Vital Signs Flashcards
When is it important to establish baseline vital signs for patients?
> 65 years old or < 2 years old
Debilitated
Performed limited aerobic activity for > several weeks
History of cardiovascular problems
Recent trauma
What information does Vital signs give?
Baseline
status of cardiovascular/pulmonary system
guides clinical judgement
how do vital signs guide clinical judgement
-Screening
-Guide prognosis and plan of care
-Monitor progress
-Evaluate effectiveness of intervention
-Guide referral to PCP
-VS measurement yield the most useful information when performed and recorded at periodic intervals over time as opposed to a signal measure in time
What should you do when you get abnormal values at rest?
- determine the cause
- observe: use logical systematic approach to observing your patient
- check if information is extremely abnormal or inconsistent with patient cues
- check equipment/factors that may alter the accuracy
- ask a more experience therapist to recheck
What should you observe about a patient if given abnormal values?
facial expression
overall appearance
signs of pain or distress
skin condition
What are some factors that affect Vital signs
level/amount of physical activity
Environmental temperature
Age
Hormonal status
Emotional status
Physiological status: Illness, disease, trauma, medication, pain
When should you take vitals?
initial eval
after exercise
in response to a change in condition or noted adverse effects to activity
what are adverse affects to activity?
Mental confusion, slow response to commands,
Nausea, syncope, vertigo
Diaphoresis
Change in appearance
Drop in BP
Pupil constriction
- diaphoresis
- syncope
- profusely sweating
- fainting
What is the normal ranges for respiratory rate
(neonates, infants, children and adults)
Neonates: 40-60
Infants: 25-50
Children: 15-30
Adults: 12-20
What are the parameters of respiratory rate and explain?
- Rate: number of breaths per minute
- Rhythm: regularity of breathing pattern/interval between breath - Regular (normal) or irregular (abnormal)
- Depth: refers to amount of air exchange with each inspiration
-Deep breathing: greater thoracic expansion
-Shallow breathing: minimal chest expansion - Character: refers to deviation from normal/resting respiration
- Observe for rate and quality
Define
1. tachypnea
2.bradypnea
3.dyspnea
4. orthopnea
Tachypnea- resp. Rate > 24
Bradypnea- resp. Rate <10
Dyspnea- difficult or labored breathing
Orthopnea- difficulty breathing lying down
ATS scale
Grade 0: only breathless w/ strenuous exercise
Grade 1: troubled by shortness of breath when hurrying on level ground; walking up a slight hill
Grade 2: on level ground, walks more slowly than people of same age b/c of breathlessness/stopping to catch breath while walking own pace
Grade 3: stops of breath while walking about 100 yards/a few minutes on level ground
Grade 4: Too breathless to leave the house
What are factors that affect the respiratory rate and explain?
Factors that affect respiration rate
Age: younger you are the faster you breath
Physical activity/exercise
Emotions:
environment/air quality
Altitude
disease/pathology/medications
give an example of how to document the respiratory rate
15 breaths per minute, patient was seated and at rest
What are the ranges of Blood pressure for each category that someone can fall in?
Normal: S= less than 120 AND D =less than 80
Elevated: S=120-129 AND D= less than 80
High blood pressure (hypertension stage 1): S=130-139 OR D=80-89
High blood pressure (hypertension stage 2): S=140 or higher OR D=90 or higher
Hypertensive crisis: S= higher than 180 AND/OR D=higher than 120
What are the normal ranges of BP for neonates, infants, children, adults
Neonates (1-28 days old): Systolic <60; D highly variable
Infants (1-12 months): S: 70-95; D: highly variable
Children 1-8 years): S: 80-110; D: highly variable
Adults: S: 90-140; D: 60-90
What are factors that affect BP?
Age: increases as you age and peaks around puberty
Physical activity/exertion
emotions/anxiety
Hydration: lack of hydration decreases BP
Medication
Pain
Position of the patient and extremity (orthostatic hypotension)
what are factors that can influence BP?
-exercise
-valsalva maneuver
-orthrostatic hypotension
- Exercise: does intensity need to be changed
-Increase in SBP and no change or slight increases in DBP
-Drop in SBP or failure of SBP to increase with increased workload in indication for stopping exercise - Valsalva maneuver: force exhalation:
-Decrease Blood flow to heart and drop in BP followed by rapid increase in HR/BP when breath is released due to increase in intrathoracic pressure - Orthostatic hypotension: getting up to quickly
Sudden drop in BP when moving upright postured (sitting or standing
When should you not take a BP on an extremity with…
IV or other inserted line
Abnormall;y high or low muscle tone (such as following a CVA or stroke)
Axillary lymph node removal such as a mastectomy
Example of how to document BP
120/80 mmHg with patient seated at rest
What are the normal ranges for neonates, infants, children, and adults for heart rate
Adult: 60-100 bpm
child : 80-120 bpm
Newborn 100-130 bpm
Neonates: 120-160 bpm
Bradycardia vs tachycardia
Bradycardia: < 60 bpm (slow)
Tachycardia: >100 bpm (fast)
Scale to determine the quality of a pulse
+4: bounding- readily palpable, forceful, not easily obliterated by finger pressure
+3 normal- easily palpable and obliterated only by strong finger pressure
+2 week: hard to feel and easily obliterated by slight finger pressure
+1 thready: barely perceptible, easily obliterated by slight finger pressure, fades in and out
0 absent: not discernable
factors that affect pulse rate
Age: generally increases
Gender:
Physical activity: generally increases
Emotions: increases or decreases
Medications: increases or decreases
disease/pathology: increases or decreases
Physical conditioning: increases or decreases
Systemic or local heat: increases or decreases
what are some abnormal response to activity with heart rate
Pulse rate does not increase or increases slowly
Pulse rate declines before intensity of activity decreases
Rate of pulse increase exceeds the level expected
Pulse rate demonstrated abnormal rhythm
How to you document heart rate
75 BPM seated and at rest
what is a normal pulse ox range?
95-100%
hypoxia
range is 88-94
*for exercise you should never drop below 90 unless otherwise told by physician
What is temperatures normal ranges?
96.5-99.4 * F
Pryexia-
hyperpyrexia
hypothermia
Fever (pyrexia): temperature exceeding 100 degrees F
Hyperpyrexia: extreme elevation of temp above 106 degrees
Hypothermia: abnormally low temp below 95 degrees
