Vital Signs Flashcards by McKenna s

General Symptoms

fatigue
generalized weakness
fever
chills
night sweats
weight change
pain

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Fatigue is associated with

depression/anxiety
low blood count
stress
endocrine DX
viral
cancer
autoimmune
heart failure
liver or respiratory disease
electrolyte

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Fever and chills

ask: Associated symptoms? Travel? sick contacts? medication use?

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Fever maskers

NSAIDS
immunocompromised
older pts

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Causes of Night Sweats

menopause
TB
Malignancy
Medications
drug addiction
thyroid disease

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Weight Gain considerations

-excessive Kcal
-fluid retention
-medications (birth control, corticoid steroids, antidepressants, diabetetic meds)

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Weight Loss

loss of 5%s over a 6-month period
-intentional vs unintentional
-malignancy, stress, older age, medications, GI disease, endocrine disorder, smoking, dentistry, social factors)

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Acute pain

lasting hours, days or weeks
gradually resolves as injury heals
-surgery, trauma, acute illness

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Chronic Pain

-not associated with cancer or other medical condition persisting>3-6mths
-Acute pain that lasts longer than a month
-Pain recurring at intervals

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Nociceptive (somatic) pain

linked to tissue damage to the body
-acute or chronic
-dull, pressing, pulling, throbbing, boring, spasmodic, colicky

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Neuropathic pain

-direct consequence of lesion or disease affecting the somatosensory system
-persists after healing from injury
-“electric shock, pins and needles, stabbing, burning)

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OLDCARTSS

Onset, location, duration, character, aggravating and alleviating, radiation, timing, severity, symptoms

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General Survey

Apparent state of health
level of consciousness
discomfort or distress (explain)
skin color or lesion
hygiene or grooming
facial expression
odors
posture/gait
height/weight

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Nevi

Birthmark

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Stadiometers

height measurment

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BMI calculation

(Weight (lbs)/(Height in.)^2) x703

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Underweight

<18.5 kg/m2

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Normal BMI

18.5-24.5 kg/m2

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Overweight BMI

25-29.9 kg/m2

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Obesity class 1 bmi

30.0-34.9 kg/m2

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Obesity class 2

35-39.9 kg/m2

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Obesity class 3

> 40 kg/m2

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if BP cuff is too small Bp is

High

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If BP cuff is too large Bp is

low

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Palpated Radial Pulse Obliteration Pressure

Inflate cuff and feel when you stop feeling radial pulse -add 30 mmHg to determine target level for BP cuff -avoids error from auscultatory gap

Auscultatory gap

silent interval between systolic and diastolic -record the auscultatory gap in your documentation

Korotkoff sounds

heart beatNO

Normal difference between arms BP

5-10mmHg

Causes for abnormal BP pressure difference between arms

subclavian steal syndrome supravalvular aortic stenosis aortic dissection

Normal BP

120/80

Elevated BP

systolic= 120-129 AND Diastolic=<80

Stage 1 hypertension

systolic=130-139 OR diastolic= 80-90

Stage 2 hypertension

systolic= >140 OR diastolic= >90

Between two BP categories?

Use higher category

Orthostatic BP measurment

Measure BP with pt lying supine repeat with pt standing

Orthostatic Hypotension

Drop in SBP>20mmHg Drop in DBP >10mmHG

Causes of orthostatic hypotension

Blood loss older age anemia medications POTS

White coat hypertension

isolated clinic hypertension clinic bp >140/90 but normal at home -does not need treatment

Masked Hypertension

Clinic BP <140/90 but elevated BP >135/85 at home -untreated= risk of CVD, end organ damage

Tachycardia

>100 bpm

Bradycardia

<60bpm

If irregular HR rhythm

OBTAIN EKG to identify rhythm

Apnea

cessation of breathing longer than 10 seconds

Tachypnea

RR>20brpm

Bradypnea

RR <12brpm

Signs of labored breathing

nasal flaring accessory muscle use intercostal retractions position of breathing

Normal body temp

98.6 F 37 C

Pyrexia

>100.4 F

Hyperpyrexia

extreme elevation >106 F

Hypothermia

95 F

Worse way to measure temperature

axillary

Best way to measure temperature

Rectally

avoid oral temp on

unconscious patients Restless pts pts unable to close their mouth pts who cant follow directions

Rectal Temperature

lubricate the tip 1.5 inches insertion preferred in pediatric pts with fever

Rapid shallow breathing

Quick inspiration and expiration -consider salicylate intoxication, lung disease, chest pain, elevated diaphragm

Rapid deep breathing

Hyperpnea (in response to metabolic demand) Hyperventilation (rapid breathing independent of metabolic demand) Kussmaul breathing

Kussmaul breathing

compensatory over breathing due to systemic acidosis -common in diabetic ketoacidosis (DKA)

Bradypnea

Slow breathing long periods of no inhalation and expiration -consider uremia, drug induced, increased ICP

Cheyne stokes Breathing

Periods of increased inspiration and expiration/increased rate followed by apnea -normal in children and adults while sleeping -consider: heart failure, drug induced respiratory depression, TBI

Ataxic (Biot) breathing

irregular rate, inspiration and expiration -consider: meningitis, respiratory depression, and brain injury (medulla level)

Sighing respiration

Eupnea with periods of increased inspirations hyperventilation syndrome- suggested by frequent signs (causes dyspnea and dizziness)

Obstructive breathing

Prolong expiration -narrow airways that increase the resistance of airflow -consider: asthma, Chronic bronchitis, COPD

Vital Signs

Ht (feet, inches) Wt (lbs) BMI (kg/m2) BP (mmHg), which limb, standing or sitting Pulse (bpm), regular or irregular Respirations (brpm), labored? Temperature (F or C), how it was taken? Pulse Ox (%), RA or Supplement O2