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Adult Health Assesment
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Chapter 9 General Survey and Measurements
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Chapter 9 General Survey and Measurements

📋General Survey and Measurements

General Survey Characteristics

👤 The General Survey is a Study of the whole person

  • 🩺 Covers general health state & obvious physical characteristics
  • 👀 Provides an overall impression
  • 📊 Includes objective parameters that apply to the whole body, not just one system
  • 🤝 Even while introducing yourself and shaking hands → you are collecting data
  • 📝 During health history, vitals, and measurements → note these 4 areas:
    1. 👤 Physical appearance
    2. 🏗 Body structure
    3. 🚶 Mobility
    4. 🎭 Behavior

🧾 Objective Data: Physical Appearance

  • 🎂 Age: Appears stated age
  • ⚧ Sex: Sexual development appropriate for age/gender
  • 🎨 Skin color: Even tone; intact; consistent with genetic background
  • 👀 Overall appearance: General statement of distress (present/absent)
  • 🧠 Level of consciousness: Alert & oriented (person, place, time); responds appropriately
  • 🙂 Facial features: Symmetrical with movement

🏗 Objective Data: Body Structure

  • 📏 Stature: Height within normal range for age & heritage
  • ⚖️ Nutrition: Weight normal for height/build; even fat distribution
  • 🔄 Symmetry: Body parts equal bilaterally & proportional
  • 🧍 Posture: Stands comfortably erect (age-appropriate)
  • 🪑 Position: Comfortable sitting; arms relaxed; head turned to examiner

🚶 Objective Data: Mobility

  • 👣 Gait: Base as wide as shoulders
  • 🦶 Foot placement: Accurate, smooth, even, balanced; symmetric arm swing
  • 🤸 Range of motion: Full mobility, deliberate, accurate, smooth, coordinated
  • ❌ Involuntary movement: None present

🎭 Objective Data: Behavior

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🙂 Facial Expression:
  • Maintains eye contact (unless culturally inappropriate)
  • Expressions match situation → thoughtful, serious, smiling
  • Observe at rest and while talking
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😀 Mood & Affect:
  • Comfortable, cooperative with examiner
  • Interacts pleasantly
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🗣 Speech:
  • Clear & understandable articulation
  • Fluent, even pace
  • Conveys ideas clearly
  • Word choice fits culture & education
  • Communicates easily (with or without interpreter)
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👗 Dress:
  • Climate-appropriate, clean, fits body
  • Matches culture & age group
  • Examples: Amish → traditional 19th century clothing; Indian women → saris
  • Cultural dress should not be judged as bizarre
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🧼 Personal Hygiene:
  • Clean, groomed appropriately for age, job, socioeconomic group
  • Cultural variations (e.g., no deodorant, women not shaving legs)
  • Hair groomed, makeup appropriate for age & culture

⚖️ Objective Data: Measurements

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🏋️ Weight
  • Use a standardized balance or electronic standing scale.
  • Ask patient to remove shoes & heavy outer clothing.
  • For repeated weights → keep same time of day & similar clothing.
  • Record in kg + lbs.
  • Show patient how their weight compares to recommended range.
  • Compare to previous visits:
    • 📉 Weight loss → may indicate dieting success.
    • 📈 Weight gain → often due to excess calories, poor habits, sedentary lifestyle.
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📏 Height
  • Use wall-mounted device or measuring pole on balance scale.
  • Align headpiece with top of head.
  • Patient shoeless, standing straight, looking forward.
  • Feet, shoulders, buttocks should touch the wall/pole.
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🧮 Body Mass Index (BMI)
  • Practical marker of healthy weight for height.
  • Indicates risk of obesity or malnutrition.
image
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📐 Waist & Hip Circumference
  • Assesses fat distribution → indicator of health risk.
  • ⚠️ Excess abdominal fat = independent risk factor for heart disease & type 2 diabetes.
  • Waist circumference → measure at smallest circumference (below rib cage, above iliac crest).
  • Hip circumference → measure at largest buttock circumference.
  • Take measurement at end of normal expiration.

👵 Developmental Competence (Aging Adults)

  • 🧍 Posture & Gait: Normal age-related changes may alter posture and walking style.
  • ⚖️ Measurements: Weight and height decrease are common with age (bone loss, muscle changes, spinal compression).

⚠️ Abnormalities in Body Weight & Proportion

👶 Dwarfism

  • Hypopituitary dwarfism → (Non-genetic) Deficiency of growth hormone → short stature, delayed puberty.
  • Achondroplastic dwarfism → Genetic disorder affecting bone growth → short limbs, normal trunk.

📏 Gigantism vs Acromegaly (Hyperpituitarism)

  • Gigantism → Excess growth hormone in childhood → abnormal tallness.
  • Acromegaly → Excess growth hormone in adulthood → enlarged bones of face, hands, feet.

🍽 Anorexia Nervosa

  • Psychiatric disorder → severe weight loss, malnutrition, body image distortion.

🧬 Endogenous Obesity (Cushing’s Syndrome)

  • Excess cortisol → central obesity, moon face, buffalo hump, thin limbs.

🦴 Marfan Syndrome

  • Genetic connective tissue disorder → tall stature, long arms/legs/fingers, cardiac complications.