Chapter 13 | Vital Signs and Monitoring Flashcards
• How to obtain vital signs, including pulse, respirations, blood pressure, skin, temperature, and pupils • How to document vital signs on a prehospital care report • How to use various monitoring devices
1
Q
Define:
vital signs
A
outward signs of what is going on inside body
2
Q
Define:
pulse (HR)
A
rhythmic beats felt as heart pumps blood through arteries
3
Q
Define:
pulse rate (HR)
A
number of pulse beats per minute
4
Q
Define:
tachycardia
A
rapid pulse
any pulse rate above 100bpm
5
Q
Define:
bradycardia
A
slow pulse
any pulse rate below 60bpm
6
Q
Describe:
range of normal pulse rate for adults
A
60-100bpm
7
Q
Describe:
range of normal pulse rate for adolescents (11-18 years old)
A
60-100bpm
8
Q
Describe:
range of normal pulse rate for children
A
80-120bpm
9
Q
Describe:
range of normal pulse rate forinfants and newborns
A
80-160bpm
10
Q
List:
causes of rapid, regular, and full pulse
3 points
A
- fever
- high blood pressure
- early blood loss
11
Q
List:
causes of rapid and irregular pulse
3 points
A
- shock
- late blood loss
- abnormal electrical activity in heart
12
Q
List:
causes of bradycardia
4 points
A
- head injury
- drugs/poisons
- heart problem
- lack of oxygen (in children)
bradycardia is low pulse rate
13
Q
Describe:
significance of no pulse
A
cardiac arrest (clinical death)
Start CPR now.
14
Q
List:
the six vital signs
A
- Pulse: presence, strength, and regularity
- Blood pressure: systolic, diastolic, and palpation (systolic only)
- Skin: color, temperature, and condition
- Respirations: rate and depth
- Pupils: size and reactivity
- Pulse oximetry: oxygen in blood
15
Q
Define:
pulse quality
A
rhythm (regular/irregular) and force (strong/weak) of pulse
16
Q
Define:
radial pulse
A
pulse felt at the wrist
17
Q
Define:
brachial pulse
A
pulse felt in the upper arm
best way to check for babies
18
Q
Define:
carotid pulse
(kuh-ROHD-ded)
A
pulse felt along the large carotid artery on either side of the neck
19
Q
Define:
femoral pulse
A
pulse taken by femoral artery
20
Q
Define:
respiratory rate (RR)
A
number of breaths a patient takes in one minute
normal RR for adult is 12-20 breaths per minute
21
Q
Define:
respiration
A
diffusion of oxygen across membrane of alveoli
22
Q
Describe:
range of normal respiratory rate for adults
A
12-20 breaths per minute
23
Q
Describe:
range of normal respiratory rate for adolescents (11-18 years old)
A
12-20 breaths per minute
same as adults
24
Q
Describe:
range of normal respiratory rate for children
A
15-30 breaths per minute
faster than adults
25
# Describe:
range of normal **respiratory rate** for *infants* and *newborns*
15-50 breaths per minute
| very fast for very small lungs
26
# Describe:
range of seriously *dangerous* **respiratory rates** for *adults*
> 24 breaths per minute
< 10 breaths per minute
27
# Define:
respiratory quality
the normal or abnormal (shallow/labored/noisy) character of breathing
28
# Define:
respiratory rhythm
the regular or irregular spacing of breaths
| not important in treating most conscious patients
29
# List:
causes of **pale skin color**
| 4 points
* low blood pressure (hypotension)
* constricted blood vessels (possibly resulting from blood loss)
* shock
* emotional distress
30
# Describe:
cause of **cyanotic skin color**
hypoxia (lack of oxygen in blood cells and tissues)
31
# List:
causes of **flushed skin color**
| 2 points
* exposure to heat
* emotional excitement
32
# Describe:
cause of **jaundiced skin color**
abnormalities of liver
33
# Describe:
cause of **mottled skin color**
occasionally in patients with **shock**
34
# List:
causes of **cool and clammy skin**
| 2 points
* shock
* anxiety
35
# Describe:
cause of **cool and moist skin**
body is losing heat
36
# Describe:
significance of **cold and dry skin**
dead
37
# List:
causes of **hot and dry skin**
| 2 points
* high fever
* heat exposure
38
# List:
causes of **hot and moist skin**
| 2 points
* high fever
* heat exposure
39
# List:
causes of **"goose pimples"**
| 4 points
* chills / exposure to cold
* communicable disease
* pain
* fear
40
# Define:
pupil
black center of the eye
41
# Define:
to dilate
to get larger
42
# Define:
to constrict
to get smaller
43
# Define:
reactivity
| (of pupils)
change in pupil size as reaction to light exposure
44
# Define:
blood pressure
force of blood against the walls of blood vessels
45
# Define:
**systolic** blood pressure
pressure created when the heart contracts and forces blood out into the arteries
| upper reading on blood pressure (best below 120)
46
# Define:
**diastolic** blood pressure
pressure remaining in arteries when left ventricle of heart is relaxed and refilling
| lower reading on blood pressure (best below 80)
47
# Describe:
range of normal **systolic blood pressure** for *adults*
≤ 120
48
# Describe:
range of normal **systolic blood pressure** for *adolescents (11-18 years old)*
about 107-117
49
# Describe:
range of normal **systolic blood pressure** for *children*
90-120
| 90+2(age)=pressure --> normal systolic pressure for a 3-year-old is 90+2(3)=96
50
# List:
*causes* of **hypertension**
| 3 causes
* medical condition
* exertion
* strong emotion (fright/distress/excitement)
| hypertension is high blood pressure
51
# List:
*causes* of **low blood pressure**
| 3 points
* athlete or other person with normally low blood pressure
* blood loss
* late sign of shock
52
# Describe:
cause of **no blood pressure**
patient with a **ventricular assist device** in the chest
53
# Define:
sphygmomanometer
| (SFIG-mo-mah-NOM-uh-ter)
the cuff and gauge used to measure blood pressure
54
# Define:
brachial artery
major artery of the arm
55
# Define:
auscultation
| (os-kul-TAY-shun)
listening (to a stethoscope)
| A stethoscope is used to ausculcate for characteristic sounds.
56
# Define:
palpation
touch
feeling
| A pulse or blood pressure may be palpated with the fingertips.
57
# Define:
blood pressure monitor
machine that automatically inflates a blood pressure cuff and measures blood pressure
58
# List
methods for measuring blood pressure
| 3 points
* auscultation
* palpation
* blood pressure monitor
59
# Define:
hypothermic
patient with a below-normal body temperature
60
# Define:
hyperthermic
patient with an above-normal body temperature
61
# Define:
febrile
feverish
62
# Define:
septic
suffering from a generalized infection
63
# Range for:
healthy and **normal body temperature**
between 96.8ºF (37ºC) and 101.3ºF (38.5ºC)
64
# Define:
pulse oximeter
electronic device for determining the amount of oxygen carried in the blood
65
# Define:
oxygen saturation (SpO₂)
ratio of amount of oxygen present in blood to the amount that could be carried
| expressed as a percentage
66
# Range for:
healthy and normal **oxygen saturation**
96% to 100%
67
# Range for:
mildly hypoxic **oxygen saturation**
91% to 95%
68
# Range for:
moderately hypoxic **oxygen saturation**
86% to 90%
69
# Range for:
severe hypoxic **oxygen saturation**
≤ 85%
70
# Define:
capnography
measurement of amount of carbon dioxide (CO₂) exhaled
71
# Significance of:
capnography
indirectly shows how well tissues are using oxygen (and performing other physiologic functions)
72
# Fill in the blank:
You should not spend more than **[BLANK]** seconds to find a patient's pulse.
You should not spend more than **10** seconds to find a patient's pulse.
73
# Describe:
proper ratio of compressions and ventilations *for adults*
| (CPR)
*30 compressions* between every *2 ventilations*
74
# Describe:
proper ratio of compressions and ventilations *for children*
| (CPR)
**1 responder:** *30 compressions* between every *2 ventilations*
**2 responders:** *15 compressions* between every *2 ventilations*
75
# List:
possible patient responsiveness categories
* **A:** *alert*
* **V:** alert to *verbal* stimuli
* **P:** alert to *pain* stimuli
* **U:** *unresponsive*
76
# List:
shockable pulse rhythms
* v-fib
* v-tach
77
# Define:
v-tach
arrhythmia caused by irregular electrical signals in the ventricles
78
# Define:
ventricular fibrillation
v-fib
arrhythmia which causes ventricles to contract in a very rapid and uncoordinated manner
79
# List:
components of pulse reporting
* rate
* strength
* regularity
* (equality)
80
# Define:
pulse equality
how closely central pulse matches peripheral pulse
81
# Explain:
how to determine **capillary refill**
**squeeze on nail bed** and see how long color takes to return
**color should return within 2 seconds** of removing pressure
82
# Define:
blown pupils
anisocoria
pupils of *inequal* size
83
# Significance of:
blown pupils
anisocoria
sign of increased cranial pressure
84
# Define:
dilated pupils
*big* pupils
| healthy pupils should dilate with less light
85
# Define:
constricted pupils
*small* pupils
| healthy pupils should constrict with more light
86
# List:
potential *causes* of **dilated pupils**
| 6 points
* speed (amphetamines or methamphetamines)
* cocaine/crack
* hallucinogens (LSD or psilocybin)
* prescription painkillers (opiates)
* heroin
* marijuana
87
# Describe:
potential *cause* of **constricted pupils**
opiates
88
# List:
characteristics of **skin**
| 3 points
* color
* temperature
* condition
89
# List:
characteristics of **respirations**
| 2 points
* rate
* depth
90
# List:
characteristics of **pupils**
| 3 points
* symmetry
* size
* reactivity
91
# Explain:
cause of "seesaw" breathing pattern in young children
children rely more on diaphragm during breathing difficulty
92
# Define:
baseline vitals
**first** set of vitals collected
used to determine "normal" and observe **trends**
93
# Describe:
appearance of **cyanotic skin**
blue-gray
94
# Describe:
appearance of **flushed skin**
red
95
# Describe:
appearance of **jaundiced skin**
yellow
96
# Describe:
appearance of **mottled skin**
blotchy
97
# Define:
cyanosis
condition of blue skin caused by hypoxia
98
# Define:
PERRL
| (acronym)
**p**upils are **e**qual, **r**ound, and **r**eactive to **l**ight
99
# Describe:
significance of **fixed pupils**
(likely) pending death
100
# Describe:
significance of **constant upward gaze**
possible stroke
101
# Define:
FAST
| (acronym)
observational test for stroke symptoms
* **face:** droopy or paralyzed
* **arm:** weak
* **speech:** difficult, impeded, slurred
* **time:** time since last seen normal
102
# Explain:
proper *stethescope placement* for **respiratory assessment**
2 rows of 2 on each side of front (4 front)
1 on each midaxillary line (2 sides)
3 rows of 2 on each side of back (6 back)
103
# Describe:
cause of **completely red skin**
possible carbon monoxide (CO) poisoning
104
# List:
factors which can affect **oxygen saturation** reading
| 5 points
* decreased circulation to finger
* carbon monoxide
* excessive movement
* nail polish
* anemia
105
# Define:
blood glucose level
quantity of glucose (sugar) in bloodstream
106
# Describe:
range of *normal* **blood glucose** level
60-140 mg/dL
107
# Describe:
range of *abnormal* **blood glucose** levels
below 60 mg/dL
above 140 mg/dL
108
# Define:
glucometer
electronic device used to measure blood glucose levels
109
# Describe:
range of normal **capnographic levels**
35 to 45 mmHg
110
# Explain:
method for gathering capnography
sensors connected to nasal cannula, intubation tube, or BVM
111
# Choose:
**D**
| pulse oximetry is not officially considered a vital sign
112
# Choose:
**B**
| mental status is the only option not considered a vital sign
113
# Choose:
**B**
## Footnote
vital signs should be recorded as they are obtained to prevent forgetting and note time they were taken
114
# Choose:
**D**
| pulse rate over 100 is tachycardia
115
# Choose:
**D**
## Footnote
sustained pulse under 48 or above 126 could be sign that something is seriously wrong
116
# Choose:
**C**
117
# Choose:
**C**
118
# Choose:
**C**
## Footnote
EMT should be aware that *excessive pressure can slow heart* (especially in older patients)
never assess carotid pulses on both sides simultaneously
119
# Choose:
**A**
120
# Fill in the blank:
Many resting people breathe more with their **[BLANK]** than with their **[BLANK]** muscles.
Many resting people breathe more with their **diaphragm** than with their **chest** muscles.
121
# Choose:
**D**
122
# Choose:
**A**
## Footnote
gurgling is a sound made by patient that usually indicates need to suction airway
123
# Choose:
**B**
124
# Choose:
**C**
| mg/dL
125
# Choose:
**B**
## Footnote
EMT should test pupils by covering patient's eyes for few moments (then uncover one at a time)
126
# Choose:
**D**
| patients in shock do not normally have unequal pupils
127
# Choose:
**C**
## Footnote
CO₂ binds to oxygen receptors — tricking pulse oximeter into falsely reporting higher O₂ saturations
128
# Choose:
**C**
129
# Choose:
**D**
130
# Identify:
| (skin condition)
mottled skin color
131
# Identify:
# Define:
sphygmomanometer
| (SFIG-mo-mah-NOM-uh-ter)
