Vitals Flashcards
Range Variations
Temp.
-35.8-37.3
Pulse
60-100bpm
Resp.
12-20 breaths/min
BP
- 120/80 is ideal
- 140/90 consistently (hypertension)
Vitals
- 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
Producing Heat
- sympathetic nervous system (fight or flight)
- basal metabolic rate (BMR)
- thyroid hormone
- shivering/muscles
- fever
Losing Heat
- 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
Temperature Definitions
- 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
Temperature Locations
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
Factors Affecting Pulse
- 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
Pulse Definitions
bradycardia-slow pulse (100)
arrythmia-abnormal rhythm (dysrhythmia)
pulse deficit-difference between apical and radial
Characters Assessed-Pulse
- rate–>beats/min
- rhythm–>regular or irregular
- strength
- weak, strong, bounding, thready
- weak is not enough blood moving
- equality–>same in both limbs
Pulse Sites
- temporal
- carotid
- apical
- brachial
- radial
- ulnar
- femoral
- popliteal
- posterior tibial
- dorsal pedis (pedal)
- peripheral–>where artery crosses bone
- apical–>at apex of heart
Factors Affecting Respirations
- 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
Respiration Definitions
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
Respiratory Characteristics Assessed
Rate-number of breaths/min
Depth-deep, normal, shallow
Rhythm-regular or irregular
Quality-amount of effort, abnormal sounds
BP Definitions
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
BP Physiology
- 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
Factors Affecting BP
- 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
Hypertension
-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
Hypotension
- 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
Pulse Oximeter
- 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
Factors Affecting SpO2
- hemoglobin
- circulation
- activity
- carbon monoxide poisoning won’t register
- compare results to other findings
- follow up for O2 therapy adjustments or breathing treatments
