Vital Signs - Unit 1 (Pulse, Blood Pressure) Flashcards
Pulse =
a wave of blood created by contraction of the left ventricle of the heart.
Compliance = the ability of the arteries to..
the ability of the arteries to contract and expand.
Peripheral Pulse - def
pulse located in the periphery of the body, IE, foot, hand, neck, etc.
Apical Pulse - def
central pulse, located at the apex of the heart.
What are some factors that affect pulse rate?
Age, Gender, Exercise, Fever, etc.
Pulse Sites - what are ones to know?
Temporal, Carotid, Apical, Brachial, Radial, Femoral, Popliteal, Posterior Tibial, Dorsalis Pedis
Assessing a pulse - includes…
rate, rhythm (regular or irregular), volume or strength or amplitude, presence or absence of bilateral equality.
Scale for Measuring Pulse Volume -
0-3+. 0 = Absent. 1+ - Thready or weak. 2+ - Normal, detected readily. 3 + - Bounding.
We should initially asses a pulse for how long?
60 seconds.
Use a doppler before saying the pulse is a 0. T/F?
True!
What are some types of heart rates? (3 not so perfect ones.)
Tachycardia, Bradycardia, Arrhythmia/dysrhythmia
Pulse deficit =
difference between the apical pulse + radial pulse. Indicates that not all heart beats are reaching the body!
Respirations - what are 2 of the acts of breathing?
Costal and Diaphragmatic.
Inspiration = active or passive?
Active.
Exhalation = active or passive?
Passive.
Respiration - external and internal. T/F?
True!
Hyperventilation - greater than __ bpm.
20.
Hypoventilation - less than __ bpm.
12.
External respiration - def
oxygen and C02 in the lungs - exchange between alveoli of the lungs + circulating blood.
Internal Respiration - def
throughout the body - exchange of O2 and CO2 between circulating blood and tissue cells.
What controls respirations?
Medulla oblongata, pons of the brain, chemoreceptors located centrally in the medulla and peripherally, etc.
What are some factors that influence the respiratory rate?
Exercise, stress, increased temp, decreased temp, increased altitude, certain meds, etc.
Assessing respirations - why?
Client’s health problems, medications, assess normal breathing, etc.
Tachypnea - def
fast breathing.
Bradypnea - def
slow breathing.
Apnea - def
no breathing.
Eupnea - def
normal breathing.
Hyperventilation - def
too much ventilation.
Hypoventilation - def
not breathing enough.
Cheyne-Stokes - def
It is alternating periods of rapid/deep breathing followed by periods of apnea. Occurs in patients who are going to die soon. Occurs at a predictable/regular rate.
Biot’s - def
Depth + rate are quick and shallow, followed by periods of apnea - it’s an irregular rate - like in severely brain damaged folks.
What is this?
This is Eupnea (normal) and Eupnea with a .. sigh!
What is this?
Tachypnea/Bradypnea.
What is this?
Hyperventilation/Hypoventilation
What is this?
Cheyne-Stoke’s/Biot’s.
What are some altered breathing patterns audbile without a stethoscope?
Rhonchi (deep, like snoring), wheezes, stridor (high pitched), girgling.
Breathing chest movements - what?
Iintercostal rectraction, substernal retraction, suprasternal retraction (clavicles), flail chest (uneven chest expansion.)
Breathing - Secretions & coughing
Hemoptysis (coughing up blood), Productive cough vs. nonproductive cough.
Arterial Blood Pressure - def
measure of the pressure exerted by the blood as it flows through the arteries.
Systolic - def
pressure of the blood as a result of the contraction of the ventricles. Normal is <120.
Diastolic - def
pressure when the ventricles are at rest. Present at all times within the arteries. Normal is less than 80.
Pulse Pressure = difference between diastolic and systolic pressures. T/F?
True!
If the pulse pressure is narrow, like 110/90 = 20, it could be because of… ____.
Dehydration, heart problems, etc.
If the pulse pressure is high, like 180/55 = 125, it could mean…
HTn, bradycardia, heart problems, aging process, etc.
Cardiac Output = __ x __, which is the volume of…
SV X HR, which is the ovlume of blood pumped out of the left ventricle.
Peripheral Vascular Resistance - def
amount of pressure exerted in resistance to the blood flow form the walls of the arteries/arterioles. BP increases with PVR.
What are some factors that effect BP?
Age, exercise, stress, race, obesity, sex, etc.
BP tends to be higer in the afternoon. T/F?
True!
Recommendations for Follow-up after screening -
<130-85 - recheck within __ year(s).
BP 130-139/85-89 - recheck within __ year(s).
BP 140-159/90-99 - Confirm within __ months.
BP 160-179/100-109 - Evaluate or refer to source of care within __ month(s).
BP = or > 180/100 - Evaluate or refer to source of care ____.
2 years.
1 years.
2 months.
1 month.
Immediately!
What are the 3 types of Sphygmomanometers?
Mercury, Aneroid (like what we do manual ones on) and Electronic.
What are the 5 phases of Korotkoff Sounds?
Phase 1 - a sharp tapping.
Phase 2 - a swishing or whooshing sound.
Phase 3 - a thump softer than the tapping in phase 1.
Phase 4 - a softer blowing muffled sound that fades.
Phase 5 - Silence.
Sites for taking B/P - 4
Upper arm, lower arm, thigh, calf.
We should NOT use limb that is/has been…
Broke, cast, Axilla or hip nodes removed (mastectomy), AV fistula, arterial line, IV line.
