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Nursing > Vital Signs > Flashcards

Vital Signs Flashcards

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0
Q

When should you assess vital signs?

A

When the HCP orders them, 1st admitted ,change in health status/new symptoms, before/after surgery/invasive procedure, before/after certain meds, and before/after any intervention that could affect vitals.

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1
Q

What are the 6 vital signs?

A

Body temp, pulse, respirations, blood pressure, oxygen sat, and pain.

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2
Q

What is normal core body temperature?

A

96.6-99.8

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3
Q

Core temp can be assessed through what sites?

A

Rectal and tympanic

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4
Q

What are some precautions to consider when taking a surface temperature?

A

The temp rises and falls in response to environment

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5
Q

What are some surface temp sites?

A

Skin, oral, and axillary

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6
Q

Shivering does what?

A

Increases heat production

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7
Q

Sweating is stopped to…

A

Prevent heat loss

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8
Q

Vasoconstriction does what?

A

Decreases heat loss

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9
Q

Epinephrine does what?

A

Increase heat production

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10
Q

Sweating does what?

A

Increases heat loss

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11
Q

Peripheral vasodilation does what?

A

Increases heat loss

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12
Q

What is hypothermia?

A

Less than 95.0

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13
Q

What is pyrexia?

A

100.4-104

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15
Q

What is hyperpyrexia?

A

105.8-107.6

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16
Q

Temperature in older adults is what compared to middle adults?

A

lower

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17
Q

What are some lifespan considerations for older adults?

A

buildup of earwax, and hemorrhoids likely

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18
Q

When should you not use a oral temperature?

A

When the child is under 3 years old

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19
Q

A characteristic of heat stroke is what?

A

Dry skin (no sweat) and temp over 106

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20
Q

Characteristics of heat exhaustion?

A

Dizzy, nauseous, temp of 101-102

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21
Q

Interventions for pyrexia include?

A

limit physical activity, provide oral hygiene, tepid sponge bath, dry clothes/linens, provide adequate fluid (2500-3000mL)

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22
Q

Peripheral pulses is located where?

A

away from the heart

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23
Q

Apical pulse is located where?

A

apex of the heart

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24
Q

What is normal pulse rate?

A

60-100 bpm

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25
Q

How is pulse rate affected by fluid loss?

A

it goes up

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26
Q

Standing for long periods of time does what to pulse rate?

A

increases

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27
Q

How does exercise affect pulse rate?

A

increases

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28
Q

Is pulse rate higher in males of females?

A

females

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29
Q

What is the most reliable pulse site?

A

apical

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30
Q

When should you assess pulse at the apical site?

A

When the person in under 3 years of age or if you get an irregular reading at a peripheral site

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31
Q

When should you not use the radial pulse site?

A

on children under 3

32
Q

Auscultation may be done over clothing or only on bare skin?

A

only on bare skin

33
Q

What is bradycardia?

A

slow heart rate less than 60 bpm

34
Q

What is tachycardia?

A

elevated heart greater than 100 bpm

35
Q

Do older or younger people have higher heart rates?

A

younger

36
Q

The apical pulse is never what compared to the radial pulse?

A

lower

37
Q

The Allen’s test is used for what?

A

to check collateral circulation

38
Q

What is an arrhythmia?

A

irregular pulse rhythm

39
Q

What is blood flow called?

A

perfusion

40
Q

What causes pulse deficit?

A

wave of pulse is too weak to be felt or vascular disease

41
Q

Heart murmurs are common in what age group?

A

newborns

42
Q

You should assess pulse in newborns how?

A

in supine position and before taking temperature

43
Q

In what age group does pulse return to baseline slowly after exercise?

A

older adults

44
Q

What is normal respiration rate?

A

12-20 a minute

45
Q

What age group has a higher resp rate?

A

children (15-25)

46
Q

How long do you assess resp for children/infants?

A

60 seconds

47
Q

What is eupnea?

A

normal rate and depth of respiration

48
Q

What is tachypnea?

A

rapid/shallow resp

49
Q

What is bradypnea?

A

abnormally slow resp, less than 12

50
Q

What is apnea?

A

stop breathing

51
Q

what is hyperpnea?

A

exaggerated, deep, labored resp

52
Q

what is hyperventilation?

A

over expansion of lungs

53
Q

what is hypoventilation?

A

under expansion of lungs

54
Q

what is Kussmaul’s

A

hyperventilation

55
Q

what is cheyeene-stokes and who does it usually occur in?

A

rhythmic waning of resp and it occurs in chronic patients as well as over doses.

56
Q

Biot’s (cluster) is what and most common where?

A

shallow breathing interrupted by apnea due to injury to central nervous system

57
Q

what is dyspnea?

A

persistent unsatisfied need for air

58
Q

what is orthopnea?

A

easier to breath sitting/standing up

59
Q

What are retractions related to?

A

struggling to breath

60
Q

Audible sounds during breathing indicates what?

A

difficulty breathing

61
Q

what is pulse oximetry?

A

amount of hemoglobin, saturated with oxygen

62
Q

what is normal oxygen saturation?

A

94-99%

63
Q

what is hypoxemia?

A

less than 90% oxygen sat

64
Q

what are characteristics of orthostatic hypotension?

A

drop in 20+ from systolic and drop in 10+ from diastolic

65
Q

what are blood pressure sounds referred as?

A

Korotoff sounds

66
Q

What blood pressures should be reported?

A

systolic greater than 140 or less than 100, and diastolic greater than 90

67
Q

what are diurnal variations in bp?

A

lower bp in mornings

68
Q

race consideration when taking bp?

A

african americans over 35 have higher bp

69
Q

does bp increases or decrease with age?

A

increase

70
Q

who has a higher bp, males or females?

A

males after puberty and females after menopause

71
Q

what is hypertension?

A

persistently elevated bp @ 2 different times

72
Q

what is primary hypertension?

A

unknown source

73
Q

what is secondary hypertension?

A

known source

74
Q

what is orthostatic hypertension?

A

bp falls when client stands/sits

75
Q

bp at the thigh is what compared to the arm?

A

systolic is 10-40 higher

76
Q

normal pulse pressure is what?

A

30-40

Nursing (8 decks)

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