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Patient Management 2 > Vital signs > Flashcards

Vital signs Flashcards

1
Q

When should you take vital signs?

A
  1. When a patient is brought to the department for any invasive diagnostic procedure
  2. Before and after the patient receives medication/as required by preprocedural screening (usually CT).
  3. Any time the patient’s general condition suddenly changes. (LOC)
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2
Q

What are Cardinal Signs?

A

Quick, objective and non-invasive evidence of patient condition.

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3
Q

Is a physician’s order required to measure vital signs?

A
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4
Q

T/F

Vital signs are measured against accepted ranges.

A

True

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5
Q

What are Physiologic responses indicators of?

A

Indicators of adversity or response to therapy.

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6
Q

Is pain considered to be a vital sign?

A

Yes

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7
Q

What is measured when taking a patients vital signs?

A
  1. Body temperature
  2. Pulse
  3. Respiration.

(Measured to monitor life supporting functions)

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8
Q

Is blood pressure considered a vital sign?

A

Blood pressure is not a true vital sign category, but is often measured with the other three in the overall assessment of the patient.

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9
Q

What is this describing?

Physiologic balance between heat produced in cells and heat lost to environment

A

Body temperature

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10
Q

T/F

Humans are cold blooded.

A

False; Humans are warm blooded

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11
Q

How much of a fluctuation in body tempurature has to occur before cellular functions and cardiopulmonary demands are affected?

A

A fluctuation of 2-3 ◦C

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12
Q

List 3 factors that can influence body temperature:

A

-Time of day
-weight
-hormone levels

(metabolic activites)

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13
Q

What part of the body performs thermoregulation?

A

The hypothalamus

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14
Q

How does the body preserve heat?

A

Shivering and vasoconstriction

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15
Q

How does the body regulate heat loss?

A

Diaphoresis and peripheral vasodilation

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16
Q

What is a normal body temperature?

A

37 °C (98.6 °F )

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17
Q

What is the Common body tempertature daily variation?

A

0.5 – 1°C (1 – 2 °F).

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18
Q

What is the common body temperature for infants (3m-3years)

A

37.2 – 37.61°C (99 – 99.7 °F)

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19
Q

What is the common body temperature for Child (5 – 13 years)?

A

36.56 - 37 °C (97.8 – 98.6 °F).

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20
Q

What can hypothermia result from?

A
  1. Induced medically
  2. Trauma to hypothalamus
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21
Q

How does hypothermia cause the body to shut down?

A

Reduces patient’s need for O2 and therefore, cardiopulmonary system slows down (bradycardia)

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22
Q

What does hyperthermia mean?

A

Elevated Body temperature

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23
Q

What does Febrile mean?

A

Related to fever

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24
Q

What is hyperthermia ussually caused by?

A

Usually due to disease process

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25
Q

How does hyperthermia cause the body to shut down?

A

As body temperature increases, body demands for O2 increase, CO2 production increases

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26
Q

How is the site for Measuring Body Temperature chosen?

A
  1. Patient’s age
  2. State of mind
  3. Ability to cooperate in the procedure.
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27
Q

T/F

Site used must be included when recording or reporting. Why or why not?

A

True; because the reading varies depending where it is measured

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28
Q

Where is oral temperature taken?

A

Mouth (under tongue)

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29
Q

When is oral temperature taken?

A

Used in adults and cooperative children

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30
Q

What is the normal oral body temperature?

A

37 °C O or 98.6 °F O

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31
Q

Where is axiallary temperature taken?

A

Armpit

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32
Q

What is the most useful area for taking temperature with infants?

A

Axillary

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33
Q

What is a normal axillary body temperature?

A

36.4 – 36.7 °C Ax or 97.6 - 98 °F Ax

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34
Q

Why is axillary temperature sometimes unreliable?

A

Time and precision of placement

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35
Q

Where is a rectal temperature taken?

A

Anal opening to rectum

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36
Q

What is the most reliable form of measuring body temperature?

A

Rectally

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37
Q

What is the colour of the Probe cover for rectal thermometers?

A

Probe cover is red

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38
Q

When should rectal temperature not be taken?

A

Should not be taken if the patient is restless or has rectal pathology.

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39
Q

When is rectal temperature used?

A

Used normally only on infants

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40
Q

What is a normal rectal body temperature?

A

37.5 °C R or 99.6 °F R

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41
Q

What is the Tympanic (Aural) Temperature meausring?

A

Temperature of the blood vessels in the tympanic membrane of the ear.

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42
Q

What is a normal tympanic body temperature?

A

36.4 °C T or 97.5 °F T

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43
Q

What are the forms of Core body temperature readings?

A
  1. Rectal temperature
  2. Tympanic temperature
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44
Q

What is being shown here?

A

A tympanic thermometer

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45
Q

What is being shown here?

A

Temperature sensitive patches

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46
Q

Where are Temperature sensitive patches placed?

A

Abdomen/forehead

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47
Q

T/F

With a temperature sensitive patch, If abnormal temperature is indicated, a more accurate method can be used to verify reading.

A

True

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48
Q

What are the ways to measure body temperature?

A
  1. Temporal Artery Thermometers
  2. Temperature Sensitive Patches
  3. Tympanic Temperature
  4. Rectal Temperature
  5. Axillary Temperature
  6. Oral Temperature
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49
Q

T/F

Measurements approximately 1 °F higher with a Temporal Artery Thermometer than oral readings.

A

True

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50
Q

What is being shown here?

A

Temporal Artery Thermometer

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51
Q

What does pulse indicate?

A

Reflects rapidity of heart contractions.

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52
Q

Why should you not press too hard while taking a pulse?

A

May obliterate if you press to hard

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53
Q

What is a normal pulse rate in an adult?

A

60 – 90 beats per minute (BPM)

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54
Q

What is the normal pulse rate in a Child (4 – 10 years)?

A

90 – 100 BPM

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55
Q

What is the normal pulse rate in an infant?

A

120 BPM

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56
Q

What does taking an Apical Pulse entail?

A

Listening to heart directly and Counting heartbeat over 1 min

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57
Q

T/F

An apical pulse may be lower than the radial pulse.

A

False; An apical pulse will never be lower than the radial pulse.

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58
Q

Where should you take an apical pulse reading?

A

5th intercostal space, 3 – 4 inches lateral to left sternal margin .

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59
Q

What are the different sites on the body that a pulse reading can be measured?

A
  1. Apical pulse
  2. Radial pulse
  3. Brachial Pulse
  4. Carotid Pulse
  5. Femoral Pulse
  6. Popliteal Pulse
  7. Temporal Pulse
  8. Dorsalis Pedis Pulse
  9. Posterior Tibial Pulse
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60
Q

Where on the body is a radial pulse taken?

A

At wrist (at base of thumb)

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61
Q

What is the most acessible spot to take a pulse reading?

A

On the wrist (radial pulse)

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62
Q

Where is a brachial pulse taken?

A

-Antecubital fossa above the elbow below the brachial artery

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63
Q

Where is a carotid pulse taken?

A

At angle of mandible over carotid artery

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64
Q

When is a carotid pulse ussually taken?

A

Typically, during CPR

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65
Q

How do you take a carotid pulse?

A

Push up with fingers slightly anterior and below the angle of the mandible.

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66
Q

Where is a femoral pulse taken?

A

Over femoral artery in groin

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67
Q

Where is a popliteal pulse taken? When would you take this kind of pulse?

A

-Behind knee
-Taken in a trauma situation

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68
Q

Where is a temporal pulse taken?

A

Over temporal artery (in front of ear)

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69
Q

Where is the Dorsalis Pedis Pulse taken?

A

At the top of the foot in line with the groove between the 1st and 2nd toes (between the extensor tendon of the great and second toe)

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70
Q

T/F

The Dorsalis Pedis Pulse may be congenitally absent

A

True

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71
Q

Where is the Posterior Tibial Pulse taken?

A

Medial aspect of ankles

72
Q

T/F

Unfit individuals and hyperthermic patients often have a low heart rate.

A

False; Fit individuals and hypothermic patients often have a low heart rate.

73
Q

When should a pulse baseline reading be taken?

A

Baseline should be obtained prior to start of invasive diagnostic imaging procedures at rest

74
Q

Where is the most accurate spot to take a pulse on infants?

A

Apical most accurate for infants.

75
Q

What does the assesment of a patients pulse indicate?

A

Assess strength and regularity of pulse as well as number of beats per minute.

76
Q

T/F

Manual palpation provides a quantitative assessment, where as rate provides a qualitative assessment.

A

False; Manual palpation provides a qualitative assessment, where as rate provides a quantitative assessment.

77
Q

What is Tachycardia and what is the average BPM for those who have it?

A

Abnormally rapid heart rate (>100 BPM)

78
Q

What is Bradycardia and what is the average BPM for those who have it?

A

Abnormally slow heart rate (<60 BPM)

79
Q

What does a graph of an ECG specifically indicate?

A

Graph of voltage versus time of the electrical activity of the heart

80
Q

What types of cardiac abdormalities does an ECG demonstrate?

A
  1. cardiac rhythm disturbances
  2. inadequate coronary artery blood flow
  3. electrolyte disturbances
81
Q

What is the simplest and fastest way of evaluating the heart’s activity?

A

Using an ECG

82
Q

What is the baseline of an ECG is called?

A

Isoelectric line

83
Q

What does the isolectric line signify?

A

Resting membrane potentials

84
Q

Label 1-2

A
  1. Isoelectric line
  2. Deflections
85
Q

What are defelections?

A

The positive or negative change in the isoelectric line over the peroid of the cycle?

86
Q

What does the P wave represent?

A

Represents depolarization of the atrial muscle cells.

87
Q

When does atrial contraction begin?

A

Atrial contraction begins at the peak of the P wave

88
Q

When does the SA node fire?

A

SA node fires at the start of the P wave

89
Q

What does the QRS complex represent?

A

Represents depolarization of the ventricular muscle cells.

90
Q

What does the S portion on an ECG represent?

A

The S portion is the return to baseline.

91
Q

What part of the ECG signifies the initial downward deflection?

A

The Q portion is the initial downward deflection

92
Q

When does contraction begin on the ECG?

A

Contraction commences at the peak of the R portion.

93
Q

What portion of an ECG signifies the initial upward deflection.

A

The R portion is the initial upward deflection.

94
Q

What does the U wave represent?

A

U wave represents the repolarization of the papillary muscles and the Purkinje fibers.

95
Q

What generates the T wave?

A

Repolarization of the ventricles

96
Q
97
Q

What triggers the PR interval?

A

Atrial depolarization

98
Q

What ends the PR interval?

A

The start of ventricular depolarization

99
Q

At what interval does the impulse travel through the AV node?

A

The PR interval

100
Q

Label 1-5

A
  1. QRS complex
  2. ST segment
  3. QT interval
  4. PR interval
  5. PR segment
101
Q

How many mV have occured over 5mm of an ECG chart?

102
Q

How much time has passed over 1mm of an ECG chart?

A

.04 seconds

103
Q

How much time has passed over 5mm of an ECG chart?

A

.20 seconds

104
Q

T/F

If the intervals between peak of QRS complexes (RR intervals) are consistent, ventricular rhythm is regular

105
Q

Is this a normal or abnormal rythm of the heart?

106
Q

Watch videos

A

https://youtu.be/GWTnHReNd-U
https://youtu.be/hySBi6n_97g
https://youtu.be/LPnv7mspvdY
https://youtu.be/JSdEK79J4dw
https://youtu.be/lKtfwiwHjLI
https://youtu.be/E4RELD0eGYE

107
Q

What is STEMI?

A

Profoundly life threatening heart attack and associated with atherosclerosis (CAD) whcih results in ST elevation.

108
Q

What pathology is being shown here?

109
Q

What is this describing?

The action of inhaling oxygen and exhaling carbon dioxide while breathing.
(One inspiration + One expiration)

A

Respiration

110
Q

What do the diaphragmatic muscles do during inspiration?

A
  1. Move downward
  2. Push abdominal contents outward
  3. Expand chest cavity
111
Q

What is the normal adult respiration rate?

A

12 –20 breaths/min

112
Q

What is the normal Child (1-10 years) respiration rate?

A

20-30 breaths/min

113
Q

What is the noraml Newborn/Infant (under 1 year) respiration rate?

A

30-60 breaths/min

114
Q

What can respiration of fewer than 10 breaths per minute for an adult result in?

A

Cyanosis, apprehension, restlessness, and change in LOC.

115
Q

What three factors must be assessed for during the Assessment of Respiration?

A
  1. Rate of respiration
  2. Pattern of respiration (regular or irregular)
  3. Depth of respiration
116
Q

What determines tidal volume?

A

The depth of respiration

117
Q

What is the abbreviation for respiration charting?

118
Q

What is dyspnea? What does it present as?

A

-Difficulty breathing.
-Often presents as shortness of breath (SOB).

119
Q

What pathology is this describing?

Causes include exercise, fever, infection, pain, heart failure, chest trauma, decreased oxygen in blood, and central nervous system pathology.

120
Q

What is the respiratory rate for those with Tachypnea?

A

Greater than 20 breaths per minute

In adults

121
Q

What is Bradypnea?

A

An abnormal decrease in respiratory rate.

122
Q

What pathology is this describing?

Results from depression of the respiratory centers of the brain – common with drug overdoses, head trauma and hypothermia.

123
Q

What is Orthopnea?

A

Difficulty breathing unless sitting up or standing erect.

124
Q

What is Apnea?

A

Absence of spontaneous ventilation.

125
Q

What is Stridor caused by?

A

Caused by narrowing or obstruction of airway

126
Q

What is stridor a first sign of?

A

May also be the first sign of a serious and even, life-threatening disorder

127
Q

What is blood pressure the product of?

A

Pressure is product of flow and resistance.

128
Q

T/F

BP is the reflection of resistance the blood meets in the systemic vasculature when it is ejected from the left ventricle of the heart during systole.

129
Q

What is Peripheral Vascular Resistance?

A

Resistance of the circulatory system (arterioles) that is used to create BP.

130
Q

Will Vasoconstriction cause an increase or decrease in PVR?

A

An increase

131
Q

Will Vasodilation cause an increase or decrease in PVR?

A

↓ PVR (shock)

132
Q

T/F

PVR is mediated on a neuro-hormonal level.

133
Q

What is cardiac output and how do you calculate it?

A

The amount of blood your heart pumps each minute.
Cardiac Output = Stroke Volume x Heart Rate

134
Q

What three things are mediating blood pressure dependant on?

A
  1. Pumping action of the heart
  2. Blood Volume
  3. Blood Viscosity
  4. Elasticity of the arterial vessel wall
135
Q

T/F

Slowing down the heart rate, increases how hard the heart must work

A

False; Slowing down the heart rate, reduces how hard the heart must work

136
Q

What pathologies decrease blood volume?

A

Dehydration/hemorrhage

137
Q

What are two types of diuretics that decrease blood pressure/volume?

A
  1. hydrochlorothiazide (HCTZ),
  2. Lasix
138
Q

What determines the viscosity of the blood?

A

The number of red blood cells in the blood plasma

139
Q

T/F

With an increased number, the blood becomes less viscous and subsequently, increases the blood pressure

A

False; With an increased number, the blood becomes more viscous and subsequently, increases the blood pressure

140
Q

What are three examples of blood thinners?

A

Aspirin, coumadin, heparin

141
Q

T/F

Vasoconstriction can result in increased blood pressure

142
Q

What type of medication is this?

Blocks the production of angiotensin (vasoconstrictor), causing the blood vessels to relax, resulting in drop in BP.

A

ACE inhibitors

143
Q

T/F

Males usually have higher blood pressure than females

144
Q

T/F

BP is lower in the morning after a night of sleep

145
Q

T/F

BP decreases after a large intake of food.

A

False; Increases after a large intake of food.

146
Q

What is the highest point of blood pressure reached in the cardiac cycle called?

A

The Systolic Pressure

147
Q

What is the lowest point of blood pressure reached in the cardiac cycle called?

A

Diastolic Pressure

148
Q

T/F

Relaxation of the ventricles generates the lowest point of blood pressure.

149
Q

What is a normal systolic blood pressure in an adult?

A

95 - 120 mmHg

150
Q

What is a normal diastolic blood pressure in adults?

A

60 - 80 mmHg

151
Q

What is a normal systolic blood pressure in a child?

152
Q

What is a normal diastolic blood pressure in a child?

A

60 - 80 mmHg

153
Q

What is a normal systolic blood pressure in adolecence?

A

85 -130 mmHg

154
Q

What is a normal diastolic blood pressure in adolecence?

A

45 - 85 mmHg

155
Q

When is a patient is considered hypertensive?

A

If systolic BP is consistently higher than 140mm Hg and diastolic greater than 90mm Hg.

156
Q

What are the categories of hypertension?

A

mild, moderate, or severe.

157
Q

When is a patient considered hypotensive?

A

A patient is considered hypotensive blood pressure is consistently lower than 95/60 mm Hg.

158
Q

What are the two ways to meausre blood pressure?

A
  1. Sphygmomanometer
  2. Stethescope
159
Q

What are the two types of Sphygmomanometers?

A
  1. Mercury manometer
  2. Aneroid manometer
160
Q

What is the most accurate Sphygmomanometer?

A

Mercury manometer

161
Q

What is being shown here?

A

Mercury manometer

162
Q

What is being shown here?

163
Q

Label 1-5

A
  1. Rubber tubing
  2. Bulb
  3. Valve
  4. Manometer Gauge
  5. Inflatable Cuff
164
Q

Label 1-6

A
  1. Binural
  2. Eartips
  3. Tubing
  4. Diaphragm
  5. Binaural spring
  6. Bell
165
Q

Where do you place your fingers on the stethescope when taking a blood pressure reading?

A

Place your fingers around the base of the bell

166
Q

What is the patient prep for taking blood pressure?

A
  1. Have patient sitting upright or lying down with arm reclined and supported.
  2. At rest for 3-5 min.
  3. Sleeves should be rolled up, no tight clothing around arm
167
Q

How is cuff size selected for a blood pressure reading?

A

Cuff should be selected according to patient size

168
Q

What artery is ussually used to measure blood pressure?

A

Typically measured over brachial artery

169
Q

How do you measure blood pressure using a Manometer?

A
  1. Inflate cuff to exceed systolic pressure in artery by 30 – 40 mm Hg
  2. Release air in cuff until pressure in cuff matches systolic pressure
  3. When no sounds are heard anymore, diastolic pressure value has been reached
170
Q

What is cyanosis?

A

Bluish tinge due to lack O2 in tissues, build up of deoxyhemoglobin.

171
Q

Where does core cyanosis develop?

A

Mucous membranes; tongue, lips or the lining of mouth

172
Q

Where does peripheral cyanosis develop?

173
Q

What is pallor? Where does is it most evident?

A

-Absence of color (Unhealthy pale appearance)
-Most evident in face and palms.

174
Q

What is diaphoretic skin?

A

Excessive sweating

175
Q

What does fever feel like to the touch?

A

Hot and dry skin

176
Q

What does syncope feel like to the touch?

A

Cold and clammy skin

Patient Management 2 (11 decks)

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