GENERAL SURVEY

Mrs. Lalaine Jean D. Lorente, RN, MAN

General survey:
> It provides information of general
appearance and behavior, vital signs, height
and weight measurements, hygiene, body image,
emotional state and development.

> assessment begins when the nurse first

meets the client

> the nurse will determine the reason the

client is seeking health care.
purpose:
1.To collect subjective data of the client’s
health.
2.To use collected data as a basis to help
assess client’s general health.
3.To differentiate expected versus unexpected
findings in the physical assessment.
What to do?
> Knowledgeable of the norms or unexpected findings

> Identify client and introduce self

> Provide for client privacy and explain the

procedure.

> Perform hand hygiene and adhere to standard

precautions

> Ensure safety by providing adequate space in the

room and good lighting and a place for the client to
iNFANTS AND YOUNG CHILDREN
> Observe the interaction between child and parent or adult.

> Note any disturbances with the parent or adult interaction

with the child.

> For infants or young children, watch the overall movement

and “tone” of the body.

> Older children should demonstrate movement and development

according to age parameters.
PREGNANT WOMEN
> As the woman enters the room, note any specific discomfort
or difficulty with ambulation.

> Note shortness of breath and overall affect of body

movement and comfort

> Weight gain and changes in body posture and comfort with
movement may be some of the obvious signs of pregnancy over
time
Physical appearance
Age – the person appears his or her
stated age
Sex – sexual development is
appropriate for gender and age.
Appears older than stated age, as
with chronic illness, chronic
alcoholism.
Delayed or precocious puberty.

Level of Consciousness – the person Confused, drowsy, lethargic

is alert and oriented, attends to
your questions and responds
appropriately
Physical appearance
Skin Color – color tone is even,
pallor, cyanosis, jaundice,
pigmentation varying with genetic
erythema, any lesions
background, skin is intact with no
obvious lesions

Facial Features – facial features Immobile, masklike, asymmetric,

are symmetric with environment drooping

*No signs of acute distress are

present.
Body Structure:
Stature – the height appears within Excessively short or tall
normal range for age, genetic
heritage

Nutrition - the weight appears Cachectic, emaciated Simple

within normal range for height and
body fat distribution is even
Symmetry – body parts look equal
bilaterally and are in relative
proportion to each other
obesity, with even fat
distribution– fat concentrated in
face, neck, trunk, with thin
extremities, as in Cushing’s
syndrome (hyperadrenalism) of a
body part
Posture and Position
the person stand comfortably erect Rigid spine and neck; moves as one
at appropriate for age unit, e.g., arthritis

the person sits comfortably in a Stiff and tense, ready to spring

chair or on the bed or examination from chair, fidgety movements
table, arms relax at sides, head Shoulders slumped; looks deflated,
turned to examiner e.g., depression
Body Structure:
Posture – the person stand comfortably
erect at appropriate for age
Position – the person sits comfortably in
a chair or on the bed or examination
table, arms relax at sides, head turned
to examiner
Body build, contour – proportions are
1. Arm span (fingertip to fingertip)
equals height
2. Body length from crown to pubis
roughly equal to length form pubis to
sole
Obvious physical deformities – note any
congenital or acquired defects
Rigid spine and neck; moves as one unit,
e.g., arthritis
Stiff and tense, ready to spring from
chair, fidgety movements Shoulders
slumped; looks deflated, e.g., depression
Tripod – leaning forward with arms braced
on chair arms, occurs with chronic
pulmonary disease Sitting straight up and
resists lying down, e.g., congestive
heart disease Curled up in fetal
position, e.g., acute abdominal pain
Elongated arm span, arm span; webbed
digits; shortened limb
Mobility
Gait – normally, the base is as
wide as the shoulder width; foot
placement is accurate; the walk is
smooth, even and well-balanced; and
associated movements, such as
symmetric arm swing, are present.
Range of Motion – note full
mobility for each joint, and that
movement is deliberate, accurate,
smooth, and coordinated.
No involuntary movement.
Exceptionally wide base. Staggered,
stumbling Shuffling, dragging,
nonfunctional leg. Limping with
injury Propulsion – difficulty
stopping.
Limited joint range of motion
Paralysis – absent movement
Movement jerky, uncoordinated
Tic, tremors, seizure
behavior
Facial Expression – the person maintains Flat, depressed, angry, sad, anxious
eye contact (unless a cultural taboo However, note that anxiety is common in
exists), expressions are appropriate to ill people. Also, some people smile when
the situation, e.g., thoughtful, serious they are anxious
or smiling(Note expressions both while
the face is ate rest and while the person
is talking)
Hostile, distrustful, suspicious, crying
Mood and affect – the person is
comfortable and cooperative with the
examiner and interacts pleasantly
Dysarthria ad dysphagia Speech defect,
Speech – articulation (the ability to monotone, garbled speech
form words) is clear and understandable
 Dress – clothing is appropriate to
the climate, looks clean, and fits
the body, and is appropriate to the
person’s culture and age group; for
example, normally, Amish women wear
clothing from the nineteenth
century, Indian women may wear
saris. Culturally determined dress
should not be labeled as bizarre by
Western standards
Trousers too large and held up by
belt suggest weight loss, as does
the addition of new holes in belt.
If the belt is moved to a looser
fit, it may indicate ascites or
obesity. Consistent wear of certain
clothing may provide clues; long
sleeves may conceal needle marks of
drug abuse; broad-brimmed hats may
eners of buttons may indicate
chronic motor dysfunction
Personal hygiene – the person appears clean and groomed
appropriately for his or her age, occupation, and
socioeconomic group. (Note that a wide variation of dress and
hygiene is “normal”. Many cultures do not include use of
deodorant or women shaving legs. Hair is groomed, brushed.
Women’s make-up is appropriate for age and culture.