Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Integ Final > Adult Vital Sign Interpretation > Flashcards

Adult Vital Sign Interpretation Flashcards

1
Q

Vital Sign Introduction

A

Detect and monitor physiologic states and assess activity responses to aid in exercise

Aids in determining patient risk for adverse events -> cardiovascular episodes and

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Compared to outpatient settings, hospitalized patients present more often with:

A

abnormal VS and are at a higher risk of immediate events requiring acute care physical therapists to assess and monitor VS with greater frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

vital signs =

A

pulse rate (PR)
respiratory rate (RR) temperature
blood pressure (BP)
tissue oxygenation (SpO2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Physical therapists should correlate current VS values with other data points such as:

A

symptoms
baseline VS
medication schedule
lab values
comorbidities

when making decisions about patient care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

blood pressure =

A

cardiac output (CO) x total peripheral resistance (TPR)

systolic/diastolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CO =

A

stroke volume (SV) x heart rate (HR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

normal bp

A

<120/ <80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

high-normal/elevated/pre-hypertensive bp

A

120-129 / <80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

stage 1 hypertension

A

130-139 / 80-90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

stage 2 hypertension

A

> 140 / >90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

hypertensive crisis =

A

> 180 / >120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hypotension:

A

< 80 mmHg SBP
< 60 mmHg DBP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mean Arterial Pressure (MAP):

A

Average pressure of the blood in the arteries during a cardiac cycle; can serve as an indicator of perfusion to vital organs

MAP = [SBP + (2 x DBP)]/36

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Normal MAP:

A

70 - 110 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MAP < 60 mmHg can result in

A

↓ perfusion of vital organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Consult with the medical team if MAP ___ to determine appropriateness of activity

A

< 65 mmHg

Low values can be a sign of stroke, internal bleeding, sepsis

High values can be a sign of kidney failure, heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pulse Pressure (PP) =

A

SBP - DBP

Normal PP range: 40 - 60 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

PP outside of the normal range is a significant factor in the development of heart disease

A

Low or “narrowed” (< 25% SBP) -> sign of heart failure (HF) (low SV), aortic valve stenosis, blood loss

Chronic elevation (> 59 mmHg) can be a sign of arterial resistance, HF, ↑ SBP, aging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Assess for BP trends as normal fluctuations occur:

A

nocturnal or postprandial dipping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

SBP ↑ with ___ and ↓ with ___

A

hypervolemia

hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Nocturnal Dipping

A

normal physiological drop in BP at night, typically by 10-20% of daytime values

Lack of nocturnal dipping can occur in conditions such as hypertension, diabetes, and obstructive sleep apnea (OSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Postprandial Dipping

A

Postprandial hypotension occurs when BP drops significantly (≥20 mmHg) within 1-2 hours after eating, as the body diverts blood to the digestive system

Take BP readings immediately before a meal and then at 30-minute intervals up to 2 hours post-meal

more common in elderly patients, those with autonomic dysfunction, or individuals with conditions like Parkinson’s disease or diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Monitor BP post PT intervention until ___

A

returns to baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hypertension (HTN) -> generally asymptomatic =

A

symptoms should not drive the need for VS assessment

Monitor for the following symptoms: headaches; visual impairments; confusion; pounding in chest, neck, or ears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Cardiovascular risk ↓ with ___

A

↓ BP

but dosage amounts of antihypertensive medications may be associated with ↑ adverse effects, including ↑ fall risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Hypotension potential causes:

A

Parasympathetic stimulation, hyperkalemia, hypokalemia, hypocalcemia, anoxia, acidosis,
hypovolemia, bedrest

Cardiac dysrhythmia

Medications

Adrenal insufficiency

Valsalva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Valsalva To prevent:

A

ask the patient to breathe rhythmically, count, or talk during PT intervention

Monitor for the following symptoms:
- lightheadedness/dizziness
- nausea
- breathlessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Orthostatic (postural) hypotension:

A

↓ SBP > 20 mmHg or ↓ DBP > 10 mmHg on standing within three minutes

Monitor for the following symptoms:
- lightheadedness
- diaphoresis
- dizziness
- confusion
- blurred vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Treatment of HTN to ↓ SBP to < 140 mmHg can ____

A

↓ the development of cognitive impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hypotension (< 120/75 mmHg) -> associated with ___ in older adults

A

↓ cognitive function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Orthostatic hypotension = more prevalent in people with ___

A

dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Cerebral hypoperfusion = associated with cognitive impairment in a study of adults ___

A

≥ 50 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Heart Rate (HR) & Pulse Rate (PR)
Normal resting rate:

A

60 - 100 beats/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Tachycardia:

A

> 100 beats/min

Relative tachycardia: ↑ resting PR > 20 beats/min from baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Bradycardia:

A

< 60 beats/min

Relative bradycardia: ↓ resting PR > 20 beats/min from baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

↑ resting HR is associated with ___

A

risk of all-cause and cardiovascular mortality

Older&raquo_space;> younger adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Pulse Rate (PR):

A

pulses palpated at an artery or measured by pulse oximetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Pulse Grade & Descriptions:

A

Absent (0) = No perceptible pulse

Thread (1+) = Barely perceptible, easily obliterated with slight pressure

Weak (2+) = Difficult to palpate, slightly stronger than thread, can be obliterated with light pressure

Normal (3+) = Easy to palpate, requires moderate pressure to obliterate

Bounding (4+) = Very strong, hyperactive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Normal response with exercise:

A

↑ 10 beats/min per MET then returns to pre-exercise level in 3-5 minutes

Borg Rating of Perceived Exertion (RPE) Scale and Breathlessness Scale -> additional measurement tools

40
Q

Electrolyte imbalances can ↑ risk of dysrhythmias =

A

magnesium, potassium, calcium, sodium

41
Q

Abnormal rhythms have a negative impact on CO ->

A

symptoms such as hypotension, weakness, fatigue, dizziness, syncope, diaphoresis, and mental confusion

42
Q

If patient’s pulse is irregularly irregular or regularly irregular ->

A

auscultate apical HR for at least 60 seconds

43
Q

Determine if resting dysrhythmia is clinically/hemodynamically significant (↓ CO) to decide if PT intervention is appropriate:

A

If PT is determined to be appropriate, then it is important to analyze the impact of the intervention on the patient’s dysrhythmia

If the dysrhythmia is worsening and/or symptoms of compromised CO are occurring or ↑ -> ↓ the exercise workload or stop the intervention depending on the magnitude of the change

44
Q

Respiratory Rate (RR)
Normal resting rate (Eupnea):

A

12 - 18 breaths/min with equal rate and depth

45
Q

Bradypnea:

A

< 10 breaths/min

Potential causes: opioids; hypothyroidism; brain disorders

46
Q

Tachypnea:

A

> 24 breaths/min (usually shallow)

Potential causes: pain; emotion; fever; metabolic disorders; ↓ elasticity of lungs (emphysema); resistance to air passages (asthma); hypoxemia; hypercapnia; ↓ tidal volume; an abnormally low blood pH (acidosis)

47
Q

For individual’s RR = 45 breaths/min use ___; if RR = ___ breaths/min no exercise

A

caution

50

48
Q

Blood Oxygen Saturation (SpO2)
Normal:

A

> 95%

49
Q

Blood Oxygen Saturation (SpO2)

Below average for population:

A

91 - 94%

50
Q

Blood Oxygen Saturation (SpO2)
Clinical Considerations:

A

SpO2 = peripherally measured O2 saturation via pulse oximetry = good indicator of SaO2

Low SpO2 = ↓ O2 delivery to the peripheral tissue

Document if patient is on room air or the amount of supplemental O2, the O2 delivery device, and conditions under which measurement is taken

Monitor for the following S/S of hypoxemia -> confusion, wheezing, changes in HR, diaphoresis, clubbing, changes in nail bed color

51
Q

___ have the least accuracy compared to other monitors

A

Fingertip monitors

52
Q

Inaccurate readings increase with ____

A

darker skin

movement

damage to nail bed or nail polish

blisters

poor perfusion

53
Q

Individuals with type 2 diabetes with glycated hemoglobin (HbA1c) ___ may result in a falsely high reading

A

> 7%

54
Q

Normal temperatures:

A

core body = 35.5 - 37.5°C (95.9 - 99.5°F)

Oral = 37°C (98.6°F)

Axillary = 36.45°C (97.6°F)

Rectal = 0.27°- 0.38°C (0.5°- 0.7°F) > oral temperature

55
Q

Hypothermia: Rectal temperature of ___

A

< 35°C (95°F)

56
Q

Hyperthermia (febrile): Oral: ____; Rectal: ____

A

> 37.5°C (99.5°F)> 38°C (100.5°F)

57
Q

Exercise and heavy exertion may ↑ the core temperature ____

A

1 - 1.5°C (2 - 3°F)

58
Q

Any change of temperature high or low can be a sign of ___

A

sepsis

59
Q

In the older adults, ___ may be the first sign of an infection instead of ____

A

confusion

temperature change

60
Q

Intensive Care Unit (ICU)

Multiple factors influence VS ->

A

medical diagnosis, medical stability, laboratory values, blood chemistry, and pharmacologic interventions

61
Q

____ and ___ of the brain and vital organs are paramount in the VS hierarchy

A

Tissue oxygenation
perfusion

62
Q

_____ = major predictors of ICU mortality

A

Mean arterial pressure (MAP), RR, PR, body temperature, tissue oxygenation, blood pH, and serum chemistry are primary VS determinants of patient stability

63
Q

Utilized in outcome measures -> APACHE II (Acute Physiology and Chronic Health Evaluation II)

A

Body temperature
Mean arterial pressure (MAP)
Heart rate (HR)
Respiratory rate (RR)
Oxygenation (PaO2, FiO2)
Serum levels (sodium, potassium, creatinine, etc.)
Hematocrit, white blood cell count, and Glasgow Coma Scale (GCS)

64
Q

The key for effective and safe PT management of patients in ICU is:

A

to have patient-centered goals and strong
interdisciplinary collaboration

65
Q

Important:

A

discussions about VS with the ICU team and appropriate orders addressing VS ranges are specified

66
Q

PT provider is expected to communicate to ICU team any deviation from the prescribed ranges during the PT intervention:

A

Due to the high medical complexity of these patients, documentation should indicate a close and continuous monitoring of VS throughout the PT intervention

67
Q

Minimum PT documentation for VS in the ICU is:

A

Specific amount of supplemental O2 and/or circulatory support VS at rest, with position change, peak exercise/activity, and cool-down/recovery values

68
Q

Perfusion

A

Indicates the delivery of blood to vital organs/tissues

measured indirectly (Liters/min - L/ min)

69
Q

Normal adult resting CO:

A

4.0 - 8.0 L/min

70
Q

Cardiac Index (CI)

A

Parameter that relates the cardiac output (CO) from left ventricle in one minute to body surface
area -> relating heart performance to the size of the individual

71
Q

Normal CI:

A

2.5 - 4.0 L/min/m2

72
Q

MAP

A

is average pressure during a single cycle

MAP is largely based on DBP because most of the cardiac cycle is spent in diastole

Normal MAP: 70 - 110 mmHg

73
Q

Consult with the medical team if MAP < ___ to determine appropriateness of activity

A

65 mmHg

74
Q

BP manual readings are more accurate than electronic cuff ->

A

however, the electronic cuffs are used in the ICU
because they can be cycled/ recorded automatically at set time intervals

75
Q

Pulmonary artery pressure (PAP) =

A

reflects the amount of force your heart is exerting
to pump blood from your heart to your lungs

Increase in PAP = increase work rate of the right side of the heart

76
Q

Pulmonary artery systolic pressure (PASP):

A

15 - 25 mmHg

77
Q

Pulmonary artery diastolic pressure (PADP):

A

8 - 15 mmHg

78
Q

Mean pulmonary artery pressure (MPAP):

A

10 - 20 mmHg

79
Q

Intracranial Pressure (ICP):

A

the pressure exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue

80
Q

Normal ICP:

A

5 - 15 mmHg (acceptable levels as high as 22 mmHg; discuss with medical team)

↑ ICP is indicator of excessive compression on the brain = can lead to cerebral ischemia and herniation

81
Q

Normal SpO2 and SaO2:

A

95 - 100%

82
Q

Normal SvO2:

A

65 - 75%

83
Q

SpO2 =

A

peripherally measured O2 saturation via pulse oximetry

84
Q

SaO2 =

A

oxyhemoglobin saturation measured via arterial blood gas (ABG)

85
Q

SvO2 =

A

mixed venous O2 saturation and indirect measure of peripheral O2 extraction

86
Q

Normal Partial Pressure of O2 (PaO2)

A

80 - 100 mmHg

87
Q

Continuous Renal Replacement
Therapy (CRRT) =

A

commonly used to provide renal support for critically ill patients with acute kidney injury, particularly patients who are hemodynamically unstable

88
Q

ICU Support Devices & Effect on VS: CRRT

Clinical Considerations

A

Monitor for hypotension

PT providers should work within MAP
parameters as prolonged duration of
MAP < 73 mmHg can accelerate the
progression of acute kidney injury

89
Q

Extracorporeal Membrane Oxygenation (ECMO)

Advanced form of life support -

A

targeted at the heart and lungs

may be indicated in cases of acute severe cardiac or pulmonary failure that is both potentially reversible and unresponsive to conventional management

90
Q

For VV ECMO patients -> A saturation ___ is sufficient

A

in the low 90s

91
Q

Patients may require additional mechanical ventilation or ECMO support to perform PT intervention due to:

A

↑ CO, O2 consumption and CO2 production during the physical activity

92
Q

Intra-Aortic Balloon Pump (IABP):

A

IABP is a mechanical device that increases myocardial oxygen perfusion and indirectly increases cardiac output

Placed in the aorta = A balloon inflates and deflates via counter pulsation, meaning it actively deflates in systole and inflates in diastole

93
Q

Positive Pressure Ventilation (Invasive & Non-
invasive): Clinical Consideration

A

Continuous VS monitoring for patients on mechanical
ventilation is imperative during PT intervention to
ensure patient safety

PT provider might consider pre-hyperoxygenation
prior to suctioning to avoid O2 desaturation

94
Q

MAP should be maintained between ___ during exercise

A

70 - 90 mmHg

95
Q

Gold standard for measuring HR and rhythm is ___

A

ECG

96
Q

Arterial blood gas measurement is the gold standard ->

A

only gives one snapshot in time

97
Q

Parameters regarding safe and effective exercise include =

A

Borg RPE Scale of no > 13/20 without onset of signs and symptoms of angina

Electrocardiogram (ECG) changes including ST shifts no > 1 mm and/or no ↑ ventricular arrhythmias,

Dyspnea no > 5/10

MAP maintained between 70 - 90 mmHg

LVAD flow remains above 3 L/min

98
Q

Sepsis =

A

Defined as a life-threatening organ dysfunction due to a dysregulated host response to an infection

99
Q

Sepsis Risk factors:

A

age, frailty, multiple comorbidities, indwelling lines or catheters, invasive procedures, breach in skin integrity, and immunosuppression

100
Q

An individual with at least two of the following indicates strong consideration for ICU admission due to organ dysfunction:

A

RR > 22 breaths/minute
Change in mental status
SBP < 100 mmHg

Integ Final (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions