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Patient Care > Test 4 > Flashcards

Test 4 Flashcards

1
Q

vital signs

A

measurements of the body’s most basic functions

-used to detect/monitor medical problems

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2
Q

where can vital signs be measured?

A

anywhere

  • medical setting
  • home
  • onsite of a medical emergency
  • elsewhere
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3
Q

what are types of vital signs?

A
  • body temperature
  • heartrate/pulse
  • respiration rate
  • blood pressure
  • oxygen saturation
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4
Q

what is body temperature?

A

physiologic balance between heat production in body tissues and heat lost to the environment

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5
Q

what is body temperature controlled by?

A

hypothalamus

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6
Q

what can body temperature be influenced by?

A

normal and abnormal conditions

  • environment
  • time of day
  • age
  • weight
  • hormones
  • emotions
  • exercise
  • digestion
  • injury
  • disease
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7
Q

what is temperature most commonly measured in?

A

celcius

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8
Q

what are ways to measure body temperature?

A
  • oral (under the tongue)
  • rectal (anal opening)
  • axillary(under armpit)
  • tympanic membrane (through auditory canal)
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9
Q

what is the oral thermometer?

A

blue

electric

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10
Q

how is oral recorded?

A

O

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11
Q

what is the rectal thermometer?

A

red

electric

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12
Q

how is rectal recorded?

A

R

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13
Q

what is the axillary thermometer?

A

electric

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14
Q

how is axillary recorded?

A

Ax

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15
Q

what type of thermometer is tympanic membrane?

A

tympanic

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16
Q

how is tympanic membrane recorded?

A

T

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17
Q

what way of measuring body temperature is the safest?

A

axillary-but very position dependant so not reliable

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18
Q

what is normal body temp for a newborn-1 year?

A

C=37.5-37.7

F=99.4-99.7

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19
Q

what is the normal body temp for a person 3-5 years?

A

C=37-37.2

F=98.6-99

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20
Q

what is a normal body temp for a person 7-9 years?

A

C=36.7-36.8

F=98.1-98.3

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21
Q

what is the normal body temp for a person 10 years or older?

A

C=36.6

F=97.8

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22
Q

what is the rule of thumb for axillary temp?

A

about 0.5 degrees Celsius lower than oral

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23
Q

what is the rule if thumb for rectal temperature?

A

about 0.5-1 degree Celsius higher than oral

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24
Q

what is the rule of thumb for tympanic temperature/

A

about 0.8 degrees Celsius higher than oral

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25
Q

what is pyrexia?

A

body temp elevated above normal values

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26
Q

what are symptoms for pyrexia?

A
  • increased pulse rate
  • increased respiratory rate
  • general discomfort or aching
  • loss of appetite
  • flushed skin that is hot to touch
  • chills
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27
Q

what can happen if body temp remains high for a prolonged amount of time?

A

can cause damage to CNS

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28
Q

what is hypothermia?

A

body temperature below normal values

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29
Q

what are symptoms for hypothermia?

A
  • shivering
  • slurred speech
  • slow and shallow breathing
  • weak pulse
  • confusion
  • drowsiness
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30
Q

what can be medically induced?

A

hypothermia-reduce a patients need for oxygen

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31
Q

what can heart rate/pulse be influenced by?

A

internal and external conditions

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32
Q

what is heart rate/pulse measured in?

A

beats per minute

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33
Q

what do you take notes of when measuring heart rate?

A

-rate
-rhythm
-strength
-characteristics
LOOK IN NOTES

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34
Q

rate

A

number of beats per minute

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35
Q

rhythm

A

interval between beats

  • even or uneven
  • arrhythmia?
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36
Q

arrhythmia

A

any variation from the normal rhythm of the heart

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37
Q

tachycardia

A

abnormally rapid pulse rate

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38
Q

what is an abnormal rapid heart rate?

A

over 100 bpm

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39
Q

bradycardia

A

abnormally slow pulse rate

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40
Q

what is an abnormal slow pulse rate?

A

under 60 bpm

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41
Q

strength

A

pressure you feel or hear

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42
Q

what is normal resting heart rate for an infant?

A

120bpm

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43
Q

what is the normal resting heart rate for 4-10 year old?

A

90-100 bpm

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44
Q

what is an normal resting heartrate for an adult?

A

60-90 bpm

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45
Q

where are the pulse locations?

A
  • temporal
  • carotid
  • apical
  • brachial
  • radial
  • femoral
  • popliteal
  • posterior tibial
  • dorsalis pedis
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46
Q

what are important tips for measuring heart rate?

A
  • don’t press on the artery too much
  • never use your thumb
  • feel for 30s and x2
  • if irregular count for 1 minute
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47
Q

how is a strong pulse rate of 80 beats/min documented?

A

HR: 80bpm, strong

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48
Q

what is the function of respiration?

A

exchange oxygen and carbon dioxide between the external environment and blood circulating in the body

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49
Q

what does one respiration cycle equal?

A

one respiration and one expiration

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50
Q

what can respiration rate be influenced by?

A
  • medication
  • illness
  • exercise
  • age
  • body habitus
  • body position
  • e.t.c
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51
Q

how long do you monitor respiration rate?

A

monitor for 20 seconds and multiply by 3

-if irregular, monitor for 60 seconds

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52
Q

what is the respiration rate for infants?

A

30-60 breaths/min

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53
Q

what is the respiration rate for adults?

A

15-20 breaths/min

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54
Q

normal respirations should be___________

A

quiet
effortless
uniform

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55
Q

fewer than 10 breaths/min may result in ___________

A
  • cyanosis
  • apprehension
  • restlessness
  • decreased level of consciousness due to the inadequate supply of oxygen to body tissues
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56
Q

dyspnea

A

patient who is using an increased amount of effort to breath

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57
Q

tachypnea

A

breathing rate above the normal amount

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58
Q

what do you watch for when measuring respiration?

A
  • depth-symmetry of chest movement
  • character-distressed, wheezing, quiet, etc
  • observe skin colour
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59
Q

where is cyanosis most easily observed?

A

around the mouth, gums, nailbeds and earlobes

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60
Q

what are respirations documented with?

A
  • rate
  • depth
  • description
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61
Q

what is blood pressure?

A

amount of blood flow ejected from the left ventricle of the heart during systole (contraction) and the amount of resistance the blood meets due to systemic vascular resistance

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62
Q

what is blood pressure influenced by?

A
  • blood volume
  • blood viscosity
  • elasticity of vessel wall
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63
Q

what decreases BP?

A

-hemorrhage or dehydration causes less blood volume

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64
Q

what increases BP?

A
  • thicker blood is more viscous (hypercoagulable state)

- age, plaque reduces flexibility of vessel walls

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65
Q

what instrument measures blood pressure?

A

sphygmomanometer

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66
Q

systolic pressure

A

the highest point reached during contraction of the left ventricle as it pumps blood into the aorta.

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67
Q

diastolic pressure

A

the lowest point to which pressure drops during relaxation of the ventricles and indicates the minimal pressure exerted against the arterial walls continuously

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68
Q

who tends to have a slightly higher BP?

A

females

69
Q

what arm would you use to measure BP?

A

left arm because it is closer to the heart

70
Q

where do you apply the cuff?

A

snugly 1” above elbow crease with arrow over brachial artery

71
Q

which hand do you hold the stethoscope?

A

non-dominant hand

72
Q

which hand do you hold bulb and close valve?

A

dominant hand (use your thumb and finger)

73
Q

how much do you inflate your BP cuff?

A

20-30 mmHg

74
Q

if the cuff is deflates too slowly, the reading will be ________

A

falsely high

75
Q

if the cuff deflates too quickly, the reading will be _______

A

falsely low

76
Q

how do you find systolic blood pressure?

A

listen carefully for the pulse beat to begin and note the number on the gauge

77
Q

how do you measure diastolic pressure?

A

continue to listen to the pulsations until they become soft or the sound changes from loud to very soft or inaudible.

78
Q

if there is troubleshooting then what can you do?

A
  • deflate cuff
  • wait 1-2 min
  • have patient raise his or her arm
  • retake blood pressure
79
Q

how is oxygen delivered to tissues?

A

by blood

80
Q

what is used to monitor oxygen saturation of hemoglobin?

A

pulse oximeter-non invasive and fast

81
Q

what is a normal oxygen saturation?

A

SpO2

88%-92%

82
Q

how much does oxygen saturation have to drop for it to be concerning?

A

3% or more

83
Q

how do your properly document pulse (heart rate)?

A

HR: 80bpm (include characteristic:strong, weak, thready)

84
Q

how do you properly document respiration rate?

A

RR: 17rpm (include characteristic: laboured, wheezy)

85
Q

how do you properly document blood pressure?

A

BP:120/80 mmHg

86
Q

how do you properly document temperature?

A

T: 98.6 O

87
Q

what mental status check can sonographers do?

A
  • glascow coma scale

- change in level of consciousness

88
Q

what are the 3 areas of neurologic function in Glasgow coma scale?

A
  • eye opening
  • verbal response
  • motor responce
89
Q

LOC

A

level of consciousness

90
Q

how do you access LOC?

A
  1. ask patient to state name, date, etc
  2. note patients ability to follow directions during exam, lack of response, etc
  3. assess patients vital signs if current readings are not in the chart to provide a baseline for which to compare further measurements against
91
Q

what important when assessing patient neurological state?

A

any changes must never be ignored, notify physician

92
Q

what is shock?

A

body’s pathological reaction to illness, trauma, or severe physiologic or emotional stress?

93
Q

is shock life threatening?

A

yes

94
Q

what are different types of shock?

A
  • hypovolemic shock
  • cardiogenic shock
  • distributive shock
  • neurogenic shock
  • septic shock
  • anaphylactic shock
  • obstructive shock
95
Q

what causes hypovolemic shock?

A

20% or more of body fluid volume is lost

96
Q

what are symptoms of hypovolemic shock?

A 
increased heart rate
increased blood pressure
increased respirations
thirsty
skin is cold and clammy
cyanosis around lips and nails
97
Q

what does a sonographer do if your patient went into hypovolemic shock?

A
  • put patient in Trendelenburg position
  • make sure patient can breath
  • if wound apply direct pressure
  • keep patient warm and dry
  • no fluids
  • tell patient what is going on
98
Q

what is the cause of cardiogenic shock?

A

failure of heart to pump adequate amount of blood to vital organs

99
Q

what patients are most vulnerable for cardiogenic shock?

A
  • myocardial infarction
  • cardiac tamponade
  • dysrhythmias
100
Q

what are the symptoms of cardiogenic shock?

A
  • chest pain (jaws and arms)
  • dizziness
  • HR can be slow or fast
  • Low BP
  • respiratory distress or tachypnea
  • cyanosis
  • restless and anxiety
  • rapid change in LOC
  • cool, clammy skin
  • difficult to find carotid pulse
101
Q

what postion do we put the patient for cardiogenic shock?

A

semi-fowlers position to facilitate respiration

102
Q

what do we not do for patients in cardiogenic shock?

A

do not give them fluids (water)

103
Q

when does distributive shock occur?

A

a pooling of blood in the peripheral blood vessels resuslts in a decreasd return of blood to the heart-decrease in blood pressure-decrease in tissue perfusion

104
Q

what happens to the blood vessels in distributive shock?

A

unable to constrict properly so they are unable to return blood to the heart

105
Q

what are the types of distrutive shock?

A
  • neurogenic shock
  • septic shock
  • anaphylactic shock
106
Q

what is the cause of neurogenic shock?

A

loss of tone cause vasodilation of peripheral vessels

107
Q

examples of why neurogenic shock happen?

A
  • spinal cord injury
  • severe pain
  • neurologic damage
  • depressant action of medication
  • lack of glucose
  • adverse effects of anesthesia
108
Q

what are the symtoms to neurogenic shock?

A
  • decrease in BP (hypotension)
  • decrease in HR (bradytachia)
  • warm, dry skin
  • cool extremities
  • diminishing peripheral pulses
109
Q

what position do we put a person in neurogenic shock in?

A

supine

110
Q

what do we prepare for, for a person in neurogenic shock?

A

prepare to assist with oxygen, IV, and medications

111
Q

what is the cause of septic shock?

A

invaded with bacteria, the body begins its imune responce by releasing chemicals that increase capillary permeability and vasodilation, leading to shock syndrome

112
Q

what causes septic shock (think organisms)?

A
  • gram-positive bacteria

- viruses

113
Q

what is the phase 1 to symtoms of septic shock?

A
  • hot, dry, and flushed skin
  • increased HR and RR
  • fever
  • nausea, vomiting, and diarrhea
  • possible confusion
114
Q

what is the phase 2 symtoms of septic shock?

A
  • cool, pale skin
  • increased HR and RR
  • decreased BP
  • seizures
  • organ failure
115
Q

what is a sonographers responce to someone in septic shock?

A

keep them warm as shivering increases the body’s oxygen consumption

116
Q

what is the cause of anaphylactic shock?

A

antigen exposure-histamines-widespread vasodilation=peripheral blood pooling+contraction of smooth muscles

117
Q

what is anaphylactic shock due to?

A
  • allergy-exaggerated hypersensitivity reaction to an antigen
  • medications
  • contrast media
  • insect venous
118
Q

what are symtoms to a mild systemic reaction? (anaphylactic shock)

A
  • nasal congestion
  • itching
  • sneezing
  • eye watering
  • tight chest, mouth, throat
  • anxiety
119
Q

what are the symotms to a moderate systemic reaction? (anaphylactic shock)

A
  • flushing, feeling of warmth, hives
  • bronchospasm, edema or airways or larynx
  • dyspnea, cough, and wheezing
120
Q

what are the symtoms to a severe systemic reaction (anaphylactic shock)

A
  • abrupt onset and rapid progressionof moderate symtoms
  • decrease BP, weak thready pulse, dyspnea
  • cyanosis, seizures, respiratory and cardiac arrest
121
Q

what postion do we put a person in anaphylactic shock?

A

semi-fowlers postion

122
Q

what do we prepare for a person in anaphylactic shock?

A

assist with oxygen, IV fluids, and medications

123
Q

what medications would we give a person with anaphylactic shock?

A
  • epinephrine
  • diphenhydramine
  • hydrocortisone
  • aminophylline
124
Q

what is the cause of obstructive shock?

A

pathological conditions that interfere with the normal pumping action of the heart

125
Q

what is obstructive shock due to?

A
  • PE
  • hypertension
  • arterial stenosis
  • constrictive pericardatitis
  • tumors that interfere with blood flow through the heart
126
Q

what are the symtoms of obstructive shock?

A

mimics cardiogenic shock

127
Q

what postion do we put a person in obstructive shock?

A

semi-fowlers postion

128
Q

what is PE r with?

A
  • trauma
  • orthopedic and abdominal surgeries
  • pregnancy
  • congestive heart failure (CHF)
  • prolonged immobility
  • hypercoagable states (birth control)
129
Q

what does increased pressure of the Rt side of the heart lead to?

A

Rt ventricular dysfunction and cardiogenic / obstructive shock

130
Q

what are the symtoms to PE?

A
  • rapid, weak pulse
  • hyperventilation
  • dyspnea and tachypnea
  • tachycardia
  • apprehension
  • cough and hemoptysis
131
Q

what is diabetes caused by?

A

either insufficient production or inadequate utilization of insulin in the body cells resulting in elevated levels of glucose on the blood (hyperglycemia)

132
Q

Type 1 diabetes description

A
  • abrupt onset
  • under 30 years old
  • daily insulin injections to prevent ketoacidosis
133
Q

type 2 diabetis description

A
  • gradual onset
  • over 40 years old
  • impaired sensitivity to insulin or decreased production of insulin
  • controlled by weight loss, diet, and exercise
134
Q

gestational diabetes

A

occurs in the later months of pregnancy. Pregnancy hormones prevent the action of insulin. Treated with diet and occasionally with insulin

135
Q

Hypoglycemia

A

excess insulin in bloodstrea,

didnt eat enough food to utilize insulin

136
Q

Diabetic Ketoacidosis

A

insufficient insulin causes the liver to produce more glucose resulting in hyperglycemia

137
Q

Hyperglycemic hyperosmolar non-ketotic syndrome

A

AKA-diabetic coma

138
Q

diabtic symtoms

A

tachycardia

  • headache
  • blurred
  • extreme thirst
  • sweet odor to the breath (in ketoacidosis)
139
Q

what is the sonogrpaher responce to diabetic emergencies?

A
  • stop procedure and call radiologist
  • monitor vitals
  • preapre to administor fluids
140
Q

cerebral vascular accident

A

stroke-brain attack

141
Q

what are CVA’s caused by?

A

sudden occlusion or rupture of blood supply to the brain

142
Q

what does disruption of blood supply to the brain cause?

A

lack of oxygen to the brain tissue resulting in cell death

143
Q

BE FAST

A 
B-balance
E-eyes
F-face
A-arms
S-speech
T-time
144
Q

what are causes of respiratory obstruction

A
  • positioning
  • tongue falling
  • foreign body
  • disease
  • drug overdose
  • allergic reaction
145
Q

respiratory obstruction what does it mean?

A

gas exchange is no longer adequeate to meet bodies needs

146
Q

what is cardiac arrest?

A

heart ceases to beat effectively, blood can no longer circulate throghout the body providing oxygen to all the organs

147
Q

causses of cardiac arrest

A
  • tachycardia
  • bradycardia
  • hypovolemic shock
  • myocardial infarction
  • drug overdose
148
Q

how long can the brain survive without oxygen?

A

2-4 minutes

149
Q

respiratory disfunction symtoms

A
  • labored, noisy bretahing
  • wheezing
  • use of accessory muscles of neck, abdomen, and chest
  • neck vein dissention
  • diaphoresis (sweating)
  • axiety
  • cyanosis
150
Q

respiratory arrest symptoms

A
  • patient stops responding
  • pulse continues briefly
  • chest movements stop
  • no air is detectable
151
Q

cardiac arrest symtoms

A
  • loss of consciousness
  • loss of pulse and BP
  • dilation of pupils within seconds
  • possibility of seizures
152
Q

what are the steps to when you suspect someone going into respiratory/cardiac arrest

A
  • call code blue
  • start ABC’s
  • place patient in supine
  • put board under patient for CPR
  • DO NOT waste time with getting crash cart
153
Q

what is a seizure?

A

unsystematic discharge of neurons that results in an abrupt alteration in the brain function

154
Q

do you have a warning when someone may have a siezure?

A

onset with little or no warning

155
Q

what changes to a person with seizures?

A

change in level of consciousness

156
Q

what are seizures associated with?

A
  • infections or disease with high fevers
  • extreme stress
  • head trauma
  • brain tumours
  • structural abnormalities of the cerbral cortex
  • genetic defects
  • birth trauma
  • post natal trauma
157
Q

what are the types of seizures?

A
  • generalized

- partial (complex and simple)

158
Q

what are the symtoms to a generalized seizure?

A
  • utter a sharp cry
  • muscles become rigid and move with jerky body movements
  • eyes open wide
  • may vomit or froth at mouth
  • possible incontinence
  • deep sleep after seizure
159
Q

what are the symtoms to a partial complex seizure?

A
  • may remain motionless
  • may experience excessive emotional outburst (crying)
  • facial grimacing lip smacking, swallowing movements or panting
  • confusion afterwards with no memory of the incident
160
Q

what are the symtoms to partial simple seizure?

A
  • may speak unitelligibly
  • may be dizzy
  • may sence strange odours, tastes, or sounds
  • only a finger or hand may shake
  • will not lose consciousness
161
Q

syncope

A

transient loss of conscousness resulting from insufficient blood to the brain (fainting)

162
Q

what can cause syncope?

A
  • heart disease
  • emotional trauma
  • extreme fatigue
  • low blood pressure
  • hunger (fasting)
  • getting up too fast
163
Q

what are symtoms of syncope?

A 
pallor
dizziness
nausea
vision changes
cold, clammy skin
tachypnea
tachycardia
164
Q

what position do you put someone who was fainting?

A

lie down in supine and elevate legs

165
Q

glascow coma scale mild

A

13-15

166
Q

glascow coma scale moderate

A

9-12

167
Q

glsacow come scale severe

A

3-8

168
Q

what is hypovolemic shock due to?

A
  • internal/external hemorrhage
  • loss of plasma from burns
  • fluid loss from prolonged vomiting, diarrhea, or medications

Patient Care (3 decks)

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