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

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1
Q

Define:

vital signs

A

outward signs of what is going on inside body

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2
Q

Define:

pulse (HR)

A

rhythmic beats felt as heart pumps blood through arteries

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3
Q

Define:

pulse rate (HR)

A

number of pulse beats per minute

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4
Q

Define:

tachycardia

A

rapid pulse

any pulse rate above 100bpm

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5
Q

Define:

bradycardia

A

slow pulse

any pulse rate below 60bpm

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6
Q

Describe:

range of normal pulse rate for adults

A

60-100bpm

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7
Q

Describe:

range of normal pulse rate for adolescents (11-18 years old)

A

60-100bpm

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8
Q

Describe:

range of normal pulse rate for children

A

80-120bpm

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9
Q

Describe:

range of normal pulse rate forinfants and newborns

A

80-160bpm

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10
Q

List:

causes of rapid, regular, and full pulse

3 points

A
  • fever
  • high blood pressure
  • early blood loss
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11
Q

List:

causes of rapid and irregular pulse

3 points

A
  • shock
  • late blood loss
  • abnormal electrical activity in heart
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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

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13
Q

Describe:

significance of no pulse

A

cardiac arrest (clinical death)

Start CPR now.

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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
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15
Q

Define:

pulse quality

A

rhythm (regular/irregular) and force (strong/weak) of pulse

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16
Q

Define:

radial pulse

A

pulse felt at the wrist

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17
Q

Define:

brachial pulse

A

pulse felt in the upper arm

best way to check for babies

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18
Q

Define:

carotid pulse

(kuh-ROHD-ded)

A

pulse felt along the large carotid artery on either side of the neck

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19
Q

Define:

femoral pulse

A

pulse taken by femoral artery

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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

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21
Q

Define:

respiration

A

diffusion of oxygen across membrane of alveoli

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22
Q

Describe:

range of normal respiratory rate for adults

A

12-20 breaths per minute

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23
Q

Describe:

range of normal respiratory rate for adolescents (11-18 years old)

A

12-20 breaths per minute

same as adults

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24
Q

Describe:

range of normal respiratory rate for children

A

15-30 breaths per minute

faster than adults

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25
Q

Describe:

range of normal respiratory rate for infants and newborns

A

15-50 breaths per minute

very fast for very small lungs

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26
Q

Describe:

range of seriously dangerous respiratory rates for adults

A

> 24 breaths per minute

< 10 breaths per minute

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27
Q

Define:

respiratory quality

A

the normal or abnormal (shallow/labored/noisy) character of breathing

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28
Q

Define:

respiratory rhythm

A

the regular or irregular spacing of breaths

not important in treating most conscious patients

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29
Q

List:

causes of pale skin color

4 points

A
  • low blood pressure (hypotension)
  • constricted blood vessels (possibly resulting from blood loss)
  • shock
  • emotional distress
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30
Q

Describe:

cause of cyanotic skin color

A

hypoxia (lack of oxygen in blood cells and tissues)

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31
Q

List:

causes of flushed skin color

2 points

A
  • exposure to heat
  • emotional excitement
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32
Q

Describe:

cause of jaundiced skin color

A

abnormalities of liver

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33
Q

Describe:

cause of mottled skin color

A

occasionally in patients with shock

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34
Q

List:

causes of cool and clammy skin

2 points

A
  • shock
  • anxiety
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35
Q

Describe:

cause of cool and moist skin

A

body is losing heat

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36
Q

Describe:

significance of cold and dry skin

A

dead

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37
Q

List:

causes of hot and dry skin

2 points

A
  • high fever
  • heat exposure
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38
Q

List:

causes of hot and moist skin

2 points

A
  • high fever
  • heat exposure
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39
Q

List:

causes of “goose pimples”

4 points

A
  • chills / exposure to cold
  • communicable disease
  • pain
  • fear
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40
Q

Define:

pupil

A

black center of the eye

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41
Q

Define:

to dilate

A

to get larger

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42
Q

Define:

to constrict

A

to get smaller

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43
Q

Define:

reactivity

(of pupils)

A

change in pupil size as reaction to light exposure

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44
Q

Define:

blood pressure

A

force of blood against the walls of blood vessels

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45
Q

Define:

systolic blood pressure

A

pressure created when the heart contracts and forces blood out into the arteries

upper reading on blood pressure (best below 120)

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46
Q

Define:

diastolic blood pressure

A

pressure remaining in arteries when left ventricle of heart is relaxed and refilling

lower reading on blood pressure (best below 80)

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47
Q

Describe:

range of normal systolic blood pressure for adults

A

≤ 120

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48
Q

Describe:

range of normal systolic blood pressure for adolescents (11-18 years old)

A

about 107-117

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49
Q

Describe:

range of normal systolic blood pressure for children

A

90-120

90+2(age)=pressure –> normal systolic pressure for a 3-year-old is 90+2(3)=96

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50
Q

List:

causes of hypertension

3 causes

A
  • medical condition
  • exertion
  • strong emotion (fright/distress/excitement)

hypertension is high blood pressure

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51
Q

List:

causes of low blood pressure

3 points

A
  • athlete or other person with normally low blood pressure
  • blood loss
  • late sign of shock
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52
Q

Describe:

cause of no blood pressure

A

patient with a ventricular assist device in the chest

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53
Q

Define:

sphygmomanometer

(SFIG-mo-mah-NOM-uh-ter)

A

the cuff and gauge used to measure blood pressure

54
Q

Define:

brachial artery

A

major artery of the arm

55
Q

Define:

auscultation

(os-kul-TAY-shun)

A

listening (to a stethoscope)

A stethoscope is used to ausculcate for characteristic sounds.

56
Q

Define:

palpation

A

touch

feeling

A pulse or blood pressure may be palpated with the fingertips.

57
Q

Define:

blood pressure monitor

A

machine that automatically inflates a blood pressure cuff and measures blood pressure

58
Q

List

methods for measuring blood pressure

3 points

A
  • auscultation
  • palpation
  • blood pressure monitor
59
Q

Define:

hypothermic

A

patient with a below-normal body temperature

60
Q

Define:

hyperthermic

A

patient with an above-normal body temperature

61
Q

Define:

febrile

A

feverish

62
Q

Define:

septic

A

suffering from a generalized infection

63
Q

Range for:

healthy and normal body temperature

A

between 96.8ºF (37ºC) and 101.3ºF (38.5ºC)

64
Q

Define:

pulse oximeter

A

electronic device for determining the amount of oxygen carried in the blood

65
Q

Define:

oxygen saturation (SpO₂)

A

ratio of amount of oxygen present in blood to the amount that could be carried

expressed as a percentage

66
Q

Range for:

healthy and normal oxygen saturation

A

96% to 100%

67
Q

Range for:

mildly hypoxic oxygen saturation

A

91% to 95%

68
Q

Range for:

moderately hypoxic oxygen saturation

A

86% to 90%

69
Q

Range for:

severe hypoxic oxygen saturation

A

≤ 85%

70
Q

Define:

capnography

A

measurement of amount of carbon dioxide (CO₂) exhaled

71
Q

Significance of:

capnography

A

indirectly shows how well tissues are using oxygen (and performing other physiologic functions)

72
Q

Fill in the blank:

You should not spend more than [BLANK] seconds to find a patient’s pulse.

A

You should not spend more than 10 seconds to find a patient’s pulse.

73
Q

Describe:

proper ratio of compressions and ventilations for adults

(CPR)

A

30 compressions between every 2 ventilations

74
Q

Describe:

proper ratio of compressions and ventilations for children

(CPR)

A

1 responder: 30 compressions between every 2 ventilations
2 responders: 15 compressions between every 2 ventilations

75
Q

List:

possible patient responsiveness categories

A
  • A: alert
  • V: alert to verbal stimuli
  • P: alert to pain stimuli
  • U: unresponsive
76
Q

List:

shockable pulse rhythms

A
  • v-fib
  • v-tach
77
Q

Define:

v-tach

A

arrhythmia caused by irregular electrical signals in the ventricles

78
Q

Define:

ventricular fibrillation

v-fib

A

arrhythmia which causes ventricles to contract in a very rapid and uncoordinated manner

79
Q

List:

components of pulse reporting

A
  • rate
  • strength
  • regularity
  • (equality)
80
Q

Define:

pulse equality

A

how closely central pulse matches peripheral pulse

81
Q

Explain:

how to determine capillary refill

A

squeeze on nail bed and see how long color takes to return

color should return within 2 seconds of removing pressure

82
Q

Define:

blown pupils

anisocoria

A

pupils of inequal size

83
Q

Significance of:

blown pupils

anisocoria

A

sign of increased cranial pressure

84
Q

Define:

dilated pupils

A

big pupils

healthy pupils should dilate with less light

85
Q

Define:

constricted pupils

A

small pupils

healthy pupils should constrict with more light

86
Q

List:

potential causes of dilated pupils

6 points

A
  • speed (amphetamines or methamphetamines)
  • cocaine/crack
  • hallucinogens (LSD or psilocybin)
  • prescription painkillers (opiates)
  • heroin
  • marijuana
87
Q

Describe:

potential cause of constricted pupils

A

opiates

88
Q

List:

characteristics of skin

3 points

A
  • color
  • temperature
  • condition
89
Q

List:

characteristics of respirations

2 points

A
  • rate
  • depth
90
Q

List:

characteristics of pupils

3 points

A
  • symmetry
  • size
  • reactivity
91
Q

Explain:

cause of “seesaw” breathing pattern in young children

A

children rely more on diaphragm during breathing difficulty

92
Q

Define:

baseline vitals

A

first set of vitals collected

used to determine “normal” and observe trends

93
Q

Describe:

appearance of cyanotic skin

A

blue-gray

94
Q

Describe:

appearance of flushed skin

A

red

95
Q

Describe:

appearance of jaundiced skin

A

yellow

96
Q

Describe:

appearance of mottled skin

A

blotchy

97
Q

Define:

cyanosis

A

condition of blue skin caused by hypoxia

98
Q

Define:

PERRL

(acronym)

A

pupils are equal, round, and reactive to light

99
Q

Describe:

significance of fixed pupils

A

(likely) pending death

100
Q

Describe:

significance of constant upward gaze

A

possible stroke

101
Q

Define:

FAST

(acronym)

A

observational test for stroke symptoms

  • face: droopy or paralyzed
  • arm: weak
  • speech: difficult, impeded, slurred
  • time: time since last seen normal
102
Q

Explain:

proper stethescope placement for respiratory assessment

A

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
Q

Describe:

cause of completely red skin

A

possible carbon monoxide (CO) poisoning

104
Q

List:

factors which can affect oxygen saturation reading

5 points

A
  • decreased circulation to finger
  • carbon monoxide
  • excessive movement
  • nail polish
  • anemia
105
Q

Define:

blood glucose level

A

quantity of glucose (sugar) in bloodstream

106
Q

Describe:

range of normal blood glucose level

A

60-140 mg/dL

107
Q

Describe:

range of abnormal blood glucose levels

A

below 60 mg/dL

above 140 mg/dL

108
Q

Define:

glucometer

A

electronic device used to measure blood glucose levels

109
Q

Describe:

range of normal capnographic levels

A

35 to 45 mmHg

110
Q

Explain:

method for gathering capnography

A

sensors connected to nasal cannula, intubation tube, or BVM

111
Q

Choose:

A

D

pulse oximetry is not officially considered a vital sign

112
Q

Choose:

A

B

mental status is the only option not considered a vital sign

113
Q

Choose:

A

B

vital signs should be recorded as they are obtained to prevent forgetting and note time they were taken

114
Q

Choose:

A

D

pulse rate over 100 is tachycardia

115
Q

Choose:

A

D

sustained pulse under 48 or above 126 could be sign that something is seriously wrong

116
Q

Choose:

A

C

117
Q

Choose:

A

C

118
Q

Choose:

A

C

EMT should be aware that excessive pressure can slow heart (especially in older patients)

never assess carotid pulses on both sides simultaneously

119
Q

Choose:

A

A

120
Q

Fill in the blank:

Many resting people breathe more with their [BLANK] than with their [BLANK] muscles.

A

Many resting people breathe more with their diaphragm than with their chest muscles.

121
Q

Choose:

A

D

122
Q

Choose:

A

A

gurgling is a sound made by patient that usually indicates need to suction airway

123
Q

Choose:

A

B

124
Q

Choose:

A

C

mg/dL

125
Q

Choose:

A

B

EMT should test pupils by covering patient’s eyes for few moments (then uncover one at a time)

126
Q

Choose:

A

D

patients in shock do not normally have unequal pupils

127
Q

Choose:

A

C

CO₂ binds to oxygen receptors — tricking pulse oximeter into falsely reporting higher O₂ saturations

128
Q

Choose:

A

C

129
Q

Choose:

A

D

130
Q

Identify:

(skin condition)

A

mottled skin color

131
Q

Identify:

A

Define:

sphygmomanometer

(SFIG-mo-mah-NOM-uh-ter)