Vital Signs Flashcards by Marissa Kline

4 classic vital signs

Temperature
Pulse
Respiration
BP

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Vital statistics

Height

Weight

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Temp is an effective ____ assessment

Infection

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Pulse is an effective ___ assessment

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Respiration is an effective ____ assessment

Respiratory and metabolism

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BP is an effective ____ assessment

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Expected body temp range and average

97.2-99.9

Avg = 98.6

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When is temp lowest

Early morning

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Temp varies by 1 degree or more throughout

Menses (peaks at ovulation)

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Oral temp above ____ or rectal/ear temp above ___ is considered a fever

100.4

101

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Recent ingestion of _____ can alter temp and is AKA ____

Hot or cold substances; factitious fever

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MC cause of fever

Infection

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Remittent fever

Daily elevated temp

Returns to baseline but NOT to normal

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Intermittent (periodic) fever

Intermittently elevated temp

Returns to baseline and normal

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Examples of intermittent fever

Relapsing fever
Malaria
Rat bite fever
Hodgkin’s disease
Cyclic neutropenia

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Factitious fever

Self-induced fever

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Relapsing fever

Multiple febrile attacks lasting about 6 days

TB or malaria

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Charcot’s intermittent fever is accompanied by

Chills, RUQ pain, jaundice

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Hectic fever

Daily afternoon spike

Usually w/ facial flushing

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Continued/sustained fever

Fever for a long duration without remissions

Gram - sepsis
CNS damage

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Ephemeral fever

Febrile period lasting 1-2 days

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Essential fever (FUO)

100.4 for 3 weeks or longer

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Hyperpyrexia

Temp greater than 105

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Hyperpyrexia usually caused by CNS disorder that are caused by

Heat stroke
CVA
Brain injury after cardiac arrest

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_______ 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 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

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

“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

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