Problem
General Survey Form Objective: Conduct a General survey on a Lauren who's a female eating at McDonals. The purpose of this interaction is observation only.
I. Physical Appearance/Hygiene: i. General appearance: ii. Gender iii. Apparent age iv Ethnic group v. Appears overall healthy vi. Well-groomed or disheveled (Note the general color of skin and hygiene)
II. Body Structure and Movement (Observe general stature): i) Height appropriate for apparent age. ii)Appears well nourished iii) Weight suitable for the height iv) Position or posture (comfortable and relaxed) v. Obvious deformities vi). Walks with ease vii) Gait balanced and smooth viii) Limitations to range of motion. ix) Involuntary movements. x) Using assistive devices
III. Emotional/Mental Status and Behavior:Level of alertness Appear well rested or tired Converse appropriately Behavior appropriate for the situation Dress suitable for the weather
IV. Document observations with detailed responses in a narrative format. For example, if a client appears tired provide a description adequate for the reader to visualize the client,"Client is alert and appears tired, slumped in a chair with eyes half closed."
V. Describe two actual or potential risk factors for the client based on the assessment findings with description or reason for selection of them.