vital signs

Question 1

what are the vital signs?

Answer 1

1. temperature
2. HR (beats/min)
3. Respiration (breaths/min)
4. BP (mmHg)

Question 2

what body places may you measure temperature?

Answer 2

1. mouth
2. rectum
3. axilla
4. ear

Question 3

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?

Answer 3

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

Question 4

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?

Answer 4

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

Question 5

what can cause a false high reading of oral temperature?

what can cause a false low reading of oral temperature?

Answer 5

smoking or drinking hot liquid

talking, mouth breathing, drinking cold drink, taking out thermometer out too soon

Question 6

In what patient do we use axillary temperature?

what is the normal axillary temperature?

Answer 6

babies

97.6 ˚F or 36.5˚C; its 1˚F less or 0.5 ˚C less than oral

Question 7

for what patient do we use rectal thermometer?

what is the normal rectal temperature?

how long do you place it in the rectum?

Answer 7

for babies

1˚F or 0.5˚C degree higher than normal oral temperature

3min

Question 8

what is the normal tympanal temperature?

Answer 8

100˚F (37.8˚C) or 1.4˚F (0.8˚C) higher than oral temperature

Question 9

In what places can we detect the pulse?

Answer 9

brachial artery

radial artery

carotid artery

dorsalis pedis

posterior tibia

fermoral

Question 10

what aspects of the pulse should be described?

Answer 10

rate

rhythm

volume or amplitude

contour or character

condition of vessel wall

Question 11

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?

Answer 11

in the carotid

radial artery

Question 12

when you look for the carotid pulse, where do you look to palpate the neck?

Answer 12

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)

Question 13

what is the normal rate of the pulse?

what is considered tachycardia?

what is considered bradycardia?

Answer 13

60-100 beats per min.

more than 100 bmp

less than 60 bmp

Question 14

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?

Answer 14

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

Question 15

what are the words used to describe the rhythm of the pulse?

Answer 15

irregular or regular

Question 16

when the pulse is irregular, and it varies consistently with respiration, what is it?

what can be noticed about the rate in the pulse?

Answer 16

sinus arrhythmia

rate increases during inspiration and decreases during expiration

Question 17

Regularly irregular pulse can be seen during what?

Irregularly irregular pulse can be seen during what?

Answer 17

2nd degree heart block

atrial fibrillation

Question 18

how do we grade a pulse amplitude?

Answer 18

0 -> absent or not palpable

+1 -> diminished or weak

+2 -> normal or brisk

+3 - bounding

Question 19

how do we calculate the pulse pressure?

what is the normal pulse pressure?

what 2 factors affect pulse pressure?

Answer 19

systolic BP - diastolic BP

30-40 mmHg

1) Stroke volume 2) compliance of arterial tree

Question 20

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?

Answer 20

wide

thyrotoxicosis, AV fistula, PDA, Aoric incompetence

narrow

pericarditis, pericardial effusion, pericardial tamponade, aortic stenosis, very high tachycardia

Question 21

what may cause a bounding pulse?

what may cause a weak pulse?

Answer 21

increased Stroke volume, fever, anemia, hyperthyroid, AR, A-V fistula, PDA

hypovolemia, severe AS, CHF, hypothermia, increased peripheral resistance

Question 22

what are the ways to describe the character of the pulse? describe each.

Answer 22

• 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

Question 23

what may cause:

Pulsus Alternans:

Bisferiens pulse:

Bigeminal pulse:

Pulsus paradoxicus:

Water hammer (collapsing) pulse:

Answer 23

• 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

Question 24

what is the normal respiratory rate?

Answer 24

12-20 breaths per min