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Healthcare Gr. 12 > Patient Assessment: Vital Signs (U3) > Flashcards

Patient Assessment: Vital Signs (U3) Flashcards

1
Q

Vital signs definition?

A

Physical signs that indicate an individual is alive

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2
Q

How are vital signs seen?

A

Observed, measured and monitored to assess an individual’s level of physical functioning, patient must have been sitting for approx. 5 minutes (relax)

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3
Q

What should you do before assessing a patient?

A

Take a minute to look at the entire patient, all assessments made when seated (ex. patient hygiene level, are they relaxed….)

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4
Q

What are some factors to consider when looking at normal vital signs?

A

Age/sex/weight/exercise tolerance/condition

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5
Q

What are the four assessments, and why in that order?

A
  1. Temperature
  2. Pulse
  3. Respiration
  4. Blood pressure

Least to most invasive

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6
Q

Temperature can vary due to what reasons?

A

Time of day, illness, stress, exposure to heat/cold

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7
Q

Normal temperature?

A

36.5-37.7 degrees Celsius

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8
Q

What are the four temperature sites?

A

Oral, axillary, tympanic, rectal

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9
Q

What is the oral temperature site?

A

Within the mouth/under tongue

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10
Q

What is the axillary temperature site?

A

In the armpit

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11
Q

What is the tympanic temperature site?

A

In the ear canal

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12
Q

What is the rectal temperature site?

A

Through the anus in the rectum

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13
Q

What is a pulse?

A

Pressure of the blood felt against the wall of an artery as the heart contracts/relaxes

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14
Q

What are the three things pulse measures?

A

Rate, rhythm, volume

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15
Q

What is pulse rate?

A

Number of beats/minutes

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16
Q

What is pulse rhythm?

A

Refers to regularity

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17
Q

What is pulse volume?

A

Refers to strength

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18
Q

What is the pulse taken on?

A

Radial/carotid artery, and on arteries

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19
Q

What are the arteries that pulse is taken on?

A

Temporal, carotid, brachial, radial, femoral, popliteal, dorsalis pedis, posterior tibial

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20
Q

What is the temporal site?

A

Sides of the head

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20
Q

What is the carotid site?

A

Sides of the neck

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21
Q

What is the brachial site?

A

Inner aspect of forearm at the antecubital space

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22
Q

What is the radial site?

A

Inner aspect of the wrist, above thumb

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23
Q

What is the femoral site?

A

Inner aspect of the upper thigh

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24
Q

What is the popliteal site?

A

Behind the knee

25
Q

What is the dorsalis pedis site?

A

Top of the foot arch

26
Q

What is the posterior tibial site?

A

Medial aspect of the ankle

27
Q

What are the two most common sites for taking a pulse?

A

Radial, and apical

28
Q

What is an apical pulse?

A

Ausculated with a stethoscope on the chest wall, pulse is found on the apex of the heart (bottom)

29
Q

Characteristics of a pulse?

A

Pulse rate, rhythm, strength and intensity, bilateral presence

30
Q

How is a pulse rate found?

A

Assessed in BPM, counted for 15/20/30/60 seconds

31
Q

Tachycardia definition?

A

Pulses rate faster than normal

32
Q

Bradycardia definition?

A

Pulse rate slower than usual

33
Q

What does rhythm refer to?

A

Refers to the regularity of the pulse (spacing of the beats), the pattern of the heartbeat

34
Q

What types of pulse rhythm are there?

A

Regular and irregular

35
Q

What is an irregular pulse rhythm?

A

Arrhythmia, Usually caused by a defect in the electrical conduction pattern

36
Q

What do you do when documenting a client with an irregular heartbeat?

A

Must be measured a full minute to determine average rate, document pulse rhythm as irregular (regular for a normal patient)

37
Q

What are the two ways to describe a pulse’s strength and intensity?

A

Strong/bounding and weak/thready

38
Q

Bilateral presence definition?

A

Pulses should have bilateral presence, found on both sides

39
Q

BP definition?

A

Pressure/tension exerted on the arterial walls of blood pulsates through them

40
Q

Systolic blood pressure definition? What is expected?

A

Pressure exerted on the arteries during the contraction phase of the heartbeat (100-149mm HG)

41
Q

Diastolic blood pressure definition? What is expected?

A

Resting pressure on the arteries as the heart relaxes between contractions (60-90mm HG)

42
Q

Hypotension definition?

A

When blood pressure drops below expected

43
Q

Hypertension definitino?

A

High blood pressure (medical condition with multiple readings)

44
Q

Equipment to measure BP?

A

Sphygmomanometer/BP cuff/cuff

45
Q

Respiration definition?

A

Process of taking in O2 and expelling CO2 from lungs and respiratory tract

46
Q

One is contained in one breath?

A

One inspiration and expiration

47
Q

Dyspnea definition?

A

Difficult/laboured breathing

48
Q

Apnea definition?

A

Absence of respiration?

49
Q

Orthopnea definition?

A

Severe dyspnea in which breathing is very difficult in any position other than sitting erect/standing

50
Q

What is a tachypnea resting respiratory rate?

A

RR>20 bpm

51
Q

What is a bradypnea respiratory rate?

A

RR<12 bpm

52
Q

Cheyne-Stokes respiration definition?

A

Periods of dyspnea followed by periods of apnea (dying patient)

53
Q

Signs of respiratory distress?

A

Cyanosis, central asphyxiation, hyper/hypoventilation, rhythm of respiration and quality of respirationC

54
Q

Cyanosis definition?

A

Dusky, bluish discolouration of the skin/lips/nail beds due to low O2 and high CO2 in the bloodstream

55
Q

What is central cyanosis a sign of?

A

Respiratory distress

56
Q

Central asphyxiation definition?

A

Lock of O2 getting into the body

57
Q

What does it mean when the peripheral heart is not pumping properly?

A

Respiratory distress

58
Q

Hyperventilation definition?

A

Increased respiratory rate (related to shallow breaths)

59
Q

Hypoventilation definition?

A

Decrease in respiratory rate and depth (related to shallow breaths, but with its depth

60
Q

Rhythm respiration should be…

A

Regular

61
Q

What are the two qualities of respiration?

A

Shallow/deep

Healthcare Gr. 12 (22 decks)

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