Vitals Flashcards
What is acute care?
An inpatient hospital setting for individuals with critical medical conditions
What is the primary goal of acute care?
To stabilize the patient’s medical status and address life-threatening issues
What are three examples of acute care practice settings?
- Pre and post-surgical units
- Step-down units
- Intensive-care units
What is a chart review?
The process of finding critically relevant information about your patient prior to treating them
What are the four main reasons we chart review?
- To determine if your patient is physiologically stable for treatment
- To identify if your patient has any precautions
- To guide your interview
- To identify yellow/ red flags
What are 8 things to look for in a chart review?
- PT or OT consult
- Current and past medical history (PMH) or history and physical (H&P)
- Precautions
- Lab Values
- Vitals
- Medications
- Operative and imaging reports
- Progress notes
What does the term “physiological stability” mean?
A dynamic state of a living organism characterized by the maintenance of one or more physiological parameters within value ranges that vary only slightly in the presence of disruptive elements
A patients’ vital signs and physical signs should be monitored ______, ______, and ______, activity to assess tolerance.
Before, During, After
What is the most important parameter in progressing a task?
A patient’s physiological response
When can a patients level of activity be progressed?
When vital signs and symptoms are acceptable at the existing level of activity
What are the 5 main vital signs we are paying attention to?
- Heart Rate (HR)
- Oxygen Saturation (SP02%)
- Respiration Rate (RR)
- Blood Pressure (BP)
- Body Temperature
Heart rate is an indirect measure of contraction of what ventricle in the heart?
Left Ventricle
What does BPM stand for?
Beats per Minute
What is the normal heart rate value for an adult?
60 to 100 BPM
What is the normal heart rate value for a child (1 to 10 years of age)?
70 to 130 bpm
What is the normal heart rate value for a newborn?
100 to 150 bpm
What would be signs of intolerance for heart rate?
< 50 bpm or > 130 bpm
What are the 7 sites that we can assess heart rate at?
- Temporal
- Carotid
- Brachial
- Radial
- Femoral
- Popliteal
- Dorsal Pedal
What is a normal blood oxygen saturation?
95 - 100%
What oxygen saturation would represent hypoxemia?
< 90%
What would be signs of intolerance for oxygen saturation?
< 90%
What are some factors that may affect oxygen saturation?
Poor Circulation, Finger nail polish/ artificial nails
Respiration is described by the _____ (inflow) and _____ (outflow) of air between the environment and lungs.
inspiration, expiration
One respiration is equal to … ?
one inspiration and one exhalation
What are the normal values for respiration rate for adults and infants?
- Adults: 12 to 18 (or 20) RR at rest
- Infants: 30 to 50 RR at rest
What would be a sign of intolerance for respiration rate?
> 40 rpm
How do you assess a respiration?
- Rate: number of breaths per minute
- Depth: volume (amount) of air exchanged with each respiration
- Rhythm: regularity of the pattern
- Character: any deviations from normal, no sounds should be heard during normal, resting respiration
How would you describe blood pressure?
An indirect measurement of the pressure inside an artery caused by blood flow through the artery
What is Systolic pressure?
- Contraction of the left ventricle
- The pressure against artery walls when the heart is beating
What is Diastolic pressure?
- Rest period of the heart
- The pressure against artery walls between heartbeats
What is considered a normal blood pressure?
120/80 mmHg
What is considered a high normal blood pressure?
130-139/85-89 mmHg
What is considered a prehypertension blood pressure?
120-139/85-89 mmHg
What is considered stage 1 hypertension?
140-159/90-99 mmHg
What is considered stage 2 hypertension?
160-179/100-109 mmHg
What is considered a hypertensive crisis?
> 180/>110 mmhg
What would be signs of intolerance for blood pressure?
- Hypotension: < 90/60 mmHg
- Hypertension: >130-139/80-89 mmHg
What is orthostatic hypotension?
A form of blood pressure that happens when you stand up from sitting, sit up from laying down. Symptoms include dizziness or lightheadedness
What kind of decrease will you see in the systolic and diastolic pressures with orthostatic hypotension?
- Systolic decrease of 20 mmHg
- Diastolic decrease of 10 mmHg
(within 3 minutes of position change)
What is body temperature?
An indication of the intensity or degree of heat within the body
What is the normal range and average for body temperature?
- Normal Range: 96.8 to 99.3 degrees F
- Average: 98.6 degrees F
How does the international association for the study of pain describe pain?
Unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage
Pain can be due to a _____ injury or the _____ threat of a tissue injury.
tissue; perceived
T/F - Pain is complex and multifactorial
True
What increased when pain started being treated as a vital sign?
Opiate prescriptions
Is pain subjective or objective?
Subjective
How can you objectify pain?
Use a pain screen to give you a quantitative rating of the intensity of the pain
What are examples of pain scales?
- Verbal rating scales
- Numeric rating scales (0-10 point scale)
- Visual analogue scale
- Picture or face scales (wong-baker scale)
What are examples of nonverbal pain indicators?
- Sighs, gasps, moans, groans, cries
- Facial grimaces/ winces
- Bracing or guarding against movement
- Restlessness
- Vital sign response (increased HR, RR and or BP)
Enhanced rehabilitative services, including early mobility and an increased effort/ intensity may result in benefits including:
- improvements in patient outcomes
- reductions in hospital length of stay (LOS)
- Reduction in health care costs
- Decreasing need for post-acute care services
