Vital Signs Flashcards
in addition to counting HR, what other factors should be evaluated when recording HR?
rhythm, regularity (regularly irregular vs. irregularly irregular), amplitude
in addition to counting RR, what other factors should be evaluated when recording RR?
pattern, depth, signs of distress
what is the formula for BMI?
weight/height^2
list the ideal conditions for evaluating BP
- no caffeine or nicotine w/i 30 min.
- resting for 5 min
- quiet, warm room
- no tight clothing over arm
what normal is the normal BP variability between each arm, why is there variability?
5-10mmHg, because one arm may have more muscles (handedness)
what does BP measure?
peripheral measure of CV function, measures force exerted against walls of arteries
what part of the stethoscope is used for auscultating BP?
bell (low-pitched sounds)
what are Korotkoff sounds?
low-pitched sounds produced by turbulence of blood on the artery wall
what structure regulates body temp?
hypothalamus
pyrexia
fever
describe the process of elevated temp during fever
microorganisms invade body, endogenous pyrogens are released and travel to hypothalamus, hypothalamus initiates pyrexia by producing and releasing prostaglandins
how does body cooling occur?
via vasodilation. this increases heat loss through skin and evaporation of perspiration
what is hypothermia
when your body losses heat faster than it can produce heat. body temp
what is hyperthermia
when your body produces heat faster than it can cool itself
F to C conversion
F = (9/5) C + 32
what 5 factors determine body heat loss?
- radiation: heat given off to surrounding atmosphere
- conduction: movement of heat from one solid to another during contact
- vaporization: heat lost during evaporation of sweat
- respiration: heat lost to environment during breathing
- convection: mass movement of air or liquid
what are 5 factors that affect body temp?
- metabolic processes (sleep, digestion, exercise)
- infectious processes (fever)
- environmental factors
- ingestion of exogenous substances (cold or hot bevs, drugs)
- body heat loss
what is the threshold of fever in children
rectal >=100.5F/38C
pulse rhythm
regular or irregular?
pulse deficit
difference between apical and radial pulses, requires two people, one to listen to each pulse, may indicate irregular cardiac output if different
apical pulse
pulse at the apex (inferior portion) of the heart, each pulse is combo of S1 and S2
pulse regularity
if rhythm is irregular is it irregularly irregular or regularly regular?
pulse amplitude
force with which bolus of blood moves through the artery
what is the scaling of pulse amplitude?
4+ bounding 3+ full, increase 2+ expected/normal 1+ diminished, barely palpable 0 absent, not palpable
pulse pressure
difference between systolic and diastolic pressures (should be between 30-50mmHg)
pulsus paradoxus
premature cardiac contraction, abnormally exaggerated decrease (>10mmHg) in the amplitude of pulsation during inspiration and increase amplitude during expiration. indication of disease (e.g tracheobronchial obstruction, bronchial asthma, emphysema, pericardial effusion, constrictive pericarditis)
systole
S1, when the ventricles are at maximal contraction (lub)
diastole
S2, when ventricles are at maximal relaxation (dub)
systolic pressure
maximum pressure on artery during LV contraction
diastolic pressure
pressure exerted by blood consistently between each contraction
typical resting pulse for adult
60-90 BPM
what are 5 factors that affect pulse rate?
- heart health
- neurologic status
- emotions
- drugs
- activity level
define tachycardia
> 100 BPM
define elevated pulse
90-99BPM
define bradycardia
define a bounding pulse
hyperkinetic or strong pulse, does not “fade out”, documented as a 3+, 4+ in terms of pulse amplitude
diaphargmatic respiration
occurs when diaphragm is contracted (eupnea)
abdominal respiration
same as diaphragmatic, occurs when diaphragm is contracted, expansion of the abdomen, rather than chest
thoracic respiration
achieved using intercostal muscles, breathing into the chest
hyperapnea
increase rate, increased depth
apnea
absence of respiration
Cheyne-Stokes respiration
periodic breathing, increased AND decreased rate and depth with periods of apnea. brain damage, drug-induced respiratory compromise
tachypnea
persistant RR >20/min
bradypnea
RR>12
hyperventilation
can be due to tachyapnea or hyperpnea (increased rate, increased depth)
hypopnea
abnormal, shallow respirations
paradoxic breathing
lower thorax is drawn in during inspiration, lower thorax is let out during expiration (may occur w/ negative intrathoracic pressure, or in the event of upper airway obstruction)
Kussmaul breathing
deep, labored, rapid breathing, type of hyperpnea, associated with metabolic acidosis
what type of breathing is associated with metabolic acidosis?
Kussmaul breathing
what is the normal range of respiration in adults
12-20/min
what is tripoding?
triangular seating associated with respiratory distress
list 5 indications of respiratory distress
- accessory muscle use
- nasal flaring
- difficulty speaking
- audible breathing
- diaphroresis
what does BP measure?
peripheral CV function
systole
S1, lub, ventricles at max contraction
diastole
S2, dub, ventricles relaxed
stroke volume
amount of blood pumped out of the LV with each contraction (about 2/3 of total blood in ventricle)
what are the 5 factors that contribute to BP?
- stroke volume
- HR
- peripheral vascular resistance
- vessel diameter and length
- blood viscosity
cardiac output
stroke volume x HR
what is the range of prehypertension?
120-139/80-89
what defines hypertension for adults
> 140/90, HOWEVER, you don’t initiated Tx until 150/90 unless the patient has diabetes, then it’s 150/90
what defines hypertension for adults >60?
> 150/90
peripheral vascular resistance
resistance of vessel walls to expansion by blood
auscultatory gap
period of silence (10-15mmHg) between hearing Korotkoff sounds. if neglected could artificially lower systolic and increase diastolic reading
orthostatic BP measurement
- supine for 5-10 min then take BP and HR
- have pt. stand (if they can’t sit w/ legs dangling)
- after 1 min, repeat BP and HR
what are the cutoffs that suggest volume depletion when taking orthostatic BP?
decrease in SBP >20mmHg and decrease of >10mmHg or increase in HR >20BPM (>16BPM in elderly)
define acute pain
short duration, sudden onset, associated w/ surgery, injury, acute illness
define chronic pain
pain that last several months or longer, often sustained by pathological processes (e.g joint disease, cancer)
define nociceptive pain and name the the two different types
pain perceived by specialized peripheral nerves called nocicpetors.
- somatic nociceptive pain
- visceral nociceptive pain
define somatic and visceral nocicpetive pain
- somatic: nociceptive pain of the joints, bones, muscles, soft/connective tissue (strains, sprains)
- visceral: nociceptive pain of the soft tissues and internal organs (pregnancy and childbirth)
what are some words that are used to describe visceral nocicpetive pain?
dull, squeezing, deep, sickening
define neuropathic pain and name the two different types
long-term pain associated with damage, dysfunction of nerves involved in somatosensation. can be descrived as both loss of feeling or sensation, tingling/burning, shock-like paresthisias. 1. central 2. peripheral
define central neuropathic pain
neuropathic pain associated with damage to the CNS (e.g. phantom limb pain)
define peripheral neuropathic pain
neuropathic pain associated with damage to PNS (e.g. pinched nerve of neck may cause itching of the back)
normal temp taken with oral thermometer
98.6F/37C
normal temp taken with rectal thermometer
99.6F/37.56C
normal temp taken with axillary thermometer
97.6F/36.4C
normal temp taken with tympanic thermometer
99.6F/37.56C
which thermometer is best used on pediatric patients and kids 2 months-16 years?
tympanic
which is the most accurate method of temperature acquisition?
rectal
what is the avg. temp differential between tympanic and rectal?
T is generally 1.6F lower than rectal
list 6 factors than can increase BP
- atherosclerosis
- anxiety
- hypertension
- pain
- sedentary lifestyle
- illicit drugs, stimulates
list 4 factors that can decrease BP
- hypotension
- dehydration
- illicit drugs, depressants
- active lifestyle
normal oral temp
98.6F (37)
normal rectal temp
99.6F (37.7)
axillary
97.6F (36.4)
