Vitals Flashcards

0
Q

Range Variations

A

Temp.
-35.8-37.3

Pulse
60-100bpm

Resp.
12-20 breaths/min

BP

  • 120/80 is ideal
  • 140/90 consistently (hypertension)
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1
Q

Vitals

A
  • measures of various physiological stats
  • temp., pulse, BP, resp.
  • VS=BP+TPR

When?

  • admission
  • routine schedule
  • before and after surgery
  • any change in condition
  • before and after some meds
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2
Q

Producing Heat

A
  • sympathetic nervous system (fight or flight)
  • basal metabolic rate (BMR)
  • thyroid hormone
  • shivering/muscles
  • fever
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3
Q

Losing Heat

A
  • radiation–>warm to cooler w/o direct contact
  • conduction–>warm to cooler w/ direct contact
  • convection–>transfer of heat by air movements
  • evaporation/vapourization–>liquid to gas
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4
Q

Temperature Definitions

A
  • core–>temp of deep tissues
  • surface–>temp of skin, subcutaneous, fat, changes
  • afebrile–>no fever
  • febrile–>increased body temp
  • fever (pyrexia)–>increase in normal body temp
  • hyperpyrexia–>extreme increase in body temp
  • hypothermia–>core temp below lower normal limit
  • diaphoresis–>visible perspiration, profuse sweating
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5
Q

Temperature Locations

A

1) Oral
- 37 degrees
- less invasive, affected by fluids, foods, oxygen
- contra–>small children, oral trauma, shaking/chills

2) Rectal
- 37.5 degrees
- more accurate but embarrassing
- slow heart rate in some cardiac clients
- contra–>diarrhea, rectal trauma

3) Axillary
- 36.5 degrees
- safe and noninvasive, takes longer

4) Tympanic
- 37 degrees
- fast, accessible, expensive
- not affected by oral intake
- contra–>wax, ear surgery, ear aches

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6
Q

Factors Affecting Pulse

A
  • exercise increases short term, decreases in good athlete
  • temp. increased when hot, decreased when cold
  • emotions, increased with pain/anxiety, decreased with relaxation
  • drugs, increased with caffeine, adrenaline, decreased with digoxin, anesthesia
  • hemorrhage increases
  • postural changes increases
  • pulmonary conditions increases
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7
Q

Pulse Definitions

A

bradycardia-slow pulse (100)
arrythmia-abnormal rhythm (dysrhythmia)
pulse deficit-difference between apical and radial

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8
Q

Characters Assessed-Pulse

A
  • rate–>beats/min
  • rhythm–>regular or irregular
  • strength
    • weak, strong, bounding, thready
    • weak is not enough blood moving
  • equality–>same in both limbs
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9
Q

Pulse Sites

A
  • temporal
  • carotid
  • apical
  • brachial
  • radial
  • ulnar
  • femoral
  • popliteal
  • posterior tibial
  • dorsal pedis (pedal)
  • peripheral–>where artery crosses bone
  • apical–>at apex of heart
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10
Q

Factors Affecting Respirations

A
  • exercise, pain, anxiety, smoking all increase resp.
  • body position affects chest expansion
  • Meds
    • narcotics, anesthesia, sedatives decrease resp.
    • amphetamines, cocaine, increase resp.
  • brain injury
    • affects impulse to breathe
    • depends on part of brain injured
  • hemoglobin (hb)
    • if decreased, have to breathe more to get more oxygen
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11
Q

Respiration Definitions

A
Apnea-absence
Dyspnea-difficulty
Eupnea-normal
Bradypnea-slow
Tachypnea-fast
Orthopnea-only breathe when upright
Cheyne's Stokes-dying breathing
Kussmal's-out of control, smells like juicy fruit
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12
Q

Respiratory Characteristics Assessed

A

Rate-number of breaths/min
Depth-deep, normal, shallow
Rhythm-regular or irregular
Quality-amount of effort, abnormal sounds

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13
Q

BP Definitions

A

BP
-measurement of pressure/force exerted by blood on vessel walls

Systolic
-highest pressure exerted against artery wall when L ventricle contracts

Diastolic

  • pressure against artery wall when ventricles relax
  • heart at rest

Pulse Pressure

  • difference between systolic and diastolic
  • 40 is good average number

Korotkoff Sounds

  • sounds heard throughout BP process
  • 1st is systolic, last is diastolic
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14
Q

BP Physiology

A
  • correct cuff size
  • sphygmomanometer over brachial artery (1in. above antecubital)
  • cuff pumped until artery obliterated (no sounds)
  • 1st sound heard as pressure released is systolic
  • last audible sound is diastolic
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15
Q

Factors Affecting BP

A
  • cardiac output–>increased CO=increased BP (pumping action of heart)
  • peripheral resistance
    • smaller the vessel=increased BP (vasoconstriction)
    • larger the vessel=decreased BP (vasodilation)
  • blood volume–>increased volume=increase BP and vice versa
  • blood viscosity–>increased viscosity=increased BP
    - as you age, lose elasticity
  • age
  • stress
  • meds
  • exercise
  • disease
  • diurnal variation
  • race
  • obesity
  • gender
  • sodium intake
16
Q

Hypertension

A

-persistently above normal

Education

  • ideal body weight
  • low fat/Na and calorie appropriate diet
  • regular exercise
  • no smoking, avoid 2nd hand smoke
  • stress management
  • monitor cholesterol and BP
17
Q

Hypotension

A
  • BP below normal
  • systolic consistently below 85 and 110

Orthostatic Hypotension

  • falling BP when sitting or standing
  • blood leaves central body organs, goes to periphery
18
Q

Pulse Oximeter

A
  • noninvasive–>place on finger, nose, toe
  • estimates arterial blood oxygen saturation by sensor
  • want reading in the 90s, 75 too low
  • photo detectors measure red and infrared light absorbed by oxygenated and de-oxygenated Hb in peripheral arterial blood

Purpose

  • detect hypoxemia (too low) before signs and symptoms
  • less invasive than blood gas test
19
Q

Factors Affecting SpO2

A
  • hemoglobin
  • circulation
  • activity
  • carbon monoxide poisoning won’t register
  • compare results to other findings
  • follow up for O2 therapy adjustments or breathing treatments