Vital Signs Flashcards
Guidelines for HTN
Normal <120 and <80
Prehypertension 120-139 or 80-89
Hypertension Stage 1: 140-150 or 90-99
Hypertension Stage 2: >160 or >100
Older than 60- <150/90
Orthostatics
Series of BP taken with patient supine, sitting, and standing
Orthostatic hypotension
- drop of SBP > 20 mm Hg after standing OR
- drop in DBP > 10 mm Hg within 3 min of standing
Useful in assessing possible syncope in near adults
Cause-drugs, blood loss, prolonged bed rest, ANS disease
Normal- systolic BP drops slightly or stays the same. Diastolic BP rises.
Pulse normal
Rhythm: regular/irregular
Normal: 50-90 bpm
Respiratory Rate
Rate, rhythm, depth, effort of breathing, documenting units and details
Infants- up to 44 breaths/min
11-16 y/o- 16-24
Adult- 12-20
Elderly- 12-24
Average oral Temp
37 deg C or 98.6 deg F Fluctuates throughout day. Document units and details Pyrexia = fever > 98.6 F Hyperpyrexia > 106 F Hypothermia < 95 F
Rectal 0.5 C (1 F) > than oral temp
Axillary 0.5 C (1 F) < oral temp
Tympanic 0.8 (1.4 F) > oral temp
Types of Pain
TQ!!!!
Location, severity, associated features, pain scale 0-10 or visual scale
Types of pain:
- Nociceptive (somatic) - acute/chronic
- Neuropathic pain- somatosensory. Burning, etc. Occur after initial injury
- Central sensitization- amplification of pain signals
- Psychogenic and idiopathic pain- factors that influence pain. Psychiatric conditions like anxiety, etc
Body mass index
BMI measure of body fat based on height and weight
Limitations: overestimate fat in people with muscular build or underestimate body fat in people who lost muscle
Weight lbs x 700 / (Ht x Ht in) or//
At kg/Ht m^2
Normal: 18.5 - 24.9 Underweight < 18.5 Overweight 25-29.9 ***** TQ! Obesity I > 30 Obesity II 35-39.9 Severe Obesity >=40
If BMI is 35 or higher
Measure the patient’s waist circumference. With the patient standing, measure the waist above the hip bones. The patient may have excessive body fat if the waist measures:
- Greater than or equal to 35 inches for women
- Greater than or equal to 40 inches for men
Brachial artery location
Medial to biceps tendon
How to take BP reading
Patient avoid caffeine 30 min prior. Sit with arm at heart level and free of clothing.
Should be no entry for dialysis, scarring, or lymphedema
Korotkoff sounds
** TQ!!
When blood pressure cuff reduces pressure, the external pressure becomes less than the systolic and allows blood to rush into artery making Korotkoff sounds
Auscultatory gap
Silent interval present between systolic and diastolic pressures. Associated with arterial stiffness and atherosclerotic disease. Unrecognized gap can cause inaccurate reading
False BP readings
** TQ!
Cuff too small, BP will be too high **
Cuff too big, BP will be too low **
Venous congestion gives low systolic and high diastolic
Brachial artery below heart will give high BP
Brachial artery above heart will give low BP
Vitals
BP, Temperature, Pulse, Respiration’
Auscultory pressure
Inflate cuff to palpation BP + 30
Deflate cuff at rate of 2-3 mm Hg per second
Note level at which hear 2 consecutive heart beats
Continue lowering pressure until sounds become muffled and disappear at diastolic pressure
Listen for another drop of about 10-20 mm Hg to confirm
Rapidly deflate cuff
Wait 2 or more minutes, take another reading, and average the readings. If reading differ by > 5 mm Hg, take additional readings.
