Vital Signs Flashcards
Temperature
Normal range is 98.6 degrees Fahrenheit, or 37°C.
36.1°C to 37.2°C.
97°F to 99°F
How long does it take for temperature to return to normal after end of activity?
30 minutes
Usually changes 1 to 1.5°C.
Fever
38°C or 100.4°F.
Contact physician if it is above 38 degrees Celsius or 103°F
Hyperpyrexia
Better than 42°C or 107.6°F.
Damage to the brain as possible
It is rare
Upper limit is it by hypothalamus
Can develop a patient with severe infection, but most commonly occur in patients with intracranial hemorrhage is an other CNS lesions or TBI
Hyperthermia
Below 95°F or 35°C
Initial inspection for respiratory rate
Look at disposition
Distressed, short of breath, noisy Weezy
Respiratory rate
Rise and fall of the chest equals one cycle or breath
Normal respiratory rate
Adult- 12 to 20 breaths per minute
Infant - 30 to 60
Toddler - 24 to 40
Preschooler - 22 to 34
School-age - 18 to 30
Adolescence - 12 to 16
Respiratory rate technique
Hand on shoulder
Focus on shoulder or chest wall and measure the amount of times the chess rises and falls for one minute
Pulse oximetry
SPO2
Indirectly measures arterial blood oxygen saturation of hemoglobin in arterial blood
Pulse oximetry normal
95% to 100%
If it is below 90% referral for medical evaluation is advised
There is a percent error of less than plus or minus 2%
Factors that impair accuracy of the pulse oximetry
Bright ambient lights on probe
Nail thickness and nail polish
Skin pigmentation
Low peripheral perfusion states
Hypoxemia
Motion artifact
Carbon monoxide poisoning
Anemia
Pulse graded scale
0 to 4+
0 indicates no palpable pulse
1 indicates a faint, but detectable pulse
2 is normal
3 is increased or full
4 is bounding pulse
Normal values of heart rate
Adults 60 to 100 bpm
Hr is higher for younger children
Prevalence of hypertension, in adults 45 to 54 years old
For males is 36.8% and females it’s 32.7%
Awareness of hypertension
Only 82%
Normal BP values for adult
Systolic- 100 to 120 mmHg
Diastolic- 60 to 80 mmHg
MAP - 72 to105 mmHg
Normal systolic and diastolic
Systolic- less than 120
Diastolic - less than 80
Elevated blood pressure
Systolic- 120 to 129
Diastolic- less than 80
High blood pressure, hypertension, stage one
Systolic- 130 to 139
Diastolic 80 to 89
High blood pressure hypertension stage two
Systolic- 140 or higher
Diastolic - 90 or higher
Hypertensive crisis
Systolic- higher than 180
Diastolic - higher than 120
Children blood pressure categories
Normal- less than 120/ less than 80
Elevated- 120/ less than 80 to 129/ less than 80
Stage 1- 130/80 to 139/89
Stage 2- greater than 140/90
Normal pulse pressure
40 to 60mmHg
Hypotension
Systolic blood pressure less than 90
Diastolic less than 60
Mean pressure less than 70
This is due to the depletion of blood volume like hemorrhage, or dehydration
Cardiogenic insufficiency
Acute myocardial infarction
Antihypertensive medication
Sounds of blood pressure
First sound is the systolic- the ventricular contraction
The fifth sound is diastolic the onset of silence- ventricular relaxation
Which cuff can you not use during exercise?
You cannot use the automatic oscillometric
You can use the manual measurement during exercise
Brachial blood pressure
reflect the central blood pressure
It may underestimate systolic and overestimate diastolic
It doesn’t reflect the response to load
Orthostatic intolerance
Hypertension associated with a change of position, typically moving from supine to standing
Blood pressure should normalize within one minute
This is because of depletion of blood volume , impairment of the baro reflex mediated vasoconstruction, post operative, bed rest, pots
Heart rate normal response to change in position
Increase of 5 to 10 bpm
Heart rate Abnormal response to change of position
Increase of greater than or equal to 30 bpm
Systolic blood pressure, normal response to change in position
Decrease of 10MmHg max
Systolic blood pressure abnormal response to change a position
Decrease of greater or equal to 20MmHg with associated onset of symptoms
Diastolic blood pressure normal response to changes in position
No change
Diastolic blood pressure abnormal response to change in position
Decrease of greater than or equal to 10 mmHg with associated onset of symptoms
Hypotension without a compensatory increase in heart rate suggest
Autonomic impairment
Marked increase to greater than 100 bpm or by greater than 30 bpm suggest
Hypovolemia and if symptoms develop without hypotension, it’s POTS
A blood pressure drop immediately after standing that resolves at three minutes indicates what.
It does not indicate orthostatic hypotension
Orthostatic testing
Have patient lying in bed, but they had flat for a minimum of three minutes and preferably five minutes
Measure the blood pressure and pulse why the patient is supine
Instructed patient to sit for one minute
Ask patient about dizziness, weakness visual changes
Check pulse and blood pressure
If the patient has symptoms associated with position, change or sitting, blood pressure is greater than 90/60 with symptoms Put patient back to bed.
Instruct patient to stand
Ask about dizziness, weakness visual changes
If patient is unable to stand, set, patient upright with legs dangling over the edge
Patient should be permitted to resume supine position immediately, if near syncope
Measure blood pressure and pulse immediately after patient has stood up, then repeat measurements. Three minutes after patient stands.
Normal response to aerobic exercise
Withdrawal of baroreceptor, mediated control, increase SA node firing rate
Blood pressure response to aerobic exercise normal
Systolic- 10MmHg increase per change in workload
Diastolic- minimal, increase none or slight decrease
Normal heart rate response to aerobic exercise
10 bpm increase per change in workload
Heart rate in systolic blood pressure may be different and older patients for aerobic exercise
Trends should still be progressive without significant change in diastolic blood pressure
Maximum heart rate declines with age at a rate of .7 bpm every year
resistance training
Elicits a more pronounced BP response
Diastolic should not increase more than 20 mmHg
Immense change, in BP is due to
Sympathetic, vasoconstruction, and non-exercising vascular beds
Mechanical compression of the blood vessels in the exercising muscle beds
Changes in BP are oscillatory and related to the phase of the lift
BP Increases to max values are encountered during the concentric lifting phase
Pressure declines often to below resting values at the completion of the lift
Increases again during the eccentric phase lower than concentric
Restoration of baseline at rest is similar to that of endurance exercise
Post exercise hypotension
Presence of a prolonged decrease in resting blood pressure in the minutes in hours, following a cute exercises
Dose dependent
Higher intensity exercises result in greater reductions in BP
People with higher baseline BP demonstrate greater PEH compared to people with normal BP
