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PA 1 (RESP 214) > Module 2 Vital Signs > Flashcards

Module 2 Vital Signs Flashcards

1
Q

Why are vital signs important?

A

They are used to establish a baseline.

Useful for assessing trends in condition

Useful for tracking changes in condition

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2
Q

When should vital signs be measured?

A

On Admission

Beginning of each shift or with each assessment

Before and after any treatment/intervention

With any change in patient condition

As per policy or physicians order

More often if indicated [patient acutely ill]

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3
Q

Signs versus Symptoms?

A

Signs:
- objective data that can be seen, felt, smelled, or heard by examiner
- i.e think SOB or tripod

Symptoms:
- subjective data that isonly evident to patient and cannot be perceived by observer.
- I felt short of breath last night when…blah blah.

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4
Q

What are the 4 classic vital signs?

A

Temperature (degrees celsius)
Heart rate (bpm)
Respiration (breaths per min)
Blood pressure (mmHg)

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4
Q

What are the 4 classic vital signs?

A

Temperature (degrees celsius)
Heart rate (bpm)
Respiration (breaths per min)
Blood pressure (mmHg)

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5
Q

What is a normal temp reading?
(Afebrile = normal range)

A

37 (+ or - 0.5)

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6
Q

What regulates temp?

A

hypothalamus via vasodilation

vasoconstriction (using hormones)

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7
Q

What is a pulse evaluated for?

(Systolic bp is felt)

A

Rate
Rhythm
Strength

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8
Q

What is a normal heart rate range?

A

Adults: 60-100bpm

Pediatric: 70/80-110/120/160 bpm varies according to age

Newborn: 90-180 bpm

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9
Q

what does the autonomic nervous system do to increase/decrease HR?

A

Sympathetic Nervous system:
- Sends epinephrine + norepinephrine
to increase HR

Parasympathetic Nervous system:
- Sends Acetylcholine to decrease
HR

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10
Q

What is the difference between Tachycardia and Bradycardia?

A

Tachycardia = too fast

Bradycardia = too slow

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11
Q

Conditions that alter heart rate/rhythm?

A

Hypoxia
Inadequate blood flow
Electrolyte imbalance

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12
Q

What does the strength of a heartbeat measure?

A

The strength of the left ventricular contractions and volume of blood flowing to peripheral tissues.

So, is the pulse normal, strong, or weak (thready), or absent .

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13
Q

What are the main sites we check for a pulse?

A

Temporal: Taking temp or SpO2

Carotid: Neck, pulse check during
cardiac arrest

Brachial: Arm, medial side of bicep

Radial: Wrist. #1 on awake/alert
person

Femoral: Groin; large vessel, may be palpated during cardiac arrest to assess chest compressions

Dorsal pedis: Top of foot

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14
Q

What are the alternate sites to find a pulse?

A

Apical: point of maximal impact (heart)

Ulnar: wrist; collateral to radial

Popliteal: behind the knee

Posterior tibial: ankle; collateral to dorsal pedal

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15
Q

What is a normal respiratory rate (RR)?

What is Eupnea?

A

Adults: 12-20
Pediatric: 15-20
Toddler: 40-60

Normal RR = Eupnea

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16
Q

What do we evaluate on the RR?

Heads up: patient shouldn’t know you are assessing there RR, do it while appearing to check the pulse.

A

Rate
Regularity
Depth
Accessory muscle use/work of breathing (WOB)
I:E ratio (inspiration : expiration)
Positional changes

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17
Q

What is Orthopnea?

A

Increase SOB when laying down.

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18
Q

What is Apnea?

A

Absence of breathing - a respiratory arrest (stop).

If not reversed = could lead to death.

time of about 15 seconds.

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19
Q

what is the main difference between hyperventilation hypoventilation?

A

The main difference is in the volume/depth of breath.

hypo=low volume and rate
-increase in PaCO2

hyper=high depth of breath and rate
-decrease in PaCO2

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20
Q

What does PaCO2 mean?

A

PaCO2 = measured the partial pressure of carbon dioxide in arterial blood.

Remember - big A = alveolar.

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21
Q

What is 3 abnormal breathing patterns?

A
  1. Biots
  2. Cheyene stokes
  3. Kussmauls

(add slides on each later 27-29)

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22
Q

What do Apneustic and Agonal respirations mean?

A

GASPS FOR AIR.

Apneustic = Deep, gasping respirations (usually caused by trauma)

Agonal = slow and shallow respirations OR deep with long apnea periods.
-resembles snoring, gasping, or labored breaths.
-person appears to be choking

23
Q

What is regular Blood Pressure (BP) for adults

A

Systolic: 100 – 140 mmHg
Diastolic: 60 – 95 mmHg

24
Q

What is systolic and diastolic pressure?

A

Systolic pressure (top number) is the peak exerted during contraction of the left ventricle

Diastolic pressure (bottom number) is the force remaining during relaxation of the heart

25
Q

What is arterial blood pressure affected by?

A

The force of left ventricular contraction

Peripheral vascular resistance

Volume of blood in the circulatory system

The heart structure itself

26
Q

What is pulse pressure?
what is a normal pulse pressure

A

The difference between systolic and diastolic pressure.

This is important because a wider pulse diff can be a sign of cardiovascular disease.

Normal pulse pressure = 30-40mmHG

27
Q

Mean arterial blood pressure (MAP or MABP) is the avg pressure in a persons arteries during 1 cycle. What is a normal MAP in a a adult and how do you calculate it?

A

Normal MABP = 70-105 mmHg

28
Q

Define Biot’s

A

Deep, fast respirations with pauses of apnea.

irregular respirations and long apneic periods

29
Q

Define Cheyne-Stokes

A

Respirations that gradually become faster and deeper than normal, then slower; alternates with periods of apnea

30
Q

what is associated with Kusssmaul breathing?

A

low LOC

may be associated with ketoacidosis

31
Q

What does a pulse oximeter measure?

“the fifth vital sign”

Often referred as a “sat”

A

oxygen saturation in the blood
Heart rate.

Ideally normal > 92%

(Match with patients radial pulse to make sure its reading correctly)

32
Q

SaO2 vs. SpO2

A

SaO2 is the O2 saturation measured by the arterial blood gas

SpO2 is the O2 sat measured by pulse oximeter

33
Q

Normal SpO2 range

A

95-99%
No one will get 100%

34
Q

What is/how do you find the blood pressure normal in children?

A

Rule of thumb: (ACH) take the child’s age and multiple by 2; add 70 to that number

(Ex. 10 yrs x2 = 20+70 = 90)

If the systolic pressure is below your calculated number, the child is said to be hypotensive

35
Q

what is pulsus paradoxus

A

when systolic pressure drops more then 10mmHg upon inspiration from significant WOB

Normal is usually only 2-5mmHg
Only happens when blood momentarily gets “stuck” in the heart on the right side

36
Q

Factors affecting SpO2 monitor

A

Lower the percentage, the less accurate it is (<80%)

Motion affects accuracy, poor perfusion (Hypothermia)

Dark skin pigmentation or dark nail polish can have false highs

Presense of CO can cause the oximeter to read 100%

37
Q

Caponography function and use

A

Measurement of EtCO2 with a special nasal cannula

Reports the amount of CO2 presented at the end of a tidal expiration

Reflects: Amount of CO2 in body, pulmonary perfusion and alveolar ventilation

38
Q

What does Caponography reflect?

A

Amount of CO2 produced by the body
Pulmonary perfusion
Alveolar ventilation

39
Q

What are the normal ranges for
PaCO2 and end tidal CO2

A

Normal carbon dioxide levels in the blood (PaCO2): 35-45 mmHg

End tidal CO2 measurements will be 3-5 mmHg lower due to dead space

40
Q

Tobacco cessation 5 A’s

A

Ask
Assess
Arrange
Advise
Assist

41
Q

When/why would you use a Capnography?

A

Monitoring during conscious sedation on spontaneously breathing patient

During cardiac arrest (assess effectiveness of compressions and return of spontaneous circulation)

Confirm endotracheal tube placement in the trachea

Monitored on all intubated patients

42
Q

LOC is indicative of what?

A

Cerebral perfusion.

43
Q

When assessing vital signs, you should note what?

A

General appearance of the patient
Body position
Awake or asleep
Level Of Consciousness (LOC)
Distress, anxiety, severity of illness
Monitoring Parameters (alarms)

44
Q

Comparing multiple signs and symptoms allow for what?

A

Differential diagnosis of the patient
-patterns
-trends

45
Q

Glascow Coma Scale (GCS)

A

Neurologic assessment of a patient’s best verbal response, eye opening, and motor function.
oriented x3

46
Q

GCS of 15 means

A

Good LOC

47
Q

GCS of less than 8 indicates

A

Intubate- patient not getting sufficient O2

48
Q

GCS 3 or less means

A

Brain dead/ unresponsive

49
Q

APVU scale

A

Alert, Verbal, Painful, Unresponsive

50
Q

Common terms to describe altered LOC (add slides individually later) -slide 52

A
51
Q

Ataxia?

A

Lack of muscle coordination

52
Q

Kussmauls breathing?

A

Increased rate and depth of breathing.

Fast and deep = hyperventilation

53
Q

Adventitious breath sounds?

A

Sounds heard in addition to expected breaths.

For example: crackles or wheezing.

54
Q

What is ataxia?

A

Poor muscle control and coordination

55
Q

What is meningitis?

A

Inflammation (swelling) of the protective membranes covering the brain and spinal cord

56
Q

Pertinent Negative vs Pertinent Positive

A

Pertinent refers to the importance of either the positive or negative, so:

Negative = when you ask a patient if they have a symptom and they say no

Positive = when you ask someone if they have a symptom and they agree that they have that symptom

PA 1 (RESP 214) (11 decks)

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