vital signs Flashcards
what are the vital signs?
- temperature
- HR (beats/min)
- Respiration (breaths/min)
- BP (mmHg)
what body places may you measure temperature?
- mouth
- rectum
- axilla
- ear
what is the normal temperature of the human body?
what temperature is considered fever (pyrexia)?
what temperature is considered hyperpyrexia?
what temperature is considered hypothermia?
98-100 ˚F or 37.5˚C
more than 100˚C or more than 37.5˚C
106˚F or 41.1˚C
less than 95˚F or 35˚C
what is the oral temperature in the morning?
what is the oral temperature in the afternoon?
when should you NOT take oral measurements in the morning or afternoon? what should you do instead?
96˚F or 35.8˚C
99.1⁰F or 37.3˚C
when patient is unconscious, restless, cant close his mouth.
use a glass or electronic thermometer
what can cause a false high reading of oral temperature?
what can cause a false low reading of oral temperature?
smoking or drinking hot liquid
talking, mouth breathing, drinking cold drink, taking out thermometer out too soon
In what patient do we use axillary temperature?
what is the normal axillary temperature?
babies
97.6 ˚F or 36.5˚C; its 1˚F less or 0.5 ˚C less than oral
for what patient do we use rectal thermometer?
what is the normal rectal temperature?
how long do you place it in the rectum?
for babies
1˚F or 0.5˚C degree higher than normal oral temperature
3min
what is the normal tympanal temperature?
100˚F (37.8˚C) or 1.4˚F (0.8˚C) higher than oral temperature
In what places can we detect the pulse?
brachial artery
radial artery
carotid artery
dorsalis pedis
posterior tibia
fermoral
what aspects of the pulse should be described?
rate
rhythm
volume or amplitude
contour or character
condition of vessel wall
in what place of the body do we better detect the character or contour of the pulse?
what is the best artery to be used for detecting a pulse?
in the carotid
radial artery
when you look for the carotid pulse, where do you look to palpate the neck?
medial to the sternocleidomastoid, usually the right carotid artery, in the lower 1/3 of the neck
(at the level of the cricoid cartilage almost)
what is the normal rate of the pulse?
what is considered tachycardia?
what is considered bradycardia?
60-100 beats per min.
more than 100 bmp
less than 60 bmp
how do you obtain the heart rate if the beat is regular?
how do you obtain the heart rate if the beat is irregular?
when obtaining the heart rate and the beat is irregular, you always confirm by doing what?
locate radial artery and count for 30segs then multiply by 2 (or 15 and multiply by 4)
locate radial artery and count for 60 segs.
you confirm by auscultating in the cardiac apex
what are the words used to describe the rhythm of the pulse?
irregular or regular
when the pulse is irregular, and it varies consistently with respiration, what is it?
what can be noticed about the rate in the pulse?
sinus arrhythmia
rate increases during inspiration and decreases during expiration
Regularly irregular pulse can be seen during what?
Irregularly irregular pulse can be seen during what?
2nd degree heart block
atrial fibrillation
how do we grade a pulse amplitude?
0 -> absent or not palpable
+1 -> diminished or weak
+2 -> normal or brisk
+3 - bounding
how do we calculate the pulse pressure?
what is the normal pulse pressure?
what 2 factors affect pulse pressure?
systolic BP - diastolic BP
30-40 mmHg
1) Stroke volume 2) compliance of arterial tree
how do we call a pulse pressure higher than 40?
what may cause Pulse pressure higher than 40?
how do you call a pulse pressure lower than 25?
what may cause a pulse pressure lower than 25?
wide
thyrotoxicosis, AV fistula, PDA, Aoric incompetence
narrow
pericarditis, pericardial effusion, pericardial tamponade, aortic stenosis, very high tachycardia
what may cause a bounding pulse?
what may cause a weak pulse?
increased Stroke volume, fever, anemia, hyperthyroid, AR, A-V fistula, PDA
hypovolemia, severe AS, CHF, hypothermia, increased peripheral resistance
what are the ways to describe the character of the pulse? describe each.
- Pulsus Alternans: pulse alternates in amplitude from beat to beat even though the rhythm is basically regular.
- strong then weak
- Bisferiens pulse: increased arterial pulse where you feel 2 systolic peaks
- Bigeminal pulse: a normal beat alternating with a premature contraction. stroke volume of the premature contraction is less than the regular beats
- Pulsus paradoxicus: exaggeration of the normal drop in systolic BP seen with inspiration by more than 10 mmHg
- Water hammer (collapsing) pulse: take pulse at lower level (below heart and pulse weak); when you raise arm above heart, pulse is very strong
what may cause:
Pulsus Alternans:
Bisferiens pulse:
Bigeminal pulse:
Pulsus paradoxicus:
Water hammer (collapsing) pulse:
- Pulsus Alternans: sign of LV heart failure (accompanied by S3)
- Bisferiens pulse:causes AR or AS + AR
- Bigeminal pulse: Hypertrophic cardiomyopathy
- Pulsus paradoxicus: obstructive lung disease, pericardial tamponade, pericardial effusion
- Water hammer (collapsing) pulse: hyperthyroidism, AR, AV fistula, Paget’s disease
what is the normal respiratory rate?
12-20 breaths per min
