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Physical Diagnosis Block 1 > Vital Signs and the Assessment of Pain > Flashcards

Vital Signs and the Assessment of Pain Flashcards

1
Q

Vital Signs

A

Temperature, Pulse, BP, Respiratory Rate, Height (m^2)/weight(kg) = BMI, Pain objective)

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2
Q

Temperature

A

Balance of heat production an heat loss, controlled by hypothalamus
97.3-99.5 F (oral, adult)

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3
Q

Factors Affecting Body Temp

A

metabolic (sleep, digestion, exercise)
Infectious process (fever)
Environment (hypo- hyperthermia)
Exogenous substances (cold/hot beverage, drugs)

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4
Q

5 methods of temperature measurement

A

Oral - 98.6
Rectal - 99.6 (most accurate)
Axillary - 97.6
Tympanic - 99.6

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5
Q

What constitutes a fever?

A

Adults: oral > 98.9 @6 am or >99.9 @ 4pm

Child: rectal > 100.4

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6
Q

Respiratory Rate

A

one breathing cycling, inspiration and exhalation. measured by viewing chest rise. normal is 12-20 in adults

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7
Q

Primary Muscles of Respiration

A

Diaphragm (contracts down) and intercostals

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8
Q

4 parameters to asses in respiration

A

rate, pattern, depth, signs of distress

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9
Q

6 patterns of respiration

A

apnea, tachypnea, bradypnea, dspnea, hypopnea, hyperpnea

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10
Q

Cheyne Stokes respirations

A

periodic breathing, increased and decreased rate and depth, periods of apnea

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11
Q

Kussmaul respirations

A

deep and labored. type of hyperpnea. metabolic acidosis (ex DKA)

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12
Q

Signs of Resp. Distress

A

tachypnea, bradypnea, accessory muscle use, nasal flaring, cyanosis, difficulty speaking, audible breathing, coughing, diaphoresis

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13
Q

Signs of REsp. Distress in Infants

A

flared nostrils, anxious face, cyanosis, intercostal retractions

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14
Q

Pulse

A

Movement of blood in arteries.

Typical adult 50-90 bpm

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15
Q

Characteristics of Pulse

A

Rate (bpm)
Rhythm (regular or irregular)
Regularity (regular or irregular)
Amplitude (strong, bounding, weak,0-4+)

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16
Q

Factors Affecting Pulse

A

Heart health, exercise level, neurologic status, emotions, drugs

17
Q

Documenting Heart Rate

A

0-4+
Tachy is > 100 bpm
Brady is

18
Q

Normal BP

A

Adult SBP

19
Q

3 Factors that Affect BP

A

Stroke volume - amount of blood pumped by LV in 1 conraction
HR - bpm
Peripheral Vascular Resistance

20
Q

Cardiac Output

A

stroke volume x heart rate

21
Q

Korotkoff Sounds

A

low pitched sounds produced by turbulence of blood flow in the artery

22
Q

Auscultatory Gap

A

gap of 10-15 mmHg where korotkoff sounds can be heard, disappear, and reappear

23
Q

Pulse Pressure

A

systolic bp - diastolic bp. normal range is 30-50 mmHg

24
Q

Ideal conditions for measuring BP

A

no nicotine or caffeine
Rest
warm
no constricting clothing

25
Q

BP measurement step by step

A

1) place bell @ AC fossa, arm at heart level
2) center bladder over bracheal artery
3) inflate cuff 30mmHg above palpable radial pulse
4) deflate cuff
5) wait 30 sec, repeat steps 2-3
6) deflate slowly

26
Q

Factors affecting BP

A 
hyper or hypo tension
white coat syndrome
vascular resistance from atherosclerosis
pain
fever
weight
sedentary lifestyle
use of caffeine alcohol or drugs
27
Q

Medical Conditions that Affect BP readings

A

cardiac dysrhythmias
aortic regurgitation
venous congestion
valve replacement

28
Q

Orthostatic BP

A 
change in BP and pulse when pt. moves from supine to upright
early detection of volume depletion
1) supine for 5 min, determine BP and HR
2) stand up
3) wait 1 minute, then take BP and HR
  • drop in SBP > 10 mmHg or increase in HR > 20 bpm suggests volume depletion
29
Q

Height and Weight

A

under reported, self reporting is not adequate.

body habitus is closely linked to many chronic diseases

30
Q

BMI

A

weight (kg) / ht (m^2)

31
Q

Acute Pain

A

short duration, sudden onset, injury, surgery, acute illness

32
Q

Persistent / Chronic Pain

A

several months or longer. sustained by pathophysiologic process

33
Q

Neuropathic Pain

A

long term associated with damage or dysfunction of CNS or PNS

34
Q

How to document pain

A

value from 0-10
specify location
quality, character, severity, frequency, duration, OPQRST

Physical Diagnosis Block 1 (4 decks)

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