Test 4 Flashcards
1
Q
vital signs
A
measurements of the body’s most basic functions
-used to detect/monitor medical problems
2
Q
where can vital signs be measured?
A
anywhere
- medical setting
- home
- onsite of a medical emergency
- elsewhere
3
Q
what are types of vital signs?
A
- body temperature
- heartrate/pulse
- respiration rate
- blood pressure
- oxygen saturation
4
Q
what is body temperature?
A
physiologic balance between heat production in body tissues and heat lost to the environment
5
Q
what is body temperature controlled by?
A
hypothalamus
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
7
Q
what is temperature most commonly measured in?
A
celcius
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)
9
Q
what is the oral thermometer?
A
blue
electric
10
Q
how is oral recorded?
A
O
11
Q
what is the rectal thermometer?
A
red
electric
12
Q
how is rectal recorded?
A
R
13
Q
what is the axillary thermometer?
A
electric
14
Q
how is axillary recorded?
A
Ax
15
Q
what type of thermometer is tympanic membrane?
A
tympanic
16
Q
how is tympanic membrane recorded?
A
T
17
Q
what way of measuring body temperature is the safest?
A
axillary-but very position dependant so not reliable
18
Q
what is normal body temp for a newborn-1 year?
A
C=37.5-37.7
F=99.4-99.7
19
Q
what is the normal body temp for a person 3-5 years?
A
C=37-37.2
F=98.6-99
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
21
Q
what is the normal body temp for a person 10 years or older?
A
C=36.6
F=97.8
22
Q
what is the rule of thumb for axillary temp?
A
about 0.5 degrees Celsius lower than oral
23
Q
what is the rule if thumb for rectal temperature?
A
about 0.5-1 degree Celsius higher than oral
24
Q
what is the rule of thumb for tympanic temperature/
A
about 0.8 degrees Celsius higher than oral
25
what is pyrexia?
body temp elevated above normal values
26
what are symptoms for pyrexia?
- increased pulse rate
- increased respiratory rate
- general discomfort or aching
- loss of appetite
- flushed skin that is hot to touch
- chills
27
what can happen if body temp remains high for a prolonged amount of time?
can cause damage to CNS
28
what is hypothermia?
body temperature below normal values
29
what are symptoms for hypothermia?
- shivering
- slurred speech
- slow and shallow breathing
- weak pulse
- confusion
- drowsiness
30
what can be medically induced?
hypothermia-reduce a patients need for oxygen
31
what can heart rate/pulse be influenced by?
internal and external conditions
32
what is heart rate/pulse measured in?
beats per minute
33
what do you take notes of when measuring heart rate?
-rate
-rhythm
-strength
-characteristics
LOOK IN NOTES
34
rate
number of beats per minute
35
rhythm
interval between beats
- even or uneven
- arrhythmia?
36
arrhythmia
any variation from the normal rhythm of the heart
37
tachycardia
abnormally rapid pulse rate
38
what is an abnormal rapid heart rate?
over 100 bpm
39
bradycardia
abnormally slow pulse rate
40
what is an abnormal slow pulse rate?
under 60 bpm
41
strength
pressure you feel or hear
42
what is normal resting heart rate for an infant?
120bpm
43
what is the normal resting heart rate for 4-10 year old?
90-100 bpm
44
what is an normal resting heartrate for an adult?
60-90 bpm
45
where are the pulse locations?
- temporal
- carotid
- apical
- brachial
- radial
- femoral
- popliteal
- posterior tibial
- dorsalis pedis
46
what are important tips for measuring heart rate?
- don't press on the artery too much
- never use your thumb
- feel for 30s and x2
- if irregular count for 1 minute
47
how is a strong pulse rate of 80 beats/min documented?
HR: 80bpm, strong
48
what is the function of respiration?
exchange oxygen and carbon dioxide between the external environment and blood circulating in the body
49
what does one respiration cycle equal?
one respiration and one expiration
50
what can respiration rate be influenced by?
- medication
- illness
- exercise
- age
- body habitus
- body position
- e.t.c
51
how long do you monitor respiration rate?
monitor for 20 seconds and multiply by 3
| -if irregular, monitor for 60 seconds
52
what is the respiration rate for infants?
30-60 breaths/min
53
what is the respiration rate for adults?
15-20 breaths/min
54
normal respirations should be___________
quiet
effortless
uniform
55
fewer than 10 breaths/min may result in ___________
- cyanosis
- apprehension
- restlessness
- decreased level of consciousness due to the inadequate supply of oxygen to body tissues
56
dyspnea
patient who is using an increased amount of effort to breath
57
tachypnea
breathing rate above the normal amount
58
what do you watch for when measuring respiration?
- depth-symmetry of chest movement
- character-distressed, wheezing, quiet, etc
- observe skin colour
59
where is cyanosis most easily observed?
around the mouth, gums, nailbeds and earlobes
60
what are respirations documented with?
- rate
- depth
- description
61
what is blood pressure?
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
62
what is blood pressure influenced by?
- blood volume
- blood viscosity
- elasticity of vessel wall
63
what decreases BP?
-hemorrhage or dehydration causes less blood volume
64
what increases BP?
- thicker blood is more viscous (hypercoagulable state)
| - age, plaque reduces flexibility of vessel walls
65
what instrument measures blood pressure?
sphygmomanometer
66
systolic pressure
the highest point reached during contraction of the left ventricle as it pumps blood into the aorta.
67
diastolic pressure
the lowest point to which pressure drops during relaxation of the ventricles and indicates the minimal pressure exerted against the arterial walls continuously
68
who tends to have a slightly higher BP?
females
69
what arm would you use to measure BP?
left arm because it is closer to the heart
70
where do you apply the cuff?
snugly 1" above elbow crease with arrow over brachial artery
71
which hand do you hold the stethoscope?
non-dominant hand
72
which hand do you hold bulb and close valve?
dominant hand (use your thumb and finger)
73
how much do you inflate your BP cuff?
20-30 mmHg
74
if the cuff is deflates too slowly, the reading will be ________
falsely high
75
if the cuff deflates too quickly, the reading will be _______
falsely low
76
how do you find systolic blood pressure?
listen carefully for the pulse beat to begin and note the number on the gauge
77
how do you measure diastolic pressure?
continue to listen to the pulsations until they become soft or the sound changes from loud to very soft or inaudible.
78
if there is troubleshooting then what can you do?
- deflate cuff
- wait 1-2 min
- have patient raise his or her arm
- retake blood pressure
79
how is oxygen delivered to tissues?
by blood
80
what is used to monitor oxygen saturation of hemoglobin?
pulse oximeter-non invasive and fast
81
what is a normal oxygen saturation?
SpO2
| 88%-92%
82
how much does oxygen saturation have to drop for it to be concerning?
3% or more
83
how do your properly document pulse (heart rate)?
HR: 80bpm (include characteristic:strong, weak, thready)
84
how do you properly document respiration rate?
RR: 17rpm (include characteristic: laboured, wheezy)
85
how do you properly document blood pressure?
BP:120/80 mmHg
86
how do you properly document temperature?
T: 98.6 O
87
what mental status check can sonographers do?
- glascow coma scale
| - change in level of consciousness
88
what are the 3 areas of neurologic function in Glasgow coma scale?
- eye opening
- verbal response
- motor responce
89
LOC
level of consciousness
90
how do you access LOC?
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
what important when assessing patient neurological state?
any changes must never be ignored, notify physician
92
what is shock?
body's pathological reaction to illness, trauma, or severe physiologic or emotional stress?
93
is shock life threatening?
yes
94
what are different types of shock?
- hypovolemic shock
- cardiogenic shock
- distributive shock
- neurogenic shock
- septic shock
- anaphylactic shock
- obstructive shock
95
what causes hypovolemic shock?
20% or more of body fluid volume is lost
96
what are symptoms of hypovolemic shock?
```
increased heart rate
increased blood pressure
increased respirations
thirsty
skin is cold and clammy
cyanosis around lips and nails
```
97
what does a sonographer do if your patient went into hypovolemic shock?
- 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
what is the cause of cardiogenic shock?
failure of heart to pump adequate amount of blood to vital organs
99
what patients are most vulnerable for cardiogenic shock?
- myocardial infarction
- cardiac tamponade
- dysrhythmias
100
what are the symptoms of cardiogenic shock?
- 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
what postion do we put the patient for cardiogenic shock?
semi-fowlers position to facilitate respiration
102
what do we not do for patients in cardiogenic shock?
do not give them fluids (water)
103
when does distributive shock occur?
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
what happens to the blood vessels in distributive shock?
unable to constrict properly so they are unable to return blood to the heart
105
what are the types of distrutive shock?
- neurogenic shock
- septic shock
- anaphylactic shock
106
what is the cause of neurogenic shock?
loss of tone cause vasodilation of peripheral vessels
107
examples of why neurogenic shock happen?
- spinal cord injury
- severe pain
- neurologic damage
- depressant action of medication
- lack of glucose
- adverse effects of anesthesia
108
what are the symtoms to neurogenic shock?
- decrease in BP (hypotension)
- decrease in HR (bradytachia)
- warm, dry skin
- cool extremities
- diminishing peripheral pulses
109
what position do we put a person in neurogenic shock in?
supine
110
what do we prepare for, for a person in neurogenic shock?
prepare to assist with oxygen, IV, and medications
111
what is the cause of septic shock?
invaded with bacteria, the body begins its imune responce by releasing chemicals that increase capillary permeability and vasodilation, leading to shock syndrome
112
what causes septic shock (think organisms)?
- gram-positive bacteria
| - viruses
113
what is the phase 1 to symtoms of septic shock?
- hot, dry, and flushed skin
- increased HR and RR
- fever
- nausea, vomiting, and diarrhea
- possible confusion
114
what is the phase 2 symtoms of septic shock?
- cool, pale skin
- increased HR and RR
- decreased BP
- seizures
- organ failure
115
what is a sonographers responce to someone in septic shock?
keep them warm as shivering increases the body's oxygen consumption
116
what is the cause of anaphylactic shock?
antigen exposure-histamines-widespread vasodilation=peripheral blood pooling+contraction of smooth muscles
117
what is anaphylactic shock due to?
- allergy-exaggerated hypersensitivity reaction to an antigen
- medications
- contrast media
- insect venous
118
what are symtoms to a mild systemic reaction? (anaphylactic shock)
- nasal congestion
- itching
- sneezing
- eye watering
- tight chest, mouth, throat
- anxiety
119
what are the symotms to a moderate systemic reaction? (anaphylactic shock)
- flushing, feeling of warmth, hives
- bronchospasm, edema or airways or larynx
- dyspnea, cough, and wheezing
120
what are the symtoms to a severe systemic reaction (anaphylactic shock)
- abrupt onset and rapid progressionof moderate symtoms
- decrease BP, weak thready pulse, dyspnea
- cyanosis, seizures, respiratory and cardiac arrest
121
what postion do we put a person in anaphylactic shock?
semi-fowlers postion
122
what do we prepare for a person in anaphylactic shock?
assist with oxygen, IV fluids, and medications
123
what medications would we give a person with anaphylactic shock?
- epinephrine
- diphenhydramine
- hydrocortisone
- aminophylline
124
what is the cause of obstructive shock?
pathological conditions that interfere with the normal pumping action of the heart
125
what is obstructive shock due to?
- PE
- hypertension
- arterial stenosis
- constrictive pericardatitis
- tumors that interfere with blood flow through the heart
126
what are the symtoms of obstructive shock?
mimics cardiogenic shock
127
what postion do we put a person in obstructive shock?
semi-fowlers postion
128
what is PE r with?
- trauma
- orthopedic and abdominal surgeries
- pregnancy
- congestive heart failure (CHF)
- prolonged immobility
- hypercoagable states (birth control)
129
what does increased pressure of the Rt side of the heart lead to?
Rt ventricular dysfunction and cardiogenic / obstructive shock
130
what are the symtoms to PE?
- rapid, weak pulse
- hyperventilation
- dyspnea and tachypnea
- tachycardia
- apprehension
- cough and hemoptysis
131
what is diabetes caused by?
either insufficient production or inadequate utilization of insulin in the body cells resulting in elevated levels of glucose on the blood (hyperglycemia)
132
Type 1 diabetes description
- abrupt onset
- under 30 years old
- daily insulin injections to prevent ketoacidosis
133
type 2 diabetis description
- gradual onset
- over 40 years old
- impaired sensitivity to insulin or decreased production of insulin
- controlled by weight loss, diet, and exercise
134
gestational diabetes
occurs in the later months of pregnancy. Pregnancy hormones prevent the action of insulin. Treated with diet and occasionally with insulin
135
Hypoglycemia
excess insulin in bloodstrea,
| didnt eat enough food to utilize insulin
136
Diabetic Ketoacidosis
insufficient insulin causes the liver to produce more glucose resulting in hyperglycemia
137
Hyperglycemic hyperosmolar non-ketotic syndrome
AKA-diabetic coma
138
diabtic symtoms
tachycardia
- headache
- blurred
- extreme thirst
- sweet odor to the breath (in ketoacidosis)
139
what is the sonogrpaher responce to diabetic emergencies?
- stop procedure and call radiologist
- monitor vitals
- preapre to administor fluids
140
cerebral vascular accident
stroke-brain attack
141
what are CVA's caused by?
sudden occlusion or rupture of blood supply to the brain
142
what does disruption of blood supply to the brain cause?
lack of oxygen to the brain tissue resulting in cell death
143
BE FAST
```
B-balance
E-eyes
F-face
A-arms
S-speech
T-time
```
144
what are causes of respiratory obstruction
- positioning
- tongue falling
- foreign body
- disease
- drug overdose
- allergic reaction
145
respiratory obstruction what does it mean?
gas exchange is no longer adequeate to meet bodies needs
146
what is cardiac arrest?
heart ceases to beat effectively, blood can no longer circulate throghout the body providing oxygen to all the organs
147
causses of cardiac arrest
- tachycardia
- bradycardia
- hypovolemic shock
- myocardial infarction
- drug overdose
148
how long can the brain survive without oxygen?
2-4 minutes
149
respiratory disfunction symtoms
- labored, noisy bretahing
- wheezing
- use of accessory muscles of neck, abdomen, and chest
- neck vein dissention
- diaphoresis (sweating)
- axiety
- cyanosis
150
respiratory arrest symptoms
- patient stops responding
- pulse continues briefly
- chest movements stop
- no air is detectable
151
cardiac arrest symtoms
- loss of consciousness
- loss of pulse and BP
- dilation of pupils within seconds
- possibility of seizures
152
what are the steps to when you suspect someone going into respiratory/cardiac arrest
- 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
what is a seizure?
unsystematic discharge of neurons that results in an abrupt alteration in the brain function
154
do you have a warning when someone may have a siezure?
onset with little or no warning
155
what changes to a person with seizures?
change in level of consciousness
156
what are seizures associated with?
- 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
what are the types of seizures?
- generalized
| - partial (complex and simple)
158
what are the symtoms to a generalized seizure?
- 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
what are the symtoms to a partial complex seizure?
- 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
what are the symtoms to partial simple seizure?
- 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
syncope
transient loss of conscousness resulting from insufficient blood to the brain (fainting)
162
what can cause syncope?
- heart disease
- emotional trauma
- extreme fatigue
- low blood pressure
- hunger (fasting)
- getting up too fast
163
what are symtoms of syncope?
```
pallor
dizziness
nausea
vision changes
cold, clammy skin
tachypnea
tachycardia
```
164
what position do you put someone who was fainting?
lie down in supine and elevate legs
165
glascow coma scale mild
13-15
166
glascow coma scale moderate
9-12
167
glsacow come scale severe
3-8
168
what is hypovolemic shock due to?
- internal/external hemorrhage
- loss of plasma from burns
- fluid loss from prolonged vomiting, diarrhea, or medications
