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Nursing - 115 > Vital Signs - Unit 1 (Pulse, Blood Pressure) > Flashcards

Vital Signs - Unit 1 (Pulse, Blood Pressure) Flashcards

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1
Q

Pulse =

A

a wave of blood created by contraction of the left ventricle of the heart.

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2
Q

Compliance = the ability of the arteries to..

A

the ability of the arteries to contract and expand.

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3
Q

Peripheral Pulse - def

A

pulse located in the periphery of the body, IE, foot, hand, neck, etc.

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4
Q

Apical Pulse - def

A

central pulse, located at the apex of the heart.

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5
Q

What are some factors that affect pulse rate?

A

Age, Gender, Exercise, Fever, etc.

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6
Q

Pulse Sites - what are ones to know?

A

Temporal, Carotid, Apical, Brachial, Radial, Femoral, Popliteal, Posterior Tibial, Dorsalis Pedis

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7
Q

Assessing a pulse - includes…

A

rate, rhythm (regular or irregular), volume or strength or amplitude, presence or absence of bilateral equality.

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8
Q

Scale for Measuring Pulse Volume -

A

0-3+. 0 = Absent. 1+ - Thready or weak. 2+ - Normal, detected readily. 3 + - Bounding.

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9
Q

We should initially asses a pulse for how long?

A

60 seconds.

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10
Q

Use a doppler before saying the pulse is a 0. T/F?

A

True!

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11
Q

What are some types of heart rates? (3 not so perfect ones.)

A

Tachycardia, Bradycardia, Arrhythmia/dysrhythmia

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12
Q

Pulse deficit =

A

difference between the apical pulse + radial pulse. Indicates that not all heart beats are reaching the body!

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13
Q

Respirations - what are 2 of the acts of breathing?

A

Costal and Diaphragmatic.

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14
Q

Inspiration = active or passive?

A

Active.

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15
Q

Exhalation = active or passive?

A

Passive.

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16
Q

Respiration - external and internal. T/F?

A

True!

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17
Q

Hyperventilation - greater than __ bpm.

A

20.

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18
Q

Hypoventilation - less than __ bpm.

A

12.

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19
Q

External respiration - def

A

oxygen and C02 in the lungs - exchange between alveoli of the lungs + circulating blood.

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20
Q

Internal Respiration - def

A

throughout the body - exchange of O2 and CO2 between circulating blood and tissue cells.

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21
Q

What controls respirations?

A

Medulla oblongata, pons of the brain, chemoreceptors located centrally in the medulla and peripherally, etc.

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22
Q

What are some factors that influence the respiratory rate?

A

Exercise, stress, increased temp, decreased temp, increased altitude, certain meds, etc.

23
Q

Assessing respirations - why?

A

Client’s health problems, medications, assess normal breathing, etc.

24
Q

Tachypnea - def

A

fast breathing.

25
Q

Bradypnea - def

A

slow breathing.

26
Q

Apnea - def

A

no breathing.

27
Q

Eupnea - def

A

normal breathing.

28
Q

Hyperventilation - def

A

too much ventilation.

29
Q

Hypoventilation - def

A

not breathing enough.

30
Q

Cheyne-Stokes - def

A

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.

31
Q

Biot’s - def

A

Depth + rate are quick and shallow, followed by periods of apnea - it’s an irregular rate - like in severely brain damaged folks.

32
Q

What is this?

A

This is Eupnea (normal) and Eupnea with a .. sigh!

33
Q

What is this?

A

Tachypnea/Bradypnea.

34
Q

What is this?

A

Hyperventilation/Hypoventilation

35
Q

What is this?

A

Cheyne-Stoke’s/Biot’s.

36
Q

What are some altered breathing patterns audbile without a stethoscope?

A

Rhonchi (deep, like snoring), wheezes, stridor (high pitched), girgling.

37
Q

Breathing chest movements - what?

A

Iintercostal rectraction, substernal retraction, suprasternal retraction (clavicles), flail chest (uneven chest expansion.)

38
Q

Breathing - Secretions & coughing

A

Hemoptysis (coughing up blood), Productive cough vs. nonproductive cough.

39
Q

Arterial Blood Pressure - def

A

measure of the pressure exerted by the blood as it flows through the arteries.

40
Q

Systolic - def

A

pressure of the blood as a result of the contraction of the ventricles. Normal is <120.

41
Q

Diastolic - def

A

pressure when the ventricles are at rest. Present at all times within the arteries. Normal is less than 80.

42
Q

Pulse Pressure = difference between diastolic and systolic pressures. T/F?

A

True!

43
Q

If the pulse pressure is narrow, like 110/90 = 20, it could be because of… ____.

A

Dehydration, heart problems, etc.

44
Q

If the pulse pressure is high, like 180/55 = 125, it could mean…

A

HTn, bradycardia, heart problems, aging process, etc.

45
Q

Cardiac Output = __ x __, which is the volume of…

A

SV X HR, which is the ovlume of blood pumped out of the left ventricle.

46
Q

Peripheral Vascular Resistance - def

A

amount of pressure exerted in resistance to the blood flow form the walls of the arteries/arterioles. BP increases with PVR.

47
Q

What are some factors that effect BP?

A

Age, exercise, stress, race, obesity, sex, etc.

48
Q

BP tends to be higer in the afternoon. T/F?

A

True!

49
Q

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 ____.

A

2 years.

1 years.

2 months.

1 month.

Immediately!

50
Q

What are the 3 types of Sphygmomanometers?

A

Mercury, Aneroid (like what we do manual ones on) and Electronic.

51
Q

What are the 5 phases of Korotkoff Sounds?

A

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.

52
Q

Sites for taking B/P - 4

A

Upper arm, lower arm, thigh, calf.

53
Q

We should NOT use limb that is/has been…

A

Broke, cast, Axilla or hip nodes removed (mastectomy), AV fistula, arterial line, IV line.

Nursing - 115 (35 decks)

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