6Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 9: General Survey, Measurement, Vital SignsChapter 9: General Survey, Measurement, Vital SignsObjective DataObjective DataMobilityMobilityGait: normally, base is as wide as shoulder width Gait: normally, base is as wide as shoulder width •Foot placement: accurate; walk smooth, even, and well-Foot placement: accurate; walk smooth, even, and well-balanced; and associated movements, such as balanced; and associated movements, such as symmetric arm swing, are present symmetric arm swing, are present •Range of motion (ROM): note full mobility for each joint, Range of motion (ROM): note full mobility for each joint, and that movement is deliberate, accurate, smooth, and and that movement is deliberate, accurate, smooth, and coordinatedcoordinated•No involuntary movementNo involuntary movementSlide 9-7Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 9: General Survey, Measurement, Vital SignsChapter 9: General Survey, Measurement, Vital SignsObjective DataObjective DataBehaviorBehaviorFacial expression: person maintains eye contact Facial expression: person maintains eye contact (unless a cultural taboo exists), expressions (unless a cultural taboo exists), expressions appropriate to situation, e.g., thoughtful, serious, appropriate to situation, e.g., thoughtful, serious, or smilingor smilingMood and affect: person comfortable and Mood and affect: person comfortable and cooperative with examiner and interacts pleasantlycooperative with examiner and