Vital Signs/Cardinal Signs

Question 1

What are the 5 vital signs?

Answer 1

Temperature
Pulse
Respirations
Blood Pressure
Pain

Question 2

balance between heat produced by the body and heat loss from the body

Answer 2

Body Temperature

Question 3

Types of body temperature

Answer 3

Surface and core temperature

Question 4

Temperature of the deep tissues of the body such as abdominal and pelvic cavity.

Answer 4

Core temperature

Question 5

Temperature of skin, SQ tissue and fat. Rises and falls in response to the environment.

Answer 5

Surface temperature

Question 6

4 processes involved in heat loss

Answer 6

• Radiation - transfer of heat from surface to surface of one object to surface of another w/o contact
• Conduction - transfer of heat from one surface to another through direct contact
• Convection - dispersion of heat by air currents
• Evaporation - vaporization of moisture from the respiratory tract, mucosa of the mouth and skin

Question 7

Body temperature is above the usual range

Answer 7

Pyrexia/Hyperthermia/Fever

Question 8

Very high fever, 41°C (105.8°F) and above

Answer 8

Hyperpyrexia

Question 9

Core body temperature is below the lower limit of normal

Answer 9

Hypothermia

Question 10

What are the 5 types of fever?

Answer 10

Intermittent - alternates at regular intervals

Remittent - wide range of temp fluctuations more than 2°C for over 24 hrs

Relapsing - short febrile periods

Constant - fluctuates minimally but always remains above normal.

Fever spike (Staircase) - temperature rises to fever level rapidly following a normal temperature then
returns to normal within a few hours

Question 11

What are the four ways of assessing body temperature?

Answer 11

Oral
Rectal
Axillary
Tympanic Membrane

Question 12

Considered to be the most convenient and most accessible way of assessing body temperature

Answer 12

Oral

Question 13

Considered to be a very accurate way of assessing body temperature

Answer 13

Rectal

Question 14

Safest and non-invasive way of assessing body temperature

Answer 14

Axillary

Question 15

Frequent site for estimating core body temperature

Answer 15

Tympanic Membrane

Question 16

When will you start Tepid Sponge Bath (TSB)?

Answer 16

If there is 1°C to 2°C increase in body temperature

Question 17

Wave of blood created by contraction of the left ventricle of the heart

Answer 17

Pulse

Question 18

What are the 8 pulse sites?

Answer 18

• Temporal
• Carotid
• Radial
• Apical
• Brachial
• Femoral
• Popliteal
• Posterior tibia and Dorsal Pedal

Question 19

excessively fast heart rate (over 100 beats/min)

Answer 19

Tachycardia

Question 20

heart rate in adult that is less than 60 beats/min

Answer 20

Bradycardia

Question 21

The pattern of the beats and the intervals between beats.

Answer 21

Rhythm

Question 22

Irregular rhythm is referred to as

Answer 22

dysrhythmia or arrhythmia

Question 23

The three processes in the act of breathing

Answer 23

Ventilation, Diffusion, and Perfusion

Question 24

movement of air in and out of the lungs

Answer 24

ventilation

Question 25

exchange of gases from higher pressure to an area of lower pressure. It occurs at the alveolocapillary membrane

Answer 25

diffusion

Question 26

availability and movement of the blood for transport of gases, nutrients and metabolic waste products

Answer 26

Perfusion

Question 27

Two types of breathing

Answer 27

Costal (thoracic) and Diaphragmatic (abdominal)

Question 28

primary respiratory center. CO2 is the primary chemical stimuli for breathing

Answer 28

Medulla oblongata

Question 29

contains pneumotaxic center that is responsible for rhythmic quality of breathing, and apneustic center that is responsible for deep prolonged inspiration

Answer 29

Pons

Question 30

peripheral chemoreceptors that are sensitive to 02 and CO2 level in the blood

Answer 30

Carotid and Aortic Bodies

Question 31

cessation of breathing

Answer 31

Apnea

Question 32

quick, shallow breaths (>20cpm)

Answer 32

Tachypnea

Question 33

abnormally slow breathing (<12cpm)

Answer 33

Bradypnea

Question 34

very deep to very shallow breathing followed by temporary apnea

Answer 34

Cheyne-Stokes

Question 35

rapid, deep and labored breathing

Answer 35

Kussmaul's

Question 36

difficult and labored breathing

Answer 36

Dyspnea

Question 37

ability to breathe only in upright sitting or standing position

Answer 37

Orthopnea

Question 38

shrill, harsh sound heard during inspiration

Answer 38

Stridor

Question 39

snoring or sonorous respiration

Answer 39

Stertor

Question 40

high-pitched musical squeak or whistling sound occurring on expiration

Answer 40

Wheeze

Question 41

gurgling sounds heard as air passes through moist secretions in the respiratory tract

Answer 41

Bubbling

Question 42

Shallow breaths interrupted by apnea

Answer 42

Biot's (cluster) respirations

Question 43

Pressure exerted by blood as it flows through the arteries

Answer 43

Blood pressure (BP)

Question 44

blood pressure that falls when the client sits or stands

Answer 44

Orthostatic Hypotension

Question 45

What are the 5 Korotkoff’s Sound phases?

Answer 45

Phase 1: first faint, clear tapping or thumping sounds are heard Phase 2: heard sounds have a muffled, whooshing or swishing sound quality Phase 3: sounds become crisper and more intense, softer thumping sound Phase 4: sound become muffled and have a soft, blowing quality Phase 5: period of silence

Question 46

an unpleasant sensory and emotional experience associated with actual and potential tissue damage.

Answer 46

Pain

Question 47

What are the characteristics of Pain?

Answer 47

PQRST ``` Provoking factors Quality Radiation Severity/Intensity Time ```

Question 48

What are the 3 ways to assess pain?

Answer 48

Descriptive Pain Intensity Scale Numeric Pain Scale Visual Analogue Scales