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Neuro muscular > Red Flags, vitals and lines > Flashcards

Red Flags, vitals and lines Flashcards

1
Q

What are vital signs

A

*Heart rate (HR), respiratory rate (RR), blood pressure (BP), oxygen saturation (O2) all give vital information of a person’s cardio/pulmonary system and status as well as how other systems are working.

*Observation alone of a patient will not tell you cardio/pulmonary status

*Assessing vital signs can also give you information of how a person is responding to exercise and therapy

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2
Q

what are Normal vital ranges for adults

A

BP 120/80 mmHg

RR 12-20 breaths per minute

HR 60-100 beats per minute, average 60

O2 sats 100 %

***Many stroke patient suffer from cardiovascular disease which caused CVA. A fib #1 risk factor for ishemic stroke

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3
Q

what is blood pressure

A

*The force that blood exerts on an vessel wall

*Pressure is highest in arteries (top number) than veins (bottom number)

*Control center is lower pons and upper medulla

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4
Q

what are Factors that influence blood pressure:

A

-Blood volume
-Diameter and elasticity of the arteries
-Cardiac output
-Age
-Physical activity
-Valsalva maneuver
-Orthostatic hypotension

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5
Q

Blood pressure values

A

Hypertension: > 140/90
Prehypertension: 120-139/80-89
Hypotension: systolic < 100
Medical emergency: > 180/110

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6
Q

what is respiratory rate

A

Function is to supply the body and organs with oxygen and remove carbon dioxide

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7
Q

what are factors that influence RR

A

-Age
-Body size and structure
-Exercise
-Body position
-Environment
-Stress
-Pharmacology

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8
Q

what is heart rate?

A

*Wave of blood in the artery created by contraction of the left ventricle during a cardiac cycle

*Pulse is when the blood is forced out of the heart into systemic system

*Bradycardia: slow heart rate, below 60 bpm

*Tachycardia: fast heart rate, greater than 100 bpm

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9
Q

what are factors that influence HR

A

Age
Gender
Stress
Exercise
Medications
Heat and fever

-Fetal 120-160 bpm
-Newborn 70-170
-Adults 60-100
-Male and boys typically lower than females
-Stress can increase HR
-Hr increases with exercise to provide additional blood flow to muscles

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10
Q

Intracranial Pressue (ICP) is

A

-Pressure exerted by fluids (CSF) inside the skull and on the brain tissue

-If pressure is too high, the brain can herniate

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11
Q

signs of Pressure ICP

A

Vomiting
Headache

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12
Q

What are ICP values

A

Normal: 4-15 mmHg
Mild hypertension: 20-30 mmHg
Sever hypertension: > 39 mmHg

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13
Q

what is Hemoglobin (Hb)

A

Amount of hemoglobin in RBCs that transports O2 throughout the body

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14
Q

what are Hemoglobin values

A

Male: 14-17 g/dL
Female: 12-16 g/dL
< 8 g/dL no exercise
8-10 g/dL light exercise
> 10 g/dL resistive exercise

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15
Q

what is Hematocrit (Hct)

A

% of RBCs throughout the body

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16
Q

what are values of Hematocrit (Hct)

A

Male: 40-51%
Female: 36-47%
< 25% no exercise
> 25% light exercise
> 35% resistive exercise

17
Q

what is International Normalizing Ratio (INR) and values?

A

How well your blood clots

Normal: .8-1.2
4: no increase in intensity
4-5: no resistance
5-6: no exercise
> 6: bed rest

18
Q

what are red flags values

A

BP >180/90 mmHg
Labored breathing
O2 less than 90 %
ICP > 39 mmHg
Anemia: hemoglobin < 8 g/dL
INR: > 5
When in doubt ALWAYS ask and seek MD guidance

19
Q

what is a Arterial catheter (Art line)

A

-Measures arterial blood pressure in real time

-Goes directly into the artery

-More accurate than BP

-If it is pulled, there will be heavy bleeding

-Physician has to replace it

Depending on placement (hip or wrist) limit ROM
—In hip, limit to 60-80 degrees of hip flexion which may limit ability to sit

20
Q

what is External Ventricular Drains

A

-Measures ICP
-Drains CSF
-Consult with healthcare before mobilizing patient with EVD

21
Q

what is Bolt

A

-Real time measure of ICP
-Hole drilled into the skull to measure
-Typically seen in TBI
-Typically these patients are too unstable to mobilize so PROM may be only option

normally have low GCS cant move

22
Q

what are Central venous catheters (Central lines)

A

*Swan-Ganz catheter: inserted into the neck and goes down large vein through the vena cava into the right atrium

*Can deliver medication directly into the circulatory system

directly in heart, cause arrhythmias or pneumothorax

23
Q

what is Peripherally inserted central catheter (PICC)

A

Peripherally inserted into the vein and goes directly into the heart. Used with longer course antibiotics

directly in heart, cause arrhythmias or pneumothorax

24
Q

what is a ventilator

A

*Used for people who cannot breath on their own

*Usually and endotracheal tube

*If on vent more than 14-21 days, patients usually get a tracheostomy where the tube goes to a hole in their neck directly into the trachea

*Ventilators are not very portable, so may need respiratory therapy to assist

*Increased likelihood to de sat so watch O2

*High risk of barotrauma if vent settings are high

Consider how much buffer room with settings and how much they are safely be moved on settings

25
Q

a high flow nasal cannula

A

*A way to give high amounts of oxygen to a patient without needing to intubate

*Consider how much buffer room they: can mobilize if they are not near maximum settings that would tax cardiopulmonary system

*Next step after this is intubation so you do not want to push too much

26
Q

what is a fecal management system

A

Collects fecal matter into a bag and often used with c-diff

27
Q

a foley is?

A

*Urine collection and gravity dependent

*Can be foley, external, or suprapubic

*In SCI can often be noxious and cause autonomic dysreflexia

*Bags are easy to pull and very messy so be aware

*Hurt a lot when accidentally pulled

*Keep below waistline as they are gravity dependent

28
Q

what is Nasogastric tube (NG):

A

through the nose to stomach and short term solution

If someone has a feeding tube, they are most likely NPO so do not give them water or food
Easy to pull when patients are agitated

29
Q

Percutaneous Endoscopic Gastrostomy (PEG): is

A

directly into the abdomen and a long term solution, common in patients with more severe injuries

30
Q
A

Neuro muscular (12 decks)

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