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Vital Signs > Vital Signs > Flashcards

Vital Signs Flashcards

1
Q

What are the 4 most common vital signs assessed?

A
  1. Body Temperature (degrees F or C)
  2. Heart Rate or pulse (beats per min (bpm))
  3. Respiratory Rate of Breathing (breaths per min (bpm))
  4. Blood Pressure (mmHg - Systolic/Diastolic)

Oxygen Saturation and Perception of Pain are also common, however, not the most common like those 4 listed above.

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2
Q

What is the signficance of assessing vital signs?

A

There are normative values for vital signs and knowing a patient’s baseline values can provide a basis for determining how a patient is responding to an intervention or in documenting signs of disease or injury.

The vital sign parameters really provide feedback about the patient’s status or response.

Baseline data is a useful tool used for comparison

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3
Q

What are some things that affect vital sign parameters?

A
  • Overall physical condition and any associated acute or chronic conditions
  • Level of physical activity or rest
  • Environmental Temperatures
  • Person’s age
  • Emotional Status of the person
  • Use of medications
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4
Q

Body Temperature

A
  • Taken by placing a thermometer in the mouth, the rectum, under the arm (axilla) or in the external auditory canal (ear)
  • The most common site is under the tongue; but the most accurate site is the rectum
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5
Q

What is the normal Body Temperature for:

Oral?

Rectal?

Axillary?

A

Oral: 98.6 degrees F or 37 degrees C (ranges from 96.8 - 99.3 degrees F)

Rectal: Generally higer than oral by .5 - .9 degrees F (ranges from 99.1 - 99.5)

Axillary: Generally lower than oral by ~ 1.1 degrees F (about 97.5)

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6
Q

What are some factors that affect Body Temperature

A
  1. Time of day - usually lower in the morning and higher later in the day
  2. Site used to measure body temperature
  3. Age - higher in the very young and lower in the elderly
  4. Environment
  5. Infection - increases with a major body infection
  6. Emotions - increases slightly during stressful periods
  7. Physical Activity - increases initially but then levels out once the person adapts
  8. Mentrual Cycle and Pregnancy - temperature rises slightly during ovulation and during pregnancy
  9. Oral Cavity Temperature - recent intake of warm, hot or cold liquids or food may result in an inaccurate assessment of oral temperature
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7
Q
  1. Wash hands
  2. Clean Thermometer with Alcohol swab
  3. Position patient and explain procedure
  4. Make sure the level of mercury in the thermometer is 96 degree F or below by shaking the thermometer a few times
  5. Ask the person to open their mouth and then you place the bulb of the thermometer under the person’s tongue. Instruct the person to hold the thermometer in place with their lips, not their teeth and tell them to breathe through their nose
  6. Leave the thermometer in place for at least three to five minutes
  7. Remove the thermometer and hold it horizontally at eye level so that the mercury column is clearly visible. Read the level of mercury and then clean the thermometer with alcohol before storing
  8. Record to the nearest tenth of degree and indicate degrees F
A

Process of assessing Body Temperature

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8
Q

What is Hyperthermia or Pyrexic?

What is Hyperpyrexic?

A

Hyperthermia or Pyrexic is:

  • Having a fever
  • Body temperature is above 100 degrees F

Hyperpyrexic is:

  • Body temperature is above 106 degrees F
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9
Q

What is Hypothermia?

A

Hypothermia is:

Decreased Body Temperature

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10
Q

Define Heart Rate or Pulse

A
  • The rhythmical throbbing of an artery as a result of the contraction of the left ventricle of the heart and is a measure of how many times the heart beats per minute
  • Pulse rate can be assessed by palpating over an artery or by ausculation of the heart with a stethoscope
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11
Q

What are (8) Pulse Measurement Sites?

A
  1. Temporal Artery
  2. Carotid Artery
  3. Brachial Artery
  4. Radial Artery
  5. Femoral Artery
  6. Popliteal Artery
  7. Doral Pedal Artery
  8. Posterior Tibial Artery
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12
Q

Temporal Artery

A

Anterior and adjacent to the ear

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13
Q

Carotid Artery

A

Lateral to the voice box and in front of the SCM (Sternocliedo Mastoid) muscle

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14
Q

Brachial Artery

A

Medial to the biceps in the anticubital fossa or medial aspect of the midshaft of the humerus

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15
Q

Radial Artery

A

Just medial to the radial styloid process on the anterior aspect of the distal forearm

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16
Q

Femoral Artery

A

Middle of anterior groin

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17
Q

Popliteal Artery

A

Posterior knee between tendons of the hamstring muscles

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18
Q

Dorsal Pedal

A

Midline or slightly medial on the dorsum of the foot

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19
Q

Posterior Tibial

A

Medial aspect of the foot inferior to the medial malleolus

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20
Q
  1. Wash hands and position yourself so you can see a watch or clock that has a second hand
  2. Get permission and explain pending measurement to patient
  3. Place two or three fingertips firmly but gently over the chosen artery site (don’t use the thumb as you may end up assessing your own pulse), avoiding excessive pressure
  4. Mentally count each beat for a period of 1 minute (you can take for 15 seconds and multiply by 4 OR take for 30 seconds and multiply by 2)
  5. Record the rates per minute, noting also the rhythm and force of the beat and the sight chosen, including right verses left
A

Process of measuring Pulse Rate

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21
Q

What is a normal Heart Rate for:

Adults at rest?

Newborn?

Children ages 1-7 years?

A

(bpm = beats per min)

Adults: 600-100 bpm

Newborn: 100-130 bpm

Children ages 1-7 years: 80-120 bpm

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22
Q

What are some factors that affect Heart Rate?

A
  1. Age - a person over age 65 may exhibit a decreased HR
  2. Gender - males usually exhibit a slightly lower HR
  3. Environmental Temperature - HR increases as outside temperature increases
  4. Infection - HR increases with major body infection
  5. Physical Activity - HR will increase as a response to activity but should revery back to pre-activity level within 3 - 5 minutes of activity cessation
  6. Emotional Status - HR increases during times of stress
  7. Medications - May increase or decrease HR
  8. Cardiopulmonary Disease - Person with hypertension may have a lower HR while the person with hypotension may have a faster HR
  9. Physical Conditioning - Conditioned person may exhibit a lower resting HR
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23
Q

Strong and Regular

A

Even beats with a good force to each beat

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24
Q

Weak and Regular

A

Even beats with a poor or diminished force to each beat

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25
Q

Irregular

A

May indicate that both strong and weak beats occur during the period of measurement and that the rate is not regular and rhythmical but irregular

26
Q

Thready

A

Weak force to each beat and irregular beats

27
Q

Tachycardia

A

Rapid Heart Rate greater than 100 bpm

28
Q

Bradycardia

A

Slow Heart Rate less than 60 bpm

29
Q

What is Respiratory or Beathing Rate?

A
  • This is simply the rate of breathing
  • Upon inspiration, the chest wall expands and moves up and out
  • Upon expiration, the chest wall deflates and moves down and in
  • Measured in breaths per minute (bpm)
30
Q

What are the norms for Respiratory Rates of:

Adults?

Infants?

Children compared to adults?

A

Adults: 12 - 18 bpm

Infants: 30 - 50 bpm

Respiratory Rate is higher in children than in adults

31
Q
  1. Wash hands and secure a watch or clock with a second hand
  2. Don’t explain what you are going to do as this will invite a voluntary change in respiration
  3. However, simulate taking the radial pulse with the patient’s forearm resting on their abdomen
  4. Watch or feel for the rise and fall of the chest and count for one minute
  5. Record the number of breaths counted during the minute and also note the rhythm and depth of the respirations
A

Process for assessing Respiratory Rate

32
Q

Tachypnea

A

Increased Respiratory Rate

(Faster than 20 bpm)

33
Q

Bradypnea

A

Decreased Respiratory Rate

(Slower than 10 bpm)

34
Q

Hyperpnea

A

Increased rate exhibited by deeper breaths

35
Q

Dyspnea

A

Difficult or labored breathing

36
Q

Wheezing

A

Whistling sound

37
Q

Crackles

A

Rattling or bubbling sounds

38
Q

What are factors that affect Respiratory Rate?

A
  1. Age - The very young and elderly have increased rates of breathing
  2. Physical Activity - Rate and depth of breathing increases
  3. Emotional Status - Increase during stressful events
  4. Air Quality - Impurities in the air or lack of oxygen will cause the respiratory rate to increase
  5. Altitude - Higher altitudes cause and increase in respiratory rate until the person adjusts
  6. Disease - Pulmonary disease usually results in an increase in the respiratory rate
  7. Medications - Variable impact
39
Q

What is Blood Pressure?

A
  • Systemic Arterial Blood Pressure provides the examiner with information about the cardiac output of the heart and the peripheral vascular resistance of the allowance of blood flow through the body
  • It is a measuremenr of the pressure of blood exerted on the wall of an artery as the blood flows through that artery and is measured with a deviced called a Sphygmomanometer (commonly reffered to as a blood pressure cuff)
40
Q

What is Blood Pressure recorded in?

A

mmHg

(millimeters per mercury)

Systolic/Diastolic

41
Q

What is Systolic Pressure?

A

Systolic Pressure = BP at the time of contractions of the left ventricle (systole)

FIRST BOOM heard when taking blood pressure

42
Q

What is Diastolic Pressure?

A

Diastolic Pressure = BP at the time of the rest period of the heart (Diastole)

LAST BOOM heard when taking blood pressure

43
Q

Define Korotkoff’s Sounds

A

Korotkoff’s Sounds = sounds heard by using a stethoscope that indicate sounds that occur between the beginning of systole and the beginning of diastole

44
Q

What is a normal Blood Pressure for:

Adults?

A

Adults: 120-130/80-85 mmHg

Normal being set at 120/80 mmHg

45
Q

What are some factors that affect BP?

A
  1. Age - younger patients exhibit lower systolic and diastolic rates. Elderly patients may exhibit higher systolic rates but lower diastolic rates
  2. Physical Activity - Systolic pressure would rise but will plateau and should return to pre-activity levels within 3-5 minutes of cessation of activity
  3. Emotional Status - BP will increase during episodes of stress
  4. Medications - Various impact
  5. Size and Condition of Arteries - Patient with PAD (Peripheral Arterial Disease) will have higher blood pressure values
  6. Arm Position - Arm should be level with heart
  7. Arm Contraction - Person should relax and not contract arm muscles
  8. Blood Volume - BP decreases when there is blood loss and increases with and increase in blood volume
  9. Cardiac Output - Blood pressure increases with increased cardiac output and decreased with decreased cardiac output
  10. Obesity, Excessive Salt Intake, Nicotine, Alcohol, Kidney Disease, and Race also all affect BP.
46
Q

What is Hypertension?

A

Hypertension is:

Blood pressure consistently measured above 140/90 mmHg

47
Q

What is Hypotension?

A

Hypotension is:

Systemic BP consistently measured below 100 mmHg

48
Q

What is the process of assesing Blood Pressure?

A
  1. Wash hands and secure BP cuff and stethoscope (gather all equipment before washing hands, but clean equipment after washing hands)
  2. Explain the procedure to the patient and obtain permission to proceed (always introduce yourself as a Physical Therapist Assistant Student from Jefferson Community and Technical College)
  3. Position arm at level of the heart if seated and just straight out in front of them if supine
  4. Clean the ear pieces and the diaphragm of the stethoscope
  5. Expose the antecubital space without rolling up sleeves and palpate for the brachial pulse
  6. Apply the deflated BP cuff with the center of the bladder over the medial aspect of the arm and 1.5 finger widths above the antecubital space with the dial in view of the examiner
  7. Place the ear pieces in ears with the ear pieces directed forward. Place the diaphragm over the skin where the brachial artery was palpated
  8. Close the valve on the BP cuff and inflate no more than 200 mmHg
  9. Slowly release the valve and watch the needle fall while listening to the sounds heard (let cuff out at 2-3 mmHg per second - needs to be slow)
  10. Note when the first sound is appears (this will be the systolic number) and note when the last sound appears (this will be the diastolic number)
  11. Record the blood pressures in terms of systolic over diastolic and in terms of mm Hg, noting which arm was used and the patients position
  12. Clean the earpieces and diaphragm again (if in a contact isolation room, leave all dedicated equipment in the room)
49
Q

Define Arrhythmia

A

A condition in which the heart beats with an irregular or abnormal rhythem

50
Q

The chest wall expands and moves up and out

A

Inspiration

51
Q

The chest wall deflates and moves down and in

A

Expiration

52
Q

The tool blood pressure is measure with

A

Sphygmomanometer; blood pressure cuff

53
Q

Tool used to hear Korotkoff’s Sounds when taking blood pressure

A

Stethoscope

54
Q

What is a Pulse Oximeter?

A
  • Battery or electrical operated device used to assess the oxygen saturation (O2 SATS) of the patient’s blood by transmitting an infrared beam of light through the finger or ear (light affected by reduced hemoglobin and oxygen in the blood) to a sensor pad on the opposite side
  • Normal = 95-100
  • Anything below 90 deserves some attention
55
Q

What are some factors that impact Oxygen Saturation (O2 SATS)

A
  1. Anemia and a host of other medical conditions
  2. Higher Altitudes
  3. Person or body part being restricted of oxygen by some means
  4. Carbon Dioxide CO poisoning
  5. Pulse OX sensor being too tight or too loose
  6. Cardiac Arrest or Heart Malfunction
  7. Pulmonary Conditions
  8. Severe head trauma
  9. Choking
  10. Certain Medications
56
Q

What are some symptoms of decreased oxygen saturation?

A
  1. Air hunger
  2. Dizziness
  3. Headache
  4. Metal and Physical Fatigue
  5. Tingling in a body part
  6. Cyanosis
  7. SOB (shortness of breath)
  8. Nausea
  9. Coma
  10. Death
57
Q

What is pain?

A
  • An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage
58
Q

How is pain assessed?

A
  1. Response to pain is highly personal and subjective
  2. It is whatever the patient says it is - self report of pain is considered to be the most reliable
  3. Pain is often associated with emotional or spiritual feelings
59
Q

How is pain recorded?

A

0 being no pain and 10 being unbearable pain.

For example 3/10

For children, visual images of a face with smiles or frown (continuum) is used

60
Q

What are some words used to describe Pain?

A

Include, but not limited to the following words:

  • Dull
  • Sharp
  • Achey
  • Shooting
  • Stinging
  • Electric
  • Cramping
  • Burning
  • Deep
  • Nagging
  • Severe
  • Throbbing
61
Q

How is the documentation of pain beneficial?

A
  • If possible, record the intensity of the pain, where it is felt by the patient and the type of pain being experienced
  • This needs to be done on a continual and consistent basis
  • Documentation allows for conclusions to be drawn reguarding pain improving, staying the same or getting worse or simply changing location or type
62
Q
A

Vital Signs (1 decks)

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