Red Flags, Vitals, and Lines Flashcards
What can vital signs give us info on?
- how a person’s cardio/pulmonary system and status as well as how other systems are working
- how a person is responding to exercise and therapy
What are normal ranges for adults? (BP, RR, HR, O2)
BP: 120/80
RR: 12-20 breaths per minute
HR: 60-100 beats per minute, average 60
O2: 100%
What is blood pressure?
the force that blood exerts on a vessel wall
Pressure is highest in ______ than _____
arteries (top number)
veins (bottom number)
What is the control center for blood pressure?
lower pons and upper medulla
What factors influence blood pressure?
- blood volume
- diameter and elasticity of the arteries
- cardiac output
- age
- physical activity
- Valsalva maneuver
- orthostatic hypotension
What is hypertension? (range)
> 140/90
What is prehypertension? (range)
129-130/80-89
What is hypotension? (range)
systolic less than 100
What is a medical emergency for BP?
> 180/110
What is respiratory rate?
functions to supply the body and organs with oxygen and remove carbon dioxide
What are some factors that can impact RR?
- age
- body size and structure
- exercise
- body position
- environment
- stress
- pharmacology
What is heart rate measuring?
wave of blood in the artery created by contraction of the left ventricle during a cardiac cycle
What is pulse?
when the blood is forced out of the heart into a systemic system
What is bradycardia?
slow heart rate, below 60 bpm
What is tachycardia?
fast heart rate, greater than 100 bpm
What are some factors that can influence HR?
- age
- gender
- stress
- exercise
- medications
- heat and fever
What is intracranial pressure?
the pressure exerted by fluids inside the skull and on the brain tissue
What can happen if ICP is too high?
brain can herniate
What are signs of high ICP?
vomitting, headache
What is normal ICP?
4-15 mmHg
What is mild hypertension ICP?
20-30 mmHg
What is severe hypertension ICP?
> 39 mmHg
What is hemoglobin measuring?
the amount of hemoglobin in RBCs that transports O2 throughout the body
What are hemoglobin norms for males?
14-17 g/dL
What are hemoglobin norms for females?
12-16 g/dL
What are the exercise restrictions on hemoglobin?
< 8 g/dL no exercise
8-10 g/dL light exercise
>10 g/dL resistive exercise
What is hematocrit measuring?
% of RBCs throughout body
What are norms of hematocrit for males?
40-51%
What are norms of hematocrit for females?
36-47%
What are the exercise restrictions on hematocrit?
< 25% no exercise
> 25% light exercise
> 35% resistive exercise
What does the international normalizing ratio (INR) measure?
how well your blood clots
What is normal INR?
.8-1.2
WHat are the exercise restrictions with INR?
4: no increase in intensity
4-5: no resistance
5-6: no exercise
>6: bed rest
What are the red flags of vitals?
- BP > 180/90 mmHg
- Labored breathing
- O2 less than 90%
- ICP > 39 mmHg
- anemia: hemoglobin < 8 g/dL
- when in double ALWAY ask and seek MD guidance
What does an arterial catheter measure?
arterial blood pressure in real time
Where does the arterial catheter go?
directly in the artery
Is an arterial catheter or BP more accurate?
Arterial catheter
What will happen if the arterial catheter is pulled?
Heavy bleeding, physicians have to replace it
What can be limited depending on placement of the arterial catheter?
ROM (hip or wrist)
- in the hip limit to 60-80 degrees of hip flexion, which may limit the ability to sit
What does an external ventricular drain measure?
ICP
What does an external ventricular drain… drain?
CSF
What needs to be done before mobilizing a patient with a EVD?
consult with healthcare
What is a bolt?
real time measure of ICP
- hole drilled into the skull to measure
What kind of patient typically has a bolt?
TBI
What should we know about patients with Bolts?
typically too unstable to mobilize so PROM may be only option
Why are patients with a bolt unable to participate in movement?
low GCS
What is a swan-ganz catheter?
inserted into the neck and goes down large vein through the vena cava into the right atrium
What does a central venous catheter (central line) do?
delivers medication directly into the circulatory system
What is a peripherally inserted central catheter (PICC)?
peripherally inserted into the vein and goes directly to heart. Used with longer course antibiotics.
Should we pull on central or PICC lines?
NO
What can pulling a central line cause?
arrhythmias or pneumothorax
What is a ventalator?
- used for people who cannot breathe on their own
- usually and endotrachial tube
When do patients usually get a tracheostomy?
if on vent for more than 14-21 days
- the tube goes to a hole in their neck directly itno the trachea
What do patients with a vent or trach have an increased likelihood to do?
de sat - watch O2!
If vent settings are high, high risk of ________
barotrauma
Vents are not very ____
portable
What is a high flow nasal cannula?
a way to give high amounts of oxygen to a patient without intubating
What should we consider with a high flow nasal cannula?
how much buffer room
- can mobilize if they are not near max settings that would tax cardiopulmonary system
What is the next step after a high flow nasal cannula?
intubation
What is a fecal management system?
collects fecal matter into a bag and ofter with c-diff
What is a foley catheter?
urine collection and gravity dependent
- can be foley, external or suprapubic
Why could an SCI have problems with a foley catheter?
can often be noxious and cause autonomic dysreflexia
Why do we not want to pull a Foley catheter?
messy, easy to pull, hurts
What should we do with a foley catheter when performing PT?
keep below waistline
What is a nasogastric tube?
through the nose to stomach feeding tube, short term solution
What is a percutaneous endoscopic gastrostomy (PEG)?
directly into the abdomen feeding tube, and a long term solution, common in patients with more severe injuries
If someone has a feeding tube they are likely _____
NPO
When is a feeding tube easy to pull?
when the patient is aggitated
