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Clinical skills > physiological measurements > Flashcards

physiological measurements Flashcards

1
Q

what does NEWS stand for?

A
  • national early warning score
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2
Q

what is NEWS 2?

A
  • tool that acts as a track and trigger response
  • hospital deterioration or cardiac arrest preceded by change in vital signs
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3
Q

what physiological indices is NEWS 2 based on? (6)

A
  • respiratory rate
  • oxygen saturation
  • blood pressure
  • heart rate
  • ACVPU
  • temperature
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4
Q

what does ACVPU stand for?

A
  • alert
  • confusion
  • voice
  • pain
  • unresponsive
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5
Q

what is the scale for NEWS 2?

A
  • each have a score ranging from 0 normal range and 3 extreme cases
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6
Q

how do you calculate NEWS?

A
  • if 1-5 cause for concern and should be escalated to change nurse, junior doctor
  • if no improvement should be escalated to critical care outreach
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7
Q

what does a NEWS score of over 5 mean?

A
  • critical care outreach needs to be informed immediately
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8
Q

what is the normal respiration rate?

A
  • 12 to 20 breaths per minute
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9
Q

how is respiration rate measured?

A
  • assess rise and fall of the chest wall
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10
Q

how do you take respiratory rate manually?

A
  • count for 60 seconds
  • one full rise and fall is counted as one breath
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11
Q

what should you observe from respiratory rate?

A
  • rate
  • depth
  • rhythm
  • any abnormal movements
  • work of breathing
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12
Q

where is the control centre located?

A
  • medulla oblongata
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13
Q

what is the respiration rate controlled by?

A
  • chemical control> chemoreceptors
  • nervous control- phrenic and intercostal nerves
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14
Q

what is tachypnoea?

A
  • increase in respiratory rate
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15
Q

what is bradypnoea?

A
  • reduction of respiratory rate
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16
Q

what are the causes of tachypnoea?

A
  • respiratory pathologies
  • asthma
  • COPD
  • heart failure
  • fever
  • pain
  • distress
  • PE
  • pneumonia
  • anxiety
  • acute respiratory distress syndrome
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17
Q

what are the causes of bradypnoea?

A
  • medications
  • opioid
  • head injury
  • complications in respiratory failures
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18
Q

what do you do with the cuff when measuring BP? what should you ensure?

A
  • wrap the cuff around the upper arm bicep
  • arrow should be in line with the brachial artery
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19
Q

what position should the model be in for taking blood pressure?

A
  • sitting or in a lying position
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20
Q

what can assess postural hypertension?

A
  • lying to standing blood pressure readings
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21
Q

what is the systolic BP?

A
  • measure of the peak pressure in which blood hits the artery
  • top number
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22
Q

what is the diastolic BP?

A
  • lower lowest point
  • bottom number
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23
Q

what is the normal BP systolic rate?

A
  • 90mmhg
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24
Q

what are the precautions for measuring blood pressure?

A
  • fistulas > avoid taking from that side
  • cannulas
  • open wounds
  • fractures/ trauma
  • lymphedema
  • any surgical procedures that affect access to arm
  • skin integrity compromise
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25
Q

what is low blood pressure called?

A
  • hypotension
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26
Q

what is a high blood pressure called?

A
  • hypertension
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27
Q

what are the causes of hypotension?

A
  • hypovolaemia (loss of fluids, blood, diarrhoea, vomiting)
  • sepsis
  • anaphylaxis
  • medications
  • PE
28
Q

what are the causes of hypertension?

A
  • agitation and anxiety
  • MI
  • heart failure
  • asthma
  • stroke
  • infection
  • sepsis
  • PE
29
Q

what is oxygen saturation?

A
  • measure of the percentage of hemoglobin binding with oxygen
30
Q

what is the normal oxygenation?

A
  • normally 94-100%
31
Q

what device do you use to measure oxygen saturation?

A
  • electronic pulse oximeter device
32
Q

what do you do with the device to measure sp02?

A
  • place the device on finger with screen pointing up
  • concentration of 02 given as a percentage
33
Q

what are the precautions of oxygen saturation?

A
  • nail polish, false nails
  • history of hypoxia
  • fractures
  • trauma
34
Q

what is oxygen saturation driven by?

A
  • hypercapnic drive
35
Q

what does low sp02 indicate?

A
  • respiratory compromise
  • cardiovascular compromise
36
Q

what are the causes of low sp02?

A
  • asthma
  • heart failure
  • PE
  • MI
  • sepsis
  • acute respiratory distress syndrome pneumothorax
  • post surgery
37
Q

what is the normal heart beat?

A
  • normally between 50-100 beats per min
38
Q

how do you measure heart beat?

A
  • measured by assessing palpating the radial artery and counting the number of beats per min
39
Q

what fingers should you use while palpating the radial artery?

A
  • index and middle finger
40
Q

how can you take pulse rate using a device?

A
  • pulse oximeter
41
Q

what should you assess from the pulse rate? (3)

A
  • rate
  • strength
  • depth of pulse
42
Q

what are the precautions of taking heart rate?

A
  • open wounds
  • fractures
  • skin integrity compromise
  • arterial lines
43
Q

what can provide abnormal readings/ no reading of HR?

A
  • nail polish
44
Q

what is heart rate controlled by? where is it located?

A
  • controlled by autonomic nervous centre
  • in medulla oblongata
45
Q

what are the two different responses of HR?

A
  • sympathetic
  • parasympathetic
46
Q

what does the sympathetic nerve do?

A
  • increases HR
  • fight or flight response
47
Q

what does the parasympathetic nerve do?

A
  • reduces the HR
48
Q

what is a high heart rate called? - what number

A
  • tachycardia
  • over 100
49
Q

what is a low heart rate called? - what number?

A
  • bradycardia
  • under 50
50
Q

what are the causes of tachycardia?

A
  • anxiety
  • medication
  • heart failure
  • PE
  • anaphylaxis
  • acute respiratory distress syndrome
51
Q

what is a sign of deterioration?

A
  • increase or decrease in temperature
52
Q

what response is temperature?

A
  • homeostatic response
53
Q

where is the control centre of temperature?

A
  • hypothalamus
54
Q

what is the normal temperature? what is it called?

A
  • 36 to 37.5 degrees
  • apyrexial
55
Q

what is low grade temperature? - when does this happen?

A
  • 38 degrees
  • mild inflammation, infection or allergy
56
Q

what is moderate to high grade temp?

A
  • 38 to 40 degrees
  • infection possible wound or soft tissue injury
57
Q

what is hyperpyrexia?

A
  • high temperature
  • bacterial infections
  • or injury to the hypothalamus
58
Q

what is hypothermia?

A
  • temperature below 35
59
Q

what is hypothermia the result of?

A
  • infection
  • serious sign of potential organ compromise
60
Q

what is the A-G of imaging ?

A
  • alignment
  • bones
  • cardiac
  • diaphragm
  • expansion
  • fields
  • gadgets
61
Q

what is the alignment in imaging?

A
  • spinous process are in the centre of the trachea
62
Q

what are the bones for breathing?

A
  • clavicle
  • spinous process
  • scapula
  • ribs
63
Q

what is the cardiac aspect of imaging?

A
  • heart takes up 3rd of the distance of the angle, aortic arch, cardio- phrenic angle
64
Q

what is the diaphragm aspect of imaging?

A
  • costophrenic right shoulder should be higher than the left due to the position of the liver
65
Q

what does expansion go to?

A
  • goes to the 6th rib
66
Q

what is the field aspect of imaging?

A
  • hilum blood vessels
67
Q

what is the gadgets aspects of imaging?

A
  • identify any objects to rule out pathology

Clinical skills (13 decks)

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