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KNPE 355 > lab 2: vital signs > Flashcards

lab 2: vital signs Flashcards

1
Q

what do vital signs do?

A

information about current and changing physiological status. body’s core ability to stay alive:
- pumping blood through the heart
- breathing
- maintaining a core temperature

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2
Q

four vital signs internationally recognized

A
  1. respiratory
  2. pulse or heart rate (HR)
  3. blood pressure (BP)
  4. temperature
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3
Q

three other vital measures

A
  1. pulse oximetry
  2. pain rating scale
  3. rate of perceived exertion (RPE)
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4
Q

what are vital signs are used to establish

A
  • baseline physiological information to guide exercise program development
  • physiological response to activity to guide continuation, modification, or discontinuation of a program
  • patients immediate health risk
  • emergency cardiac or resporatory interventions
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5
Q

how can vital signs be affected

A

age, physical activity, emotional status, physiological status, clinician accuracy, equipment accuracy, environmental temperature

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6
Q

heart rate

A

indirect measure of rate and rhythm of left ventricle contraction

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7
Q

3 observable measures in HR

A
  1. rate
  2. rhythm,
  3. intensity
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8
Q

heart rate rate measure

A

the number of times the heart contracts in a given period of time (recorded at beats per minute -bpm)

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9
Q

heart rate rhythm measure

A

regular: heart beats at a fixed interval
regular-irregular: heart rate that occasionally skips a beat
irregular-irregular: highly disorganized heart beat

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10
Q

heart rate intensity measure

A

0: absent
1: weaker than expected or thready; may be difficult to palpate
2: normal; able to palpate with normal pressure
3: bounding; may be able to see pulsation; doesn’t disappear with palpation

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11
Q

factors affecting HR

A

age (as age increases, HR decreases), sex (male lower than female), fever, pain, stress, digestion, meds, hypovolemia (loss of blood), hypoxia and hypoxemia (O2 decrease, increased HR), BP, electrolyte balance

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12
Q

respiratory rate (RR)

A

normal rate is 12-20 breaths per minute for adults

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13
Q

RR documentations (3 ways)

A
  1. rate
  2. pattern
  3. mechanics
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14
Q

RR rate docmentation

A

number of breaths per minute

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15
Q

RR pattern documentation

A
  • eupnea (normal pattern)
  • tachypnea (increased rate, >24bpm)
  • bradypnea (slowo rate, <10bpm)
  • hyperventilation
  • hypoventilation
  • cheyne-strokes (deep to shallow w/ apneic periods)
  • kussmaul’s breathing (deep, regular and increased)
  • apnea (absence for several seconds)
  • biots breathing (shallow w/ periods of apnea)
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16
Q

RR mechanics documentation

A
  • percentage of diapjragmatic vs lateral costal vs aprical (normal = D:70%, LC: 30%, A: trace)
  • use of accessor muscles (sing of increased work of breathing)
  • any signs of distress
  • inspiratory to expiratory ratio (1:2 or 1:3)
17
Q

factors affecting RR and depth

A

age (decreases RR), exercise, illness processes, meds, pain, emotions

18
Q

oxygen saturation

A

percent saturation of arterial O2 is estimate of how much O2 is travelling through body in RBC’s. range is 95-100%

19
Q

how to measure O2 saturation

A

indirect measure with pulse Ox placed on index finger, uses light beams to estimate O2 sat
- an absolute decrease is SpO2 of 5% or more during exercise is considered an abnormal response (exercise induced hypoxemia - needs follow up tests)
- less than 80% with signs of hypoxemia is indication to stop exercise

20
Q

factors affecting SpO2

A

lung disease, decreased circulation, hypotension
with pulse ox:
- lower perfusion, hemoglobin abnormalities, dark skin tone, nail polish/ acrylic nails, movement during exercise

21
Q

rate of perceived exertion (RPE)

A

subjectively monitor a clients ability to tolerate exercise using borg scale (6-20)

22
Q

blood pressure

A

variable that reflects cardiac output, peripheral vascular resistance and haemodynamic factors. an indirect measure of pressure inside an artery
- recorded as mmHG
- use Korotkoff sounds

23
Q

systolic pressure

A

indicated by the first faint clear tapping sounds heard upon graduallt releasing the air in the cuff (phase 1). this is the pressure at the time of contraction of the left ventricle

24
Q

diastolic pressure

A

indicated by the disappearance of all sounds (phase 5). this is the pressure at the time of ventricular filing (‘resting’ pressure)

25
Q

Korotkoff sounds - phase 1

A

first clear tapping sound that can be heard, often faint at first but increasing
- this is the initial flow of blood through the artery as the constriction of the artery is released; this is the systolic BP

26
Q

Korotkoff sounds - phase 2

A

softer sound, may be a swishing sound or murmur
- no clinical significance has been determined

27
Q

Korotkoff sounds - phase 3

A

louder and more crisp sound
- no clinical significance has been determined

28
Q

Korotkoff sounds - phase 4

A

sound changes from crisp and distinct to muffled
- some consider this the first diastolic BP; useful during exercise assessment and when phase 5 is not detectable

29
Q

Korotkoff sounds - phase 5

A

cessation of sound
- diastolic BP

30
Q

categories for BP in adults

A

hypotension: <90/<60
normal: <120/<80
elevated: 120-129/<80
hypertension stage 1: 130-139/80-89
hypertension stage 2: >140->90

  • for ppl 18 or older who are not on meds for HBP*
31
Q

BP signs to stop exercise

A
  • SBP greater than 250
  • DBP greater than 115
  • drop in SBP more than 10 from base
  • failure of SBP to increase w/ increased workload
32
Q

BP measurement errors

A
  • inappropriate cuff size
  • tested arm unsupported
  • legs crossed while sitting
  • unsupported sitting
  • arm that is not level with heart
  • rapid cuff deflations during auscultation prior to 5th Korotkoff sound
  • equipment malfunction
  • auditory errors
33
Q

radial pulse procedure

A
  • support left arm on stable surface or w/ arm below level of heart
  • using 2+3rd digits, palpate for pulse (1-2cm above wrist crease, lateral to the flexor tendons)
  • count the number of beats in 1 min
  • record bpm
  • repeat with 30sec x2 count
34
Q

brachial pulse procedure

A
  • support left arm on stable surface with arm below level of heart with elbow extended and forearm supinated
  • using 2+3rd digits, palpate gently for the brachial pulse (medially on the elbow crease)
  • record for 1 min
  • repeat with 30sec x2 count
35
Q

respiratory rate procedure

A
  • client sitting, feet supported, abdomen unrestricted by clothing (belt)
  • simulate measuring of radial pulse
  • observe clients abdomen or anterior chest wall
  • count the number of elevations (inhales) in one minute
  • record
  • repeat with 20 sec x3
  • then place hand lightly on sternum or upper abdomen to palpate their inspirations
36
Q

BP procedure

A
  1. seated comfortably
  2. remove restricting clothing
  3. clean equipment
  4. choose appropriate cuff size
  5. support left arm at level of heart with elbow extended
  6. place deflated cuff around left arm 3-6cm above antecubital fossa
  7. palpate for brachial pulse to line up cuff. then palpate for radial pulse and pump the cuff until all pulsations disappear (est of SBP). deflate cuff then allow time to recover
  8. place stethoscope in ears (away from your face), and the bell flat over the brachial pulse
  9. inflate the cuff ~ 20mmHg aove SBP
  10. slowly release air while listening for Korotkoff sounds. after cessation, confirm by continuing slowly for 10mmHg
  11. record SBP and DBP
  12. repeat 2 times
  13. clean equipment
37
Q

vital signs functional task

A

1 minute sit to stand test - most widely used functional test for ppl w/ COPD.
- clients w/ COPD not able to get more than 12 have been found to have lower metabolic power

38
Q

1 min STST procedure

A
  • ask client to hold arms stationary on their hips
  • goal is to complete the sitting and standing positions correctly and fully w/o using arms for support while rising and sitting
  • test begins when clinician says “go” and client stands then without delay sits back down repeating as many times as possible at self-selected speed
    rest is allowed but time wont stop
39
Q

vital signs and exercise activities

A

20 jumping jacks, 10-15 push-ups, 30 sec wall sit, 1 min plank

KNPE 355 (13 decks)

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