Vital Signs

Question 1

What the 5 basic Vitals?

Answer 1

Temp
HR
RR
SPO2
BP

Question 2

Vitals should be measures every….

Answer 2

4 to 6 hrs or atleast beginning or mid shift

Question 3

Device that measures heart rate and rhythm continously at home and hospital

Answer 3

Hospital- telemetry
Home- holter monitor

Question 4

Frequency of vital

Answer 4

Depends on severity of patients condition.

After surgery…taken every 15 min for 2 hrs, then every 30 min for 1-2 hrs, then hourly until patient stable….so 15, 30, 1 hr.

Question 5

To understand normal vitals, we need to understand what is normal for the patient based on their…..

Answer 5

Age, disease and treatment protocol.

Question 6

Comparison for trends with one or 2 measurements is enough…t/f

Answer 6

False…patients condition changes slowly….either compared over an entire shift or the 24 hrs indicates clear picture.

Question 7

Isolated measurements are not enough hence trends are important which can be over time for minutes or days…t/f

Answer 7

True

Question 8

Initial measurement is called..

Answer 8

Baseline

Question 9

Decreased pain perception is a sign of….

Answer 9

Hypoxemia

Question 10

Bedside vital assessment includes….

Answer 10

Constant awareness of
Look
Listen
Touch
Question
Validate
Reassess
Analyze
Trend

Question 11

Body temperature is highest in the…and lowest ….

Answer 11

Lowest in the morning…and highest in the afternoon…connect metabolism with temp…morning metabolism is low the temp is also low…and vice versa

Question 12

Normal temp ranges…

Answer 12

36.0- 37.5, with daily variation of 1-2 farhenheit

Question 13

Body temperature is regulated by….

Answer 13

Hypothalamus….if increased the vasodilation takes place at peripheral and if decreased temp then vasodilation contraction.

Question 14

Pyrexia=febrile=hyperthermia, but is the diffference

Answer 14

Pyrexia is high temp due to infection

Question 15

Axillary has good accuracy for….and poor accuracy for…

Answer 15

Good for infants and neonates
Bad for adults.

Question 16

Rectal is accurate for all ages except…

Answer 16

Neonates…

Question 17

Equilibration error is for..

Answer 17

Rectal and axillary

Question 18

Which site is easier to palpate pulse for infants

Answer 18

Brachial

Question 19

Blood flow to brain…is checked thru

Answer 19

Carotid

Question 20

Low bp can be confirmed thru which site of pulse

Answer 20

Femoral

Question 21

Juhi is hypotension and emotional so it is ….
And Rachid is in pain due to leg…
Asma is anemic
Huda is does exercise
Only one stands out that is….

Answer 21

Hypercapnia

All are eg of tachycardia

Question 22

What is pulses pardoxus?

Answer 22

• Hard inhalation causes decreased intrathoracic pressure
• Causes stagnation (pooling or collection) of blood at the right ventricle
• Less blood flow available to be pumped out to periphery
• Also reduced pumping strength of heart
• BP readings that are >10mmHg different are considered significant

Question 23

What is pulsus alterans?

Answer 23

Alternating strong and weak pulses not due to respiratory cycle
• Likely caused by heart problems such as poor contractility or
electrical signa

Question 24

In spo2 what technology measures the hg

Answer 24

Spectrophotonomy- measure the light source absorption sensor
Down side is it only measures the functional Hb….not the dysfunctional..therefore it cannot differentiate between what is bound to Hb…just measure if something is bound or not

Question 25

On spo2 what technology measures the pulse

Answer 25

Photoplethysmography…measures the pulsatile signal

Question 26

Normal systol and diastole

Answer 26

Systole is 90-140
Diastole is 60- 90

Overall 120/80

Question 27

Tachypneic is just rapid rate but doesnt necessarily reduces paco2, but if paco2 decreases that is for sure hyperventilartion. T/f

Answer 27

T

Question 28

Sudden pain, severe hypoxemia, septicemia(infection induced shock), uremia (renal failur induced shock), CNS depressant drugs, trauma, hypovolemic, dysrhythmia, heart failure/MI, all are symptoms of….

Answer 28

Hypotension

Question 29

Increased SVR, heart failure, dysrhthmia, hypervolaemia, CNS stimulants drugs, fever, Hypoxemia PaO2<30, pain, emotions(white coat syndrome) all are symptoms of…

Answer 29

Hypertension.

Question 30

What is normal pulse pressure?

Answer 30

35-40, it is the difference between systolic and diastolic BP

If narrow pulse pressure then it means increased SVR

If wide pulse pressure then it means reduced SVR

Question 31

WHAT is mean arterial pressure?

Answer 31

Assessment of the average pressure to which the arterial system is exposed to over one complete systolic and diastolic cycle.

MAP= (2xdiastolic) + systolic/3

Normal value= 70-105 mmhg

Question 32

Explain pulsus pardoxus

Answer 32

When we inhale normally our SBP decreases by 2-4mmhg, but with pulsus paradoxus, SBP decreases by more than 10 mmHg on inspiration. This is due to the negative intrathoracic pressure, which encourages the venous return and discourages the arterial blood flow out of the left ventricle. How?
This is because the increased venous to right ventricle on inspiration increases the right ventricular filling pressure, which causes interventricular septum to distend towards the left ventricle, which results in reduced left ventricular filling, reduced stroke volume, reduced CO and decreased SBP on inhalation. Eg: acute asthma, cardiac temponade.

Question 33

Hypotension occurs when the…..ventricle is weak, the blood volume is…or vaso……is excessive. These can occur as a side effect of certain medications eg: beta blockers, diuretics

Answer 33

Left, reduced, vasodilation.

Question 34

Errors in bp reading, when narrow cuff it can produce a…

Answer 34

40 mmHg increase…giving false high

Question 35

Error in bp, when wide cuff, it can produce a…..

Answer 35

3-5mmhg decrease….a false low.