VITAL SIGNS Flashcards
what are the vital signs?
Blood pressure, heart rate, respiratory rate, and temperature
what are the blood pressure devices?
mercury, aneroid, electronic
how do we select the right blood pressure cuff?
-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
affect if the brachial artery is 7 to 8 cm below heart level?
the blood pressure will read 6 cm higher
if the brachial artery is 6 to 7 cm higher, how will the blood pressure read?
the blood pressure will read 5 cm lower
where should the cuff be on the arm and how should the arm be, flexed or relaxed?
2.5 cm above the antecubital crease with the arm slightly flexed
what is the affect of a loose cuff?
falsely high readings
what is the ausculatory gap?
a silent interval that may be present between systolic and diastolic pressures
what is the affect of an unrecognized auscultary gap?
may lead to serious underestimation of systolic pressure or underestimation of diastolic pressure
should ausculatory gap be recorded?
findings must be recorded completely
what is an ausculatory gap is associated with what?
arterial stiffness and atherosclerotic disease
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?
aortic regurgitation
record both figures
by making the sounds less audible, this may produce artificially low systolic and high diastolic pressure?
venous congestion
what happens when the pressure difference is more than 10-15 mmHg?
subclavian steal syndrome, aortic dissection
Systolic less than 120mmHg—Diatolic less than 80mmHg
normal
Systolic 120-139mmHg—Diastolic 80-89
Prehypertension
Systolic 140-159mmHg—Diastolic 90-99
Hypertension Stage 1
Systolic greater than/equal to 160—Diastolic greater than/equal
to 100mmHg
Hypertension Stage 2
BP target for patients with diabetes and chronic kidney disease is
less than 130/80mmHg
Adoption of healthy lifestyles by all people is now considered
indespensible
isolated systolic hypertension
systolic BP is greater than/equal to 140mmHg, and diastolic
BP is less than 90mmHg
T/F, Treatment of isolated systolic hypertension in patients 60 years or older reduces total
mortality and both mortality and complications from cardiovascular disease
T
this heart condition arises from the narrowing of the thoracic aorta, usually proximal but
sometimes distal to the left subclavian artery
coarctation of the aorta
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
coarctation of the aorta and occlusive aortic disease
how do you take a orthostatic hypotension? what is the affect on the BP?
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
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?
orthostatic hypotension
Causes include drugs, moderate or
severe blood loss, prolonged bed rest, and diseases of the autonomic nervous system
Average oral temperature? in the morning? late afternoon/evening?
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
Rectal temperatures are higher than oral temperatures by how much?
0.4-0.5°C or 0.7-0.9°F
Axillary temperatures are lower than oral temperatures by how much?
1°, but take 5 to 10 minutes to
register and are less accurate
when are oral temperatures not recommended?
when patients are unconscious, restless, or unable to close their mouths
refers to an elevated body temperature
Fever or pyrexia
refers to extreme elevation in temperature, above 41.1°C or 106°F
Hyperpyrexia
refers to an abnormally
low temperature below 35°C or 95°F rectally
Hypothermia
what increases the discrepancy between oral and rectal temperatures? which temps are more reliable
rapid respiratory rates
rectal temps
what temp should we insert an oral temperature?
shake the thermometer down to 35°C (96°F) or below
what causes fever?
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
chief case of hypothermia? other predisposing causes?
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
Palpation of an irregularly irregular rhythm reliably indicates?
atrial fibrillation
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
white coat hypertension
Home or ambulatory hypertension, unlike ‘white coat’ or isolated office hypertension, signals
increased risk
cardiovascular disease
what is the affect of using a small cuff on obese patients?
it overestimates systolic blood pressure
what are the causes of sustained hypertension in newborns?
renal artery disease (stenosis, thrombosis), congenital renal malformations, and coarctation of the aorta
A pulse rate that is too rapid to count (greater than 180-200/min) usually indicates?
paroxysmal supraventricular tachycardia
what does bradycardia result from?
drug ingestion, hypoxia, intracranial or neurologic conditions, or , rarely, cardiac arrhythmia such as heart block
what are the respiratory rates like for newborns with cyanotic cardiac disease, right to left shunting, and metabolic acidosis?
extremely rapid and shallow respiratory rates
this can raise respiratory rates in infants by up to 10 respirations per minute for each degree centigrade of fever?
fever
Tachypnea and increased respiratory effort in an infant are signs of possible
pneumonia
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.
anxiety
excessive bundling
temperature instability
T/F, HT is common in children?
T
what is the most frequent cause of elevated BP in children?
an improperly performed
examination, often due to an incorrect cuff size
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?
coarctation of the aorta
Transient HT in children can caused by medications to treat these diseases?
asthma and ADHD
what are the causes of sustained hypertension?
renal parenchymal or artery disease, coarctation of the aorta and primary HT
what is sinus Brady in children younger than 3 years and children 3 to 9?
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
what intervals should a Childs heart be measured?
90 to 60 second interval
average heart rate 1-2 years
110 bpm
average heart rate 2-6 years
103 bpm
average heart rate 6-10 years
95 bpm
early childhood respiratory rate
20-40
late childhood respiratory rate
15-25
what are the respirators like for children with bronchiolitis and pneumonia?
rapid respirations
what is the best single finding for ruling out pneumonia?
absence of tachypnea
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?
sepsis, UTI, pneumonia
in adolescent girls these are major public health problems, requiring frequent assessment of weight
obesity and eating disorders
The average HR for adolescents 10-14years is
85 beats/minute, with a range of 55 to 115 beats per minute considered normal.
Average HR for those 15 years and older is? -Causes of sustained HT for this age group include?
60-100 beats/minute
primary hypertension, renal parenchymal disease, and drug use
the most common dysrhythmia in children
Supraventricular Tachycardia
