VITAL SIGNS

Question 1

what are the vital signs?

Answer 1

Blood pressure, heart rate, respiratory rate, and temperature

Question 2

what are the blood pressure devices?

Answer 2

mercury, aneroid, electronic

Question 3

how do we select the right blood pressure cuff?

Answer 3

-Width of the inflatable bladder of the cuff should be about 40% of upper arm circumference
-Length of the inflatable bladder should be about 80% of upper arm circumference
-Standard cuff is 12X23cm for arm circumferences up to 28cm
-If the cuff is too small, the blood pressure will read high; if the cuff is too large, the blood
pressure will read low on a small arm and high on a large arm

Question 4

affect if the brachial artery is 7 to 8 cm below heart level?

Answer 4

the blood pressure will read 6 cm higher

Question 5

if the brachial artery is 6 to 7 cm higher, how will the blood pressure read?

Answer 5

the blood pressure will read 5 cm lower

Question 6

where should the cuff be on the arm and how should the arm be, flexed or relaxed?

Answer 6

2.5 cm above the antecubital crease with the arm slightly flexed

Question 7

what is the affect of a loose cuff?

Answer 7

falsely high readings

Question 8

what is the ausculatory gap?

Answer 8

a silent interval that may be present between systolic and diastolic pressures

Question 9

what is the affect of an unrecognized auscultary gap?

Answer 9

may lead to serious underestimation of systolic pressure or underestimation of diastolic pressure

Question 10

should ausculatory gap be recorded?

Answer 10

findings must be recorded completely

Question 11

what is an ausculatory gap is associated with what?

Answer 11

arterial stiffness and atherosclerotic disease

Question 12

in some people, the muffling point and the disappearance point are farther apart. This is an instance in the sounds never disappear? what happens when the different is greater than or equal to 10 mmHg?

Answer 12

aortic regurgitation

record both figures

Question 13

by making the sounds less audible, this may produce artificially low systolic and high diastolic pressure?

Answer 13

venous congestion

Question 14

what happens when the pressure difference is more than 10-15 mmHg?

Answer 14

subclavian steal syndrome, aortic dissection

Question 15

Systolic less than 120mmHg—Diatolic less than 80mmHg

Answer 15

normal

Question 16

Systolic 120-139mmHg—Diastolic 80-89

Answer 16

Prehypertension

Question 17

Systolic 140-159mmHg—Diastolic 90-99

Answer 17

Hypertension Stage 1

Question 18

Systolic greater than/equal to 160—Diastolic greater than/equal
to 100mmHg

Answer 18

Hypertension Stage 2​

Question 19

BP target for patients with diabetes and chronic kidney disease is

Answer 19

less than 130/80mmHg

Question 20

Adoption of healthy lifestyles by all people is now considered

Answer 20

indespensible

Question 21

isolated systolic hypertension

Answer 21

systolic BP is greater than/equal to 140mmHg, and diastolic

BP is less than 90mmHg

Question 22

T/F, Treatment of isolated systolic hypertension in patients 60 years or older reduces total
mortality and both mortality and complications from cardiovascular disease

Answer 22

T

Question 23

this heart condition arises from the narrowing of the thoracic aorta, usually proximal but
sometimes distal to the left subclavian artery

Answer 23

coarctation of the aorta

Question 24

these heart disease are distinguished by hypertension in the upper extremities and low blood pressure in the legs and by diminished or delayed femoral pulses

Answer 24

coarctation of the aorta and occlusive aortic disease

Question 25

how do you take a orthostatic hypotension? what is the affect on the BP?

Answer 25

Measure BP supine after the patient is resting up to 10 minutes, then within 3 minutes after the patient stands up Normally as the patient rises form horizontal to standing position, systolic pressure drops slightly or remains unchanged, while diastolic pressure rises slightly

Question 26

a drop in systolic BP of more than/equal to 20mmHg or in diastolic BP of more than/equal to 10mmHg within 3 minutes of standing is called? what can cause this?

Answer 26

orthostatic hypotension Causes include drugs, moderate or severe blood loss, prolonged bed rest, and diseases of the autonomic nervous system

Question 27

Average oral temperature? in the morning? late afternoon/evening?

Answer 27

37°C or 98.6°F In the morning it falls as low as 35.8°C or 96.4°F Late afternoon/evening it may rise as high as 37.3°C or 99.1°F

Question 28

Rectal temperatures are higher than oral temperatures by how much?

Answer 28

0.4-0.5°C or 0.7-0.9°F

Question 29

Axillary temperatures are lower than oral temperatures by how much?

Answer 29

1°, but take 5 to 10 minutes to | register and are less accurate

Question 30

when are oral temperatures not recommended?

Answer 30

when patients are unconscious, restless, or unable to close their mouths

Question 31

refers to an elevated body temperature

Answer 31

Fever or pyrexia

Question 32

refers to extreme elevation in temperature, above 41.1°C or 106°F

Answer 32

Hyperpyrexia

Question 33

refers to an abnormally | low temperature below 35°C or 95°F rectally

Answer 33

Hypothermia

Question 34

what increases the discrepancy between oral and rectal temperatures? which temps are more reliable

Answer 34

rapid respiratory rates rectal temps

Question 35

what temp should we insert an oral temperature?

Answer 35

shake the thermometer down to 35°C (96°F) or below

Question 36

what causes fever?

Answer 36

include infection, trauma such as surgery or crush injuries, malignancy, blood disorders such as acute hemolytic anemia, drug reactions, and immune disorders such as collagen vascular disease

Question 37

chief case of hypothermia? other predisposing causes?

Answer 37

exposure to cold reduced movement as in paralysis, interference with vasoconstriction as from sepsis or excess alcohol, starvation, hypothyroidism and hypoglycemia. Elderly people are especially susceptible to hypothermia and also less likely to develop fever

Question 38

Palpation of an irregularly irregular rhythm reliably indicates?

Answer 38

atrial fibrillation

Question 39

this describes hypertension in people whose BP measurements are higher in the office than at home or in more relaxed settings usually greater than 140/90 -Occurs in 10-25% of patients especially women and anxious individuals, and may last for several visit

Answer 39

white coat hypertension

Question 40

Home or ambulatory hypertension, unlike ‘white coat’ or isolated office hypertension, signals increased risk

Answer 40

cardiovascular disease

Question 41

what is the affect of using a small cuff on obese patients?

Answer 41

it overestimates systolic blood pressure

Question 42

what are the causes of sustained hypertension in newborns?

Answer 42

renal artery disease (stenosis, thrombosis), congenital renal malformations, and coarctation of the aorta

Question 43

A pulse rate that is too rapid to count (greater than 180-200/min) usually indicates?

Answer 43

paroxysmal supraventricular tachycardia

Question 44

what does bradycardia result from?

Answer 44

drug ingestion, hypoxia, intracranial or neurologic conditions, or , rarely, cardiac arrhythmia such as heart block

Question 45

what are the respiratory rates like for newborns with cyanotic cardiac disease, right to left shunting, and metabolic acidosis?

Answer 45

extremely rapid and shallow respiratory rates

Question 46

this can raise respiratory rates in infants by up to 10 respirations per minute for each degree centigrade of fever?

Answer 46

fever

Question 47

Tachypnea and increased respiratory effort in an infant are signs of possible

Answer 47

pneumonia

Question 48

may elevate the body temp of children? may elevate the skin temperature but not the core temperature? may result from sepsis, metabolic abnormality, or other serious conditions? Older infants rarely manifest temperature instability.

Answer 48

anxiety excessive bundling temperature instability

Question 49

T/F, HT is common in children?

Answer 49

T

Question 50

what is the most frequent cause of elevated BP in children?

Answer 50

an improperly performed | examination, often due to an incorrect cuff size

Question 51

In children, as in adults, BP readings from the thigh are approximately 10mmHg higher than those from the upper arm. If they are the same or lower, what should be suspected?

Answer 51

coarctation of the aorta

Question 52

Transient HT in children can caused by medications to treat these diseases?

Answer 52

asthma and ADHD

Question 53

what are the causes of sustained hypertension?

Answer 53

renal parenchymal or artery disease, coarctation of the aorta and primary HT

Question 54

what is sinus Brady in children younger than 3 years and children 3 to 9?

Answer 54

less than 100 beats per minute in children younger than 3 years, and less than 60 beats per minute in children 3 to 9 years

Question 55

what intervals should a Childs heart be measured?

Answer 55

90 to 60 second interval

Question 56

average heart rate 1-2 years

Answer 56

110 bpm

Question 57

average heart rate 2-6 years

Answer 57

103 bpm

Question 58

average heart rate 6-10 years

Answer 58

95 bpm

Question 59

early childhood respiratory rate

Answer 59

20-40

Question 60

late childhood respiratory rate

Answer 60

15-25

Question 61

what are the respirators like for children with bronchiolitis and pneumonia?

Answer 61

rapid respirations

Question 62

what is the best single finding for ruling out pneumonia?

Answer 62

absence of tachypnea

Question 63

Young children with infections can have extremely high fevers (up to 104°F or 40°C). Children younger than 3 years, who appear very ill with a fever, should be evaluated for possible?

Answer 63

sepsis, UTI, pneumonia

Question 64

in adolescent girls these are major public health problems, requiring frequent assessment of weight

Answer 64

obesity and eating disorders

Question 65

The average HR for adolescents 10-14years is

Answer 65

85 beats/minute, with a range of 55 to 115 beats per minute considered normal.

Question 66

Average HR for those 15 years and older is? -Causes of sustained HT for this age group include?

Answer 66

60-100 beats/minute primary hypertension, renal parenchymal disease, and drug use

Question 67

the most common dysrhythmia in children

Answer 67

Supraventricular Tachycardia​