3 - Vital Signs Flashcards
What the pulse?
When the heart beats - it pushes blood through the aorta and peripheral vasculature and creates a pulse
This pumping action causes the blood to pound against the artery walls, creating a pressure wave with each heart beat that is felt in the periphery = ______
PULSE
Pulse can be palpated to assess for ?
heart rate, rhythm and force
What are the peripheral pulse locations?
- temporal
- carotid
- apical
- brachial
- radial
- femoral
- popliteal
- dorsalis pedis
- posterior tibial
How do you measure the radial pulse?
1) Place the pads of the 1st and 2nd fingers on the palmar surface of the patient’s wrist medial to the radius
2) Press down until pulsation is felt, but be careful not to occlude the artery
3) Count the number of beats in 30 seconds and if the beat is regular, multiply that by 2
* Avoid using a 15 second count interval
4) If the beat is irregular, count the number of beats in 1 minute
5) Record as beats/min (bpm)
Average HR for adults and elderly?
60-100 bpm
Average HR for conditioned athlete?
50-100 bpm
Average HR for 6-12 yrs ?
80-120 bpm
Average HR for 1-6 yrs ?
75 - 160 bpm
Average HR for newborn ?
70 - 170 bpm
Bradycardia
< 60
Tachycardia
> 100
Regular rhythm ?
normal and steady
Irregular rhythm ?
arrhythmia ?
What is the force/quality of one’s pulse?
-Strength of the heart’s stroke volume
-A normal pulse is easily palpated, does not fade in and out and is not easily obstructed
-Force is described by subjective 4-point scale
0 = absent
1 = weak, thready
2 = normal
3 = full or bounding
T or F: Respiratory rate is better done with the patient being aware that it’s happening.
False - done without patient knowing bc it changes as soon as someone is aware it is being done
How do you measure a respiratory rate?
1) Maintain the position for a radial pulse measurement
2) Observe the patient’s chest or abdomen for respirations
3) Count the number of respirations in 30 seconds and if he rhythm is regular, multiple this number by 2
4) If the rhythm is irregular, count the number of respirations for 1 minute
5) Record the value as respirations per minute (rpm)
Normal adult RPM
12-20 rpm
Bradypnea
< 12
Tachypnea
> 20
_____ is regulated by the hypothalamus to maintain the core temperature within a narrow range.
temperature
Normal temp range
35.8 - 37.3 degrees C
Diurnal fluctuations of ~ 1 degrees C normally occur:
____ temp in the early morning
lowest
Diurnal fluctuations of ~ 1 degrees C normally occur:
____ temp in the late afternoon to early evening
highest
________ secretion during ovulation in females causes ~0.5 degrees C rise in temp
Progesterone
What else can increase body temp?
- exercise
- smoking
- hot beverages
Older adults usually have _____ temperatures
lower (mean 36.2 degrees C)
____ have wider normal variations in temp
Children
Measuring Temp:
_____ for alert patients
Oral
Measuring Temp:
______ for confused or comatose patients, or people unable to close their mouth
Rectal
Measuring Temp:
Rectal temp is usually _________ than oral
0.5 degrees C higher
Measuring Temp:
______ for infants and small children when other routes are not accessible
Axillary (armpit)
Measuring Temp:
Axillary (armpit) is ______ than oral
0.5 degrees C lower
Measuring Temp:
______ is for unconscious patients, emergency departments or recovery units, labour and delivery units.
Tympanic (ear)
Measuring Temp:
Tympaic (ear) is _______ than oral
0.8 degrees C higher
How do you use an oral thermometer?
-Thermometer is placed under tongue (in either of the sublingual pockets) and lips are closed
What can alter an oral temperature?
- Hot or cold liquids
- Smoking
*Delay taking a temp by 10-15 mins
How do you use a rectal thermometer?
- Patient in lateral position with hips flexed
- Wear gloves, lubricate rectal, blunt-tip thermometer
- Insert thermometer 2-3 cm into rectum
- Leave in place for at least 2 mins
How do you use an axillary (armpit) thermometer?
- Place thermometer under arm into centre of axilla
- Fold patient’s arm over chest and keep in place
- Leave in place for 5 mins in children and 10 mins in adults
How do you use a tympanic (ear) thermometer?
- Place a new, disposable cover on the probe tip
- Gently pull ear up and back to straighten the ear canal
- If under 3 year old - pull ear downward and back
- Gently place probe into ear canal
- Activate thermometer, temperature will be read in 2-3 seconds
___________:
- Regulated by hypothalamus
- Set point elevated above normal
Pyrexia (fever)
_________:
- Failure of thermoregulation
- Heat production/external heat exposure > heat loss
Hyperthermia
________:
-Heat loss > heat production
Hypothermia
What can cause pyrexia (fever)?
- infection
- tissue breakdown (ex. MI)
- neurological (ex. tumor)
What can cause hyperthermia?
- heat stroke
- drugs (ex. serotonin syndrome)
- hyperthyroidism
What can cause hypothermia?
- accidental, prolonged exposure to cold
- intentional induction (ex. CV surgery)
Arterial Oxygen Saturation is measured in any clinical setting where ______ may occur or is suspected
Hypoxemia (low oxygen concentration in blood)
- respiratory conditions
- pulmonary embolism
- infection
- syncope
- postoperative stages, anesthesia/sedation
- drug overdose/toxicity
Normal range of arterial oxygen saturation?
95 - 100 % (<90% is considered low)
What can determine arterial oxygen saturation?
Can be determined by blood sampling or by pulse oximeter (noninvasive)
What is a pulse oximeter?
Detects the ratio of oxygenated hemoglobin to total hemoglobin, which is then converted into the % of O2 saturation.
Advantages of a pulse oximeter?
- rapid
- noninvasive
- simple application
Limitations of a pulse oximeter?
Accuracy requires:
- adequate BP
- absence of strong venous pulsation
- clear nails
Conditions that interfere with accuracy:
- carbon monoxide poisoning
- poor perfusion
- patient movement
