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Vital Signs Flashcards

1
Q

What are the three questions you should ask when evaluation vital signs for a patient?

A
  1. are they in normal range?
  2. is it safe to engage in physical therapy? if so, what dose/intensity is appropriate?
  3. does the patient need to consult other healthcare providers to manage abnormal finding?
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2
Q

What are vital signs indicators of?

A

general health and physiological status

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3
Q

What might deviations from normal vital sign ranges mean?

A

abnormal condition/health status

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4
Q

What should be established to determine changes in values resulting from physical therapy?

A

baseline measurements

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5
Q

what are the six types of vital signs?

A

pulse
pulse patency
pulse oximetry
blood pressure
respiration rate
body temperature

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6
Q

what kind of patient is it extremely important to establish baseline measurements in?

A

high risk patients

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7
Q

what are examples of a high risk patient?

A

“older” adult >65 years of age
children < 2 years of age
children at high risk (obesity, DM)
debilitated patients
acutely ill/ICU admits
deconditioned
history of CV system issues
recent trauma/SC injury/stroke
medical condition/disease affecting cardiopulm system

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8
Q

what are some influencing factors for changes in vital signs?

A

amount of physical activity (high or low)
environmental temperature
age
emotional status (anxiety, stress)
physiological status (weak heart muscles)
medications (caffeine - increase, beta blockers - decrease)

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9
Q

what should you do if a patient experiences mental confusion, exhaustion, fatigue/lethargy, or slowed reactions to commands?

A

stop treatment immediately

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10
Q

what should you do if a patient has decrease response to verbal or tactile stimuli?

A

sequence of command:
1. talk to them
2. place your hand on their shoulder
3. sternum rub

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11
Q

what do you do if a patient begins to experience nausea, syncope, or vertigo?

A

lay them down immediately

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12
Q

what do you do if a patient has a change of appearance (pallor, erythema)?

A
  1. lay them down
  2. lift feet up to where they are above head for blood flow
  3. cold compress
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13
Q

what do you do if a patient experience pupil dilation or constriction?

A

lay them down immediately

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14
Q

what do you do if a patient has a loss of consciousness?

A

place them in a safe position and allow them to regain consciousness

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15
Q

what vital sign is measured to assess the cardiovascular system’s capacity to provide blood flow during imposed physical stress?

A

pulse

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16
Q

what does pulse measure?

A

the cardiovascular system’s capacity to provide blood flow during imposed physical stress

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17
Q

in a well-conditioned individual, what will happen to the pulse when exercise increases

A

pulse increases

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18
Q

in a well-conditioned individual, what will happen to the pulse when exercise plateaus?

A

pulse will plateau

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19
Q

in a well-conditioned individual, what will happen to the pulse when exercise is stopped?

A

return to normal within 3-5 minutes or sooner

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20
Q

what does pulse measure whenever it is measured after treatment or other exercise?

A

the cardiovascular system’s recovery capability following physical stress

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21
Q

what is the pulse rate?

A

the number of beats per minute

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22
Q

what is the average adult pulse?

A

60 - 100 bpm

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23
Q

what is considered a bradycardic pulse rate?

A

< 60 bpm

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24
Q

what is considered a tachycardic pulse rate?

A

> 100 bpm

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25
what is the definition of a resting HR?
measurement of the heart rate without imposed stress
26
what is the average pulse rate of an adult?
60-100 bpm
27
what is the average pulse rate of a child (ages 1-7)?
80 - 120 bpm
28
what is the average pulse rate of a newborn?
100 - 130 bpm
29
what is the difference in pulse and heart rate?
pulse is palpable representation of the HR. in some cases, electrical activity in the heart may generate a non-palpable beat
30
what is the patency defined as?
the openness of the peripheral portion of the cardiovascular system
31
what are you measuring when you assess patency?
the presence of absence of a pulse as well as the force at the selected peripheral arterial site
32
what is patency a preliminary indication of?
arterial occlusion resulting from blockage or peripheral vascular insufficiency
33
what does patency reflect?
peripheral circulation
34
what are the typical sites to assess patency?
inguinal popliteal posterior tibial dorsal pedal
35
what are the typical sites used to count the pulse rate?
carotid and radial
36
what is the preferred location to assess heart rate?
apical (apex of heart, with stethoscope)
37
why should you not use the thumb to assess pulse?
the thumb has its own pulsations
38
what is the most accurate count for pulse?
60 seconds
39
what is the margin of error if you measure the pulse for 10 seconds?
+/- 6
40
what is the margin of error if you measure the pulse for 15 seconds?
+/- 4
41
why should you use 2-4 fingers when measuring pulse rates in the older population?
they typically have thickened arteries due to atherosclerosis (calcification), which causes the arteries to be cord-like and slippery
42
what are the amplitudes of patency and what does each mean?
0 = absent 1+ = thready, weak 2+ = normal 3+ = strong, bounding
43
what is the respiration rate?
the number of cycles (inspiration, expirations) per minute
44
what is the normal respiration rate in adults?
12-18 cycles per minute
45
what is the normal respiration rate in children
~20 cycles per minute
46
what is the normal respiration rate in infants?
30-50 cycles per minute
47
what is dyspnea?
difficult or labored breathing
48
what is orthopnea?
difficulty or labored breathing when the patient is lying down
49
what is apnea?
absence of respirations
50
what is hyperventilation?
rushed, forced breathing
51
what is pulse oximetry?
the degree to which oxygen is bound to hemoglobin
52
what is normal pulse oximetry
98% or greater
53
what might a significant drop in pulse oximetry indicate?
cardiopulmonary function is inadequate in this patient to meet oxygen demand posed by the activity
54
when you should monitor pulse oximetry?
before, during, after activity
55
what can pulse oximetry be used for?
demonstrating the efficacy of supplemental oxygen as well as breathing exercises and retraining
56
where is the best location to assess oxygen saturation?
right middle finger or right thumb
57
what may cause an inaccurate oxygen saturation reading?
nail polish (dark) poor perfusion improper fitted probe
58
what is the amount of decrease that should be noted for pulse oximetry?
3% to 5%
59
what reading of pulse oximetry should you request supplemental oxygen or an increase in oxygen already in use?
< 85%
60
what is it called when a patient's pulse oximetry is < 85%?
hypoxemia
61
what is the primary purpose of taking blood pressure?
determine vascular resistance to blood flow and effectiveness of cardiac muscle in pumping blood to overcome vascular resistance
62
what is used to indirectly measure blood pressure?
sphygmanomometer
63
what is the systolic blood pressure?
the pressure exerted by blood against arterial walls when the heart is contracting (left ventricle)
64
what is the diastolic blood pressure?
the pressure exerted by the arterial walls against blood when the heart is not contracting
65
what is the normal blood pressure range for an older adult (>63 years)?
120-140 mm Hg (systolic) 80-90 mm Hg (diastolic)
66
what is the normal blood pressure range for an average adult?
<120 mm Hg (systolic) <80 mm HG (diastolic)
67
what is the normal blood pressure range for adolescents (>12 years)?
100-120 mm Hg (systolic) 65-75 mm Hg (diastolic)
68
what is the normal blood pressure range for a child (1-4 years)?
100-108 mm Hg (systolic) 60 mm Hg (diastolic)
69
what is the normal blood pressure range for what is the normal blood pressure range for a child (4-12 years)?
108 mm Hg +~2mm Hg/year (systolic) 60-70 mmHg (diastolic)
70
what is the normal blood pressure range for an infant (3 month-1 year)?
90-100 mm Hg (systolic) 60-67 mm Hg (diastolic)
71
what is the normal blood pressure range for an infant (birth to 3 months)?
85-90 mm Hg (systolic) 35-65 mm Hg (diastolic
72
what classifies someone in the prehypertension/elevated stage?
120-129 systolic, <80 diastolic
73
what classifies someone has being in the hypertension I stage?
130-139 systolic, 80-89 diastolic
74
what classifies someone as being in the hypertension II stage?
>= 140 systolic, >= 90 diastolic
75
what is classified as a hypertensive crisis?
>180 / >120
76
what are some examples of risk factors of hypertension?
family history, gender, obesity, physical inactivity, DM, birth control pill, age, race, nicotine, alcohol, salt, diet
77
what are some secondary risks to hypertension?
arteriosclerosis, kidney disease
78
what is the classification of hypotension?
when the systolic pressure is less than 100 mm Hg
79
is hypotension usually life threatening?
no, but patients may experience dizziness or syncope when abruptly standing from lying or sitting
80
what population do we typically see hypotension in, and when does this create an issue?
typically in older populations, can be an issue due to not enough arterial pressure
81
what might contradict taking blood pressure in the upper extremities?
breast/axilla surgery lymphedema IV line blood transfusion arteriovenous fistula (abnormal connection between artery and vein) CVA-hemiplegic, edematous UE (precaution)
82
what will happen if your bp cuff is too narrow?
blood pressure will read high
83
what will happen if your bp cuff is too wide?
blood pressure will read low
84
what are the steps to preparing for blood pressure by auscultation?
1. wash hands 2. prep patient - place arm at horizontal level of the heart (midsternum), ask for consent, place cuff properly 3. patient may sit, stand, or lie but UE must be supported at the wrist and forearm
85
what does the cuff arrow need to point to when measuring bp, and which arm should it be taken in?
brachial artery, non-dominant arm
86
what should the starting cuff pressure be when assessing BP?
about 15-20 mm Hg above the systolic number in which you lost radial pulse sensation during pre-inflation
87
what are the sounds that you are listening for in BP called?
korotkoff's sounds
88
how do you document taking someone's blood pressure?
xxx/xx mm Hg, side and placement, position given in even numbers (rounded upward)
89
how do you perform BP by palpation?
1. wash hands, prep patient 2. place cuff w/ center of bladder over medial arm 3. palpate brachial pulse and keep fingers there
90
what is a normal response to systolic blood pressure during exercise?
increase of up to 20-30 mm Hg rising over resting without symptoms
91
what is a normal diastolic blood pressure response to exercise?
little or no change, may see slight decrease in DBP secondary to peripheral vasodilation
92
what are some red flags of blood pressure with activity?
no change in systolic blood pressure with exercise progressive rise in diastolic blood pressure, (20 mmHg or more with activity)
93
what are normal ranges for temperature?
96.6 - 99.3
94
what does taking someone's temperature tell us?
information about metabolic state, potential presence of infection, metabolic response to exercise

Patient Care Skills (6 decks)

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