Chap 13 Flashcards
Vital signs
Outward signs of what is going on inside the body, including respiration; pulse; skin color, temperature, and condition (plus capillary refill in infants and children); pupils; and blood pressure
First vital signs you take are called
Baseline vital signs
Two factors of taking a pulse
Rate and quality
Normal pulse rate of adult at rest
60-100
Rapid heart rate minimum (tachycardia)
Anything greater than 100
Slow heart rate minimum (Bradycardia)
Anything below 60
Normal heart rate range
Adult normal heart rate 60-100 Adolescent normal heart rate 60-105 School age normal heart rate 70-110 Preschool age normal heart rate 80-120 Toddler age normal heart rate 80-130 Infant age 6-12 month normal heart rate 80-140 Infant age 0-5 months normal heart rate 90-140 Newborn normal heart rate 120-140
Possible causes of rapid, regular and full pulse
Exertion, fright, fever, high blood pressure, first stage of blood loss
Possible causes of rapid, regular and thread pulse
Shock, later stages of blood loss
Possible causes of slow pulse
Head injury, drugs, some poisons, some heart problems, lack of oxygen in children
Possible causes of no pulse
Cardiac arrest
Two factors of pulse quality
Rhythm
-Regular or irregular
Force
-Strong or thready
Radial pulse
greater than 1 years old
Brachial pulse
less than a year old
Carotid pulse
- Don’t assess on both sides at same time
- Excessive pressure can slow heart rate
How to take a pulse
Count pulsations for 30 secs and times by 2
-If the pulse rate, rhythm and force is not normal, continue with your count and observations for a full 60 secs
Ventricular assist device
A pump implanted in the chest that helps the heart move blood through the circulatory system. Because the device propels blood continuously and not in waves the way the heart does, there is no pulse
Normal respiration rates
Adult 12-20, Serious if Above 24 or Below 10 Adolescent 12-20 School age 15-30 Preschooler 20-30 Toddler 20-30 Infant 6-12 months 20-30 Infant 1-6 months 25-40 Newborn 30-50
Snoring causes and interventions
Airway blocked/ open patients airway
Wheezing causes and interventions
Medical problem such as asthma/ assist patient in taking prescribed medications
Gurgling causes and interventions
Fluids in airway/ suction airway
Crowing (harsh sound when inhaling
Medical problem that cannot be treated on the scene
4 categories of respiratory quality
Normal
-Normal rise and fall of chest with no accessory muscles being used
Shallow
- Slight movement of the chest and abdomen
Labored
-Increased work of breathing
-Nasal flaring, retractions, use of accessory muscles
-Stridor, gasping, or grunting of exhale
Noisy
-Snoring, wheezing, gurgling, crowing
Respiratory categories
Rate, rhythm and quality
Best places for checking skin for blood flow
Nail beds, lower eye lids (conjunctiva), and inside of cheeks
- Infants and children
- Best place to look are the palms of the hands and the soles of the feet
Skin colors
Pink
-Normal in light-skinned patients; normal at inner eyelids, lips, and nail beds of dark-skinned patients
Pale
-Constricted blood vessels possibly resulting from blood loss, shock, hypotension, emotional distress
Cyanotic (blue-gray)
-Lack of oxygen in blood cells and tissues resulting from inadequate breathing or heart function
Flushed (red)
Jaundiced (yellow)
-Abnormalities of the liver
Mottled (blotchy)
-Occasionally in patients with shock
Skin temperature and condition
Cool, clammy -Signs of shock, anxiety Cold, moist -Body is losing heat Cold, dry -Exposure to cold Hot, dry -High fever, heat exposure Hot, moist -High fever, heat exposure Goose pimples -Chills, communicable disease, exposure to cold, pain, or fear
Capillary refill
- Should take no more than 2 secs
- Children 6 years and younger
- Check refill
- Unreliable in cold temperatures
PEARL
3 things to look for
Pupils Equal And Reactive to Light
Size, Quality and Reactivity
Pupils
Dilated
-Fright, blood loss, drugs, prescription eye drops
Constricted
-Drugs (narcotics), prescription eye drops
Unequal
-Stroke, head injury, eye injury, artificial eye, prescription eye drops
Lack of reactivity
-Drugs, lack of oxygen to brain
Blood pressure SYS DIA
Adults Less Less or equal 120 less than or equal 80 Infants and children 80 2/3 systolic Adolescent 114/ 76 School age 105/69 Preschooler 99/65
Different blood pressure causes
High blood pressure
-Medical condition, exertion, fright, emotional distress, or excitement
Low blood pressure
-Athlete or other person with normally low blood pressure; blood loss; late sign of shock
No blood pressure
-If patient is awake and talking, he may have a ventricular assist device in his chest
Blood pressure is usually not taken on anyone under what age?
3 years old
Sphygmomanometer
The cuff and gauge used to measure blood pressure
Taking blood pressure notes
- Inflate cuff 30mm higher than cut off of pulse
- allow pressure fall smoothly are 5-10mm per sec
- If pulse falls between 2 lines, round up
- Blood pressure from auscultation is the standard
MAP
Mean arterial pressure
Cases where temperature is important
- Hypothermic
- Hyperthermic
- Febrile (feverish)
- Suffering from a generalized infection (septic)
Core temperature
Reflects level of heat inside the trunk, where the heart, lungs and digestive organs function
Ave- 98.6
Normal 96-100
-Rectal is usually 1 degree higher
-Axillary is usually 1 degree lower
-Elderly usually lower than younger people
Different thermometers
- Glass
- Electronic
- Rectal
- Tympanic- Ear
- Fore head
Pulse oximeter
an electronic device for determining the amount of oxygen carried in the blood, known as the oxygen saturation or SpO2
Oxygen saturation
the ratio of the amount of oxygen present in the blood to the amount that could ne carried, expressed as a percentage
-Can be used to assess effectiveness of artificial respirations, oxygen therapy, and bronchodilators (inhaler) therapy
CO-oximeter
A different light wavelength oximeter that measure carbon monoxide as well as oxygen
Normal SpO2 % range
Normal 96-100 Mild hypoxia 91-95 Moderate hypoxia 86-90 Severe hypoxia <85 AHA doesn't recommend O2 on patients equal or greater than 95%O2
Cautions of oximeters
-inaccurate with patients with shock and hypothermic
-False readings on patients with carbon monoxide and other types of poisoning
-Smokers might have 10-15% carbon monoxide
Inaccurate reading from movement
Normal blood glucose level
At least 60-80 mg/dL
No more than 120-140
