Vital Signs Flashcards
4 classic vital signs
Temperature
Pulse
Respiration
BP
Vital statistics
Height
Weight
Temp is an effective ____ assessment
Infection
Pulse is an effective ___ assessment
CV
Respiration is an effective ____ assessment
Respiratory and metabolism
BP is an effective ____ assessment
CV
Expected body temp range and average
97.2-99.9
Avg = 98.6
When is temp lowest
Early morning
Temp varies by 1 degree or more throughout
Menses (peaks at ovulation)
Oral temp above ____ or rectal/ear temp above ___ is considered a fever
100.4
101
Recent ingestion of _____ can alter temp and is AKA ____
Hot or cold substances; factitious fever
MC cause of fever
Infection
Remittent fever
Daily elevated temp
Returns to baseline but NOT to normal
Intermittent (periodic) fever
Intermittently elevated temp
Returns to baseline and normal
Examples of intermittent fever
Relapsing fever Malaria Rat bite fever Hodgkin’s disease Cyclic neutropenia
Factitious fever
Self-induced fever
Relapsing fever
Multiple febrile attacks lasting about 6 days
TB or malaria
Charcot’s intermittent fever is accompanied by
Chills, RUQ pain, jaundice
Hectic fever
Daily afternoon spike
Usually w/ facial flushing
Continued/sustained fever
Fever for a long duration without remissions
Gram - sepsis
CNS damage
Ephemeral fever
Febrile period lasting 1-2 days
Essential fever (FUO)
100.4 for 3 weeks or longer
Hyperpyrexia
Temp greater than 105
Hyperpyrexia usually caused by CNS disorder that are caused by
Heat stroke
CVA
Brain injury after cardiac arrest
_______ can lead to malignant hyperthermia
Infections of CNS
Encephalitis/meningitis
Hypothermia
Body temp below 98.6
Hypothermia can be caused by
Chronic renal failure
Antipyrectics and NSAIDS
Temp/pulse association
For every degree of inc temp, pulse inc 10 bpm
An increase in HR may not occur if fever is due to
Rxn to drugs
Typhoid fever
Legionellosis
Mysoplasmal pneumonia
____ pulses are most palpable
Arterial
Arteries are tough and have more ____ and ____
Distensibility; tensile strength
Arterial pulses are result of
Ventricular systole
SV x HR =
CO
CO is measure of
Heart’s ability to adapt to changing environment
Normal pulse is
60-100 bpm
Below 60 bpm =
Bradycardia
Above 100 bpm =
Tachycardia
Which accessible artery is closest to the heart
Carotid
Pulses in extremities evaluate
Sufficiency of entire arterial circulation
Proximal pulses are better for evaluating
Heart activity
Descriptors of pulse that we must identify
Rate
Rhythm
Amplitude
Contour
Pulse amplitude is described on a
Scale of 0-4
3 components we must identify for respiratory cycle
Rate
Rhythm
Depth
Normal adult respiration
12-20 breaths/min
Who gets tachypnea
MC in elderly w/ COPD
Bradypnea is MC seen in patients w/
Hypothyroidism
CNS lesions
Sedative/narcotic use
Patients w/ emphysema have
Reduced lung elasticity Alveolar hyperinflation
Emphysema patients utilize ____
Pursed-lip breathing
Pursed-lip breathing increases intra-airway pressure by
Inducing auto PEEP
Positive end-expiratory pressure
Hyperpnea is an inc in ____
Rate and tidal volume
Classic form of hypernea ____ seen in patients w/ ____
Kussmaul breathing; metabolic acidosis
Patients attempt to compensate for pH by
Hyperventilating
Mneumomic for Kussmaul (MAKE UP a List)
Methanol poisoning Aspirin intoxication Ketoacidosis Ethylene glycol ingestion Uremia Paraldehyde administration Lactic acidosis
Hypopnea is characterized by
Shallow respirations
Hypopnea is a hallmark of
Respiratory failure
Obesity-hypoventilation
Obesity-hypoventilation AKA
Pickwickian syndrome
Pickwickian syndrome
Obese patient w/ excessive daytime sleepiness and elevated blood CO2
Apnea when patient is awake
Absence of respiration for at least 20 seconds
Apnea when patient is asleep
Absence of respiration for at least 30 sec
Orthopnea
Upright respiration
Orthopnea is seen MC in patients w/
CHF
Gold standard or measuring BP
Rigid wall catheter
HTN affects as many as
1 in 5 NA adults
Phase 1 Korotkoff sounds
First appearance of sound
Systolic BP
Phase 2 Korotkoff
Phase 1 sounds soften, have swishing quality
Phase 4 Korotkoff sound
Sounds become soft and blowing
Mid-diastolic pressure
Phase 5 Korotkoff sound
All sounds disappear
Diastolic BP (end-diastolic)
3 benefits of palpatory BP
Avoids overinflation
Avoids underinflation
Helps detect auscultatory gap
Auscultatory gap occurs when
Sounds disappear btw systolic and diastolic pressures
Systole occurs when
Ventricles contract
Tricuspid and mitral valves close
Diastole occurs when
Ventricles relax
Tricuspid and mitral valves open
Diastolic pressure is measure of
Peripheral vascular resistance
Systolic pressure is a measure of
CO
“Classic” BP
120/80
Normal systolic range
100-140
Normal diastolic range
60-90
BP greater than _______ considered HTN
140 systolic
90 diastolic
Should you diagnose HTN based on one measurement
NO
When is BP lowest
Morning
______ is most prevalent risk factor in heart failure, stroke and kidney failure
Systolic HTN
Systolic HTN interacting w/ ____ amplifies risk of CV events
High cholesterol and diabetes
Hypotension
Under 90/60
Orthostatic systolic hypotension
Fall in systolic of 20 or more
Orthostatic diastolic hypotension
Fall in diastolic of 10 or more
Orthostatic diastolic hypertension
Rise in diastolic to 98 or higher
Orthostatic narrowing of pulse pressure
Pulse pressure lower than 18
Orthostatic postural tachycardia
Inc in HR of 28 bpm or to greater than 110 bpm
Pulse pressure is difference between
Systolic and diastolic pressures
Normal pulse pressure range
30-40
Best BP marker for CV risk
Widened pulse pressure
Difference btw arm pulses can indicate
Coarctation of aorta
Bilateral pulses should be taken in both
Upper and lower extremities
Allow variation of up to ____ in BP from R to L arm
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