Vital signs

Question 1

What Makes Vital Signs Important?

Answer 1

• Measures essential body functions
• Indicates health status changes, signaling illness onset or recovery.
• Parameters are interdependent (e.g., fever may increase heart rate).

Question 1

When to Take Vital Signs

Answer 1

1. Baseline Measurements:
   o During admission, shift start, or home visits for reference points.
2. Response to Condition Changes:
   o When patients feel unwell or show distress.
3. During Procedures:
   o Before, during, and after procedures like surgery or transfusions.
4. Before Interventions:
   o Before administering medications or assisting mobility.

Question 2

Temperature

Answer 2

• Order of Accuracy:
  o Rectal (most accurate): ~0.5°C higher than oral.
  o Oral: Most commonly used.
  o Axillary: Less accurate but suitable for specific patients.
• Timing Adjustments:
  o Wait 5 minutes after smoking or physical exertion.
  o Wait 20-30 minutes after hot or cold beverages.
  o Wait 2 minutes if the patient has been chewing gum, as it can alter oral temperature..

Question 3

Blood Pressure (BP)

Answer 3

• Technique:
  o Cuff should cover 80% arm length and 40% width.
  o Patient seated, arm supported at heart level.
• Sites to Avoid:
  o Arms with AV fistula, PICC line, or lymph node resection.
• Timing:
  o Wait 2-3 minutes between readings for stabilization.

Question 4

. Pulse

Answer 4

Assessment:
o Frequency: Beats per minute (normal: 60-100 bpm in adults).
o Rhythm: Regularity or irregularity.
o Force: Graded from 0 (absent) to 3+ (bounding).
* Pulse Sites:
o Radial (routine checks), Apical (for irregular rhythms).

Question 5

Respiratory Rate & Oxygen Saturation

Answer 5

• Parameters:
  o Normal rate: 12-20 breaths/min.
  o SpO₂: 95-100%.
• Observation:
  o Count for 30 seconds (60 if irregular).
  o Note depth, rhythm, and accessory muscle use.

Question 6

Interpreting Vital Signs

Answer 6

• Patterns:
  o Low BP + rapid pulse → Hypovolemia or dehydration.
  o Fever + increased HR → Infection or sepsis.
• Context:
  o Relate findings to clinical scenarios (stress, pain, or illness effects).

Question 7

Common Errors to Avoid

Answer 7

• Technique Errors:
  o Incorrect cuff size or placement.
  o Poor patient positioning (e.g., unsupported arm, legs crossed).
• External Factors:
  o Failure to allow rest after physical activity or smoking.

Question 8

Key Clinical Concepts
Blood Pressure

Answer 8

• Hypertension Diagnosis:
  o Diabetes: ≥130/80 mmHg.
  o Non-diabetic: ≥135/85 mmHg (automated); ≥140/90 mmHg (manual).
• Manual vs. Doppler:
  o Manual for irregular rhythms or weak pulses.
  o Doppler for detecting faint blood flow.
• Hypertension Risks:
  o Brain: Stroke, encephalopathy.
  o Heart: Heart failure, myocardial infarction.
  o Kidneys: Chronic renal failure.

Question 9

Key Clinical Concepts
Pulse

Answer 9

• Clinical Reasoning:
  o Weak pulse → Possible hypoperfusion.
  o Bounding pulse → Possible hypertension or fever.
• Apical Pulse:
  o Ideal for assessing irregular rhythms.

Question 10

Key Clinical Concepts
Cardiac Output

Answer 10

• Formula: CO = HR x SV
  o Low CO → Dizziness, organ hypoperfusion.
  o High CO → Cardiovascular strain.

Question 11

Thermoregulation

Answer 11

Normal Temperature Ranges
* Oral: 36.4°C–37.2°C.
* Rectal: 37.0°C–38.1°C.
* Axillary: 35.2°C–36.9°C.
* Ear/Temporal: ~35.9°C–37.6°C.
Abnormal Conditions
* Hyperthermia (>40°C):
o Causes: Infection, inflammation, neurological issues.
o Risks: Heatstroke, organ dysfunction.
* Hypothermia (<35°C):
o Causes: Exposure, aging, hypothyroidism.
o Risks: Confusion, bradycardia, systemic failure.

Question 12

Age-Related Risks Temp

Answer 12

• Neonates:
  o High heat loss due to large surface area and immature thermoregulation.
• Elderly:
  o Reduced metabolism, muscle mass, and sweat gland function.
  o Lower baseline body temperature.

Question 13

Hypertension Management: CHEP Recommendations

Answer 13

• Exercise: Engage in physical activities (walking, jogging, cycling, swimming) 4–7 days/week.
• Healthy Body Weight: Use height, weight, and waist circumference to guide weight management.
• Alcohol Intake: Limit to:
  o Women: ≤2 drinks/day.
  o Men: ≤3 drinks/day.
• Sodium Intake: Reduce to <1500 mg/day for adults.
• Potassium Intake: Maintain ~90 mmol/L/day.
• Stress Management: Balance work and leisure activities.
• Healthy Diet:
  o Emphasize fruits, vegetables, low-fat dairy, whole grains, and low-cholesterol meats.