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Physical Diagnosis I -- Dr. Littrell > Vital Signs Quiz - Lecture Notes > Flashcards

Vital Signs Quiz - Lecture Notes Flashcards

1
Q

What are the four classic vital SIGNS?

A
  1. Temperature
  2. Pulse
  3. Respiration
  4. BP
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2
Q

What type of assessments are these for the following?

  1. Temperature
  2. Pulse
  3. Respiration
  4. BP
A
  1. infection
  2. cardiovascular
  3. respiratory and metabolism
  4. cardiovascular
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3
Q

What are two vital STATISTICS?

A

height and weight

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4
Q

What is the “expected” body temperature based on an oral test?

A

97.2 to 99.9 degrees F

average 98.6

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5
Q

Does temperature vary throughout the day? When it is usually the lowest?

A

yes, lower in early morning

may rise as much as 1 degree by early evening

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6
Q

How much may temperature vary during menses and when does it peak?

A

varies by 1 degree F

peaking at ovulation

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7
Q

At what temperature will an oral temp be considered a fever? What about an rectal or ear (aural) temp?

A

oral temp above 100.4 degrees F

rectal or ear temp above 101 degrees F

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8
Q

Will people that are tachypneic usually have a higher or lower temperature?

A

lower temperature

tachypneic = fast breathers

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9
Q

What must we be aware of that may cause a Factitious fever?

A

recent ingestion of hot or cold substances

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10
Q

What is the most common cause of a fever? What are some other reasons?

A

infection

inflammatory conditions or autoimmune conditions; like lupus, RA, scleroderma

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11
Q

What type of fever is described as having a daily elevated temperature and it returns to baseline, but not to normal?

A

Remittent Fever

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12
Q

What type of fever is described as having intermittently elevated temperature that returns to baseline and to normal?

A

Intermittent Fever (Periodic Fever)

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13
Q

If someone has an Intermittent Fever, what are some possible conditions that may be causing this?

A
  • PFAPA Syndrome
  • Hodgkin’s Syndrome
  • Relapsing Fever
  • Malaria
  • Rat Bite Fever
  • Cyclic Neutropenia
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14
Q

What is a self-induced fever called?

A

Factitious fever

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15
Q

What type of fever consists of multiple febrile attacks lasting about 6 days, separated by afebrile periods?

A

Relapsing Fever

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16
Q

What type of fever is accompanied by chills, RUQ pain, and jaundice?

A

Charcot’s intermittent fever

due to stones obstructing common duct

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17
Q

What type of fever is characterized by a daily afternoon spike, often with facial flushing, and usually seen with TB?

A

Hectic Fever

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18
Q

What type of fever has some duration w/o remissions, usually seen with gram - sepsis or CNS damage?

A

Continued or Sustained Fever

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19
Q

What type of fever is it when the febrile period last no more than one or two days?

A

Ephemeral fever

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20
Q

What is a FUO (fever of unknown origin) that has a temp of 100.4 F for 3 weeks or longer without an identifiable cause?

A

Essential Fever

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21
Q

What is an Essential fever MC due to in adults? What is least commonly due to?

A

infection

caner, autoimmune diseases, drug reactions

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22
Q

What is a temp that is greater than 105 F caled?

A

Hyperpyrexia

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23
Q

What must a temp be above to be considered Hyperpyrexia?

A

105 F

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24
Q

What usually causes Hyperpyrexia?

A

CNS disorders of thermoregulating centers usually from heat stroke, CVA, brain injury after cardiac arrest

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25
Q

What is it called when a body temp is below 98.6 F?

A

Hypothermia

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26
Q

What can cause temperatures lower than normal?

A

chronic renal failure and patients receiving antipyretics (acetaminophen) and NSAIDs

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27
Q

Will someone in chronic renal failure have a higher or lower temp?

A

lower–> Hypothermia

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28
Q

Generally speaking, how much does the bpm change for every degree increase in temp?

A

increased by 10 bpm

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29
Q

What conditions may not follow the general rule of the bpm increasing by 10 when the temp increases by 1?

A

Typhoid fever, mycoplasmal pneumonia

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30
Q

What is systole?

A

when the right ventricle contracts to force blood into pulmonary artery

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31
Q

Where does stroke volume occur?

A

when left ventricle contracts, forcing volume of blood through aortic valve into aorta

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32
Q

What are the arterial pulses the result of?

A

ventricle systole (ejection of blood from LV into aorta)

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33
Q

What is the equation for Cardiac Output?

A

CO = SV x R(heart rate)

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34
Q

What is the CO a measure of?

A

the heart’s ability to adapt to a changing environment

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35
Q

What is considered normal pulse rate?

A

60-100 bpm

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36
Q

When is it considered Bradycardia? Tachycardia?

A

Bradycardia = below 60

Tachycardia = above 100

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37
Q

What artery is most accessible that is closet to the heart?

A

the carotid artery

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38
Q

Describe when the pulse is felt.

A

as a forceful wave that is smooth and rapid on the ASCENDING portion of the wave

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39
Q

What is felt of the pulse on the descending wave?

A

becomes domed, less steep, and slower

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40
Q

What are the pulses in the extremities evaluating?

A

the sufficiency of the entire ARTERIAL CIRCULATION

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41
Q

What are proximal pulses better for evaluating?

A

HEART ACTIVITY

42
Q

What are the four modifiers/descriptors/characteristics for a pulse?

A
  • Rate (bpm)
  • Rhythm (regular vs irregular)
  • Amplitude (0-4)
  • Contour (pliable, if not hardened by atherosclerosis)
43
Q

What is the scale that pulse amplitude is felt on?

A 
0-4
4 = bounding
3 = full, increased
2 = expected
1 = diminished, barely palpable
0 = absent, not palpable
44
Q

T/F. Pulse amplitude is compared to other vessels.

A

FALSE– it is described as expected for THAT VESSEL,— NOT compared to other vessels

45
Q

What is respiration the measure of?

A

a full respiratory cycle (from inhalation to exhalation)

46
Q

What are the three components we evaluate for Respiration?

A
  • Rate
  • Rhythm (regular or irregular)
  • Depth (shallow, moderate, deep)
47
Q

What is the normal adult respiration per minute?

A

12-20 breaths per minute

48
Q

What are the major abnormalities with respiration?

A 
increases = tachypnea
decreases = bradypnea
49
Q

What can get tachypnea and why is it a big deal?

A

MC in elderly with COPD

50
Q

What patients may we see Bradypnea in?

A

MC with hypothyroidism

CNS lesions, sedative or narcotic use

51
Q

What patients will we commonly observe Pursed-lip breathing?

A

COPD– usually emphysema

52
Q

Why may we see Pursed-lip breathing in someone with emphysema?

A

they have reduced lung elasticity and alveolar hyperinflation –> therefore higher risk for airway closure and air trapping

pursed-lip breathing will increase intra-airway pressure by inducing auto-PEEP (pos. end-expiratory pressure)–> preventing airway closure

53
Q

What other describing signs may we see with Pursed-lip breathing?

A

wheezing or grunting

54
Q

What is the increase in rate and the tidal volume of respiration called? Describe what type of respiration this produces.

A

Hyperpnea–> rapid and deep

55
Q

What is Kussmaul breathing a classic form of?

A

Hyperpnea (increase in rate and tidal volume)

56
Q

What type of breathing will we see patients with metabolic acidosis (diabetic acidosis)?

A

Kussmaul breathing

57
Q

What type of breathing is hyperventilation?

A

Hyperpnea – to compensate for pH

58
Q

What is the mnemonic for Kussmaul breathing that may cause it?

A 
MAKE UP a List:
M = methanol poisoning
A = aspirin intoxication
K = ketoacidosis
E = ethylene glycol ingestion
U = uremia
P = paraldhyde administration
L = lactic acidosis
59
Q

What type of breathing is characterized by shallow respirations?

A

hypopnea

60
Q

What is a hallmark of impending respiratory failure or of obesity?

A

hypo-ventilation – aka Pickwickian Syndrome

61
Q

What type of breathing is Pickwickian Syndrome?

A

Hypopnea (shallow respirations)

62
Q

What type of breathing will a patient with excessive daytime sleepiness and elevated CO2 have?

A

Pickwickian Syndrome

63
Q

What is the absence of respiration for at least 20 seconds while the patient is awake or 30 seconds while the patient is asleep?

A

Apnea

64
Q

What means upright respiration?

A

Orthopnea

65
Q

What individuals is Orthopnea MC seen in?

A

patients with CHF

66
Q

What is an earlier sign for a patient that may be leading into CHF?

A

when sitting upright pools blood in dependent areas, thereby decreasing venous return (swollen legs)

67
Q

How many North American Adults are affected by Hypertension?

A

1 in 5

68
Q

Describe Phase 1 of the Korotkoff sounds.

A

the first appearance of faint, repetitive, clear tapping sounds that gradually increase in intensity for at least two consecutive beats in the SYSTOLIC BP

69
Q

Describe Phase 2 of the Korotkoff sounds.

A

brief period may following during which sounds SOFTEN and acquire a swishing quality

70
Q

What is it called when in SOME patients sounds may disappear altogether for a short time?

A

Auscultatory gap

71
Q

When does the auscultatory gap occur?

A

when the sounds disappears b/w systolic and diastolic pressures

72
Q

What is the importance of the ausculatatory gap?

A

unles the systolic pressure is palpated first, it may be underestimated

73
Q

Describe Phase 3 of the Korotkoff sounds.

A

the return of sharper sounds, become crisper to regain

74
Q

Describe Phase 4 of the Korotkoff sounds.

A

distinct, muffling sounds which become soft and blowing in quality

= mid-diastolic pressure

75
Q

Describe Phase 5 of the Korotkoff sounds.

A

point at which all sounds finally disappear completely

= diastolic BP (end-diastolic pressure)

76
Q

Which phase is the mid-diastolic pressure in?

A

phase 4

77
Q

What phase is the systolic BP in?

A

Phase 1

78
Q

What phase is the diastolic BP (end-diastolic pressure) in?

A

phase 5

79
Q

When does systole occur? (heart chambers involved, valves?)

A

ventricles contract and tricuspid and mitral (AV) valves close

80
Q

What is the measure of CO and how hard the heart is working to eject the blood (SV)?

A

systole

81
Q

When does diastole occur? (heart chambers involved, valves?)

A

ventricles relax and tircuspid and mitral valves open

82
Q

What is the measure of the peripheral vascular resistance?

A

diastolic pressure

resting resistance

83
Q

What is the “Classic” range of BP?

A

120/80

84
Q

What do we consider normal systolic range to be? What about normal diastolic range?

A

systolic = 100-140 mmHg

diastolic = 60-90 mmHg

85
Q

What what BP measurement is considered hypertension?

A

greater than 140 systolic AND/OR greater than 90 diastolic

86
Q

T/F. Hypertension can be Dx on one measurement of BP.

A

FALSE– you should NOT Dx HTN on one measurement

87
Q

What is the most prevalent risk factor in heart failure, stroke, and kidney failure?

A

systolic hypertension

88
Q

At what BP is it classically considered Hypotension?

A

under 90/60

89
Q

What does “ortho-“ mean?

A

upright

90
Q

What is a fall in systolic BP of 20 mHg or more called?

A

orthostatic systolic hypotension

91
Q

What is a fall in diastolic BP of 10 mmHg or more called?

A

Orthostatic diastolic hypotension

92
Q

What is a rise in diastolic BP to 98 mmHg or higher called?

A

Orthostatic diastolic hypertension

93
Q

What is a fall in pulse pressure to 18 mmHg or lower?

A

Orthostatic narrowing of pulse pressure

94
Q

What is an increase in heart rate of 28 bpm or to greater than 110 b/min?

A

Orthostatic postural tachycardia

95
Q

How do we get Pulse Pressure? What is a normal range?

A

systolic - diastolic pressures

30-40mmHg

96
Q

What is a widened (high) pulse pressure (over 40 mmHg) a best blood pressure marker for?

A

cardiovascular disease

97
Q

How frequently should you take the BP?

A

initial visit

if BP elevated above 140/90–> take a second after 1-2 mins

98
Q

How frequent should BP be measured for sustained blood pressure elevation?

A

at least once at each visit on the same arm

99
Q

T/F. It is sufficient enough to take pulses on one arm.

A

False– always palpate pulses bilaterally

100
Q

What should we allow a variation for in BP b/w both arms?

A

10 mmHg

Physical Diagnosis I -- Dr. Littrell (1 decks)

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