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Physical Diagnosis I Exam One > Vitals > Flashcards

Vitals Flashcards

1
Q

What are the four vital signs?

A

Temperature, pulse, respiration, and blood pressure

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2
Q

What is the normal adult average temperature?

A

98.6 degrees Fahrenheit

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3
Q

What is the range for normal body temperature?

A

96-99.6 degrees Fahrenheit

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4
Q

When is normal body temperature the lowest?

A

During least activity (sleep)

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5
Q

What age group tends to have higher fevers: children or adults?

A

Children

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6
Q

What is the term to describe how most fevers vary during their course but don’t fully return to normal until they resolve?

A

Remittent

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7
Q

What part of the nervous system regulates temperature?

A

Hypothalamus

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8
Q

What are the three typical phases of a fever?

A 
1 Chills (shivering/rigors)
2 Hot stage (set point of fever)
3 Sweating (heat dissipates)
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9
Q

What occurs when a temperature rapidly rises from normal to fever level?

A

Febrile convulsions

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10
Q

What type of fever occurs, resolves, then recurs again in a few days?

A

Relapsing (uncommon in the U.S.)

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11
Q

What is the normal range for a fever?

A

Patient’s normal to 105 degrees Fahrenheit

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12
Q

What is the range for hyperpyrexia?

A

Above 105 degrees Fahrenheit

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13
Q

When a patient exhibits hyperpyrexia, what condition can be assumed?

A

Damage to hypothalamus or heat stroke

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14
Q

Fevers are dangerous because of the possibility of what condition occurring?

A

Dehydration

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15
Q

What is the rate of water loss to the amount able to be absorbed by the body during exercise?

A

Lose 22 oz of water every 20 minutes
Absorb 6 oz every 20 minutes
(22 loss:6 gain)

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16
Q

What are the three phases of dehydration?

A

1 Heat cramps
2 Heat exhaustion
3 Heat stroke

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17
Q

If a patient presents with cold, clammy, sweaty skin and symptoms of dizziness, faintness, headache, or rapid, shallow breathing, what stage of dehydration would you suspect he/she is in?

A

Heat exhaustion

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18
Q

If a patient presents with hot dry skin and symptoms of dyspnea, arrhythmia, dilated pupils, possible seizures, coma, and even death, what stage of dehydration would you suspect he/she is in?

A

Heat stroke

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19
Q

If a patient presents with involuntary muscle hypertonicity of the legs and abdomen, what stage of dehydration would you suspect he/she is in?

A

Heat cramps

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20
Q

At what temperature do we see hyperthermia?

A

95 degrees Fahrenheit or less

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21
Q

How much blood is pumped into the arteries with every heartbeat that is felt with a pulse?

A

5 tablespoons

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22
Q

What three things are measured with the pulse?

A

Rate, rhythm, amplitude

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23
Q

What is the normal range and average resting pulse?

A

60-90 beats per minute (72 average)

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24
Q

What pulse range is indicative of bradycardia?

A

Less than 60 per minute

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25
Q

What pulse range is indicative of tachycardia?

A

More than 100 per minute

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26
Q

What is the physiologic tachycardia effect on pulse due to elevated temperature?

A

10 bp raise for every degree over 100

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27
Q

What is the cause for pathologic tachycardia?

A

Oxygen deficit (examples = anemia, hemorrhage, shock, or congestive heart failure)

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28
Q

What is the cause of physiologic tachycardia?

A

Normal response to exertion, anxiety, exercise, excitement or elevated temperature

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29
Q

What is the common heart beat irregularity that is more prominent in children where the heart rate speeds up with each inspiration and slows again with expiration?

A

Sinus arrhythmia

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30
Q

What is the common heart beat irregularity that involves disorganized electrical activity in the atria accompanied by a rapid, irregular ventricular response?

A

Atrial fibrillation

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31
Q

What is the common heat beat irregularity that involves ventricular depolarization occurring earlier than expected resulting in occasional skipped beats?

A

Premature ventricular contraction (PVC’s)

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32
Q

Which common irregularity usually accompanies pre-existing heart disease and necessitates emergency care?

A

Atrial fibrillation

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33
Q

What is the scale used to measure the amplitude of a pulse?

A 
0 absence
1 weak, feeble
2 expected/normal
3 full/increased
4 water-hammer, bounding
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34
Q

What is the normal appearance of the contour of a pulse?

A

Smooth, domed-shaped wave

35
Q

How could pain or paresthesia of vascular origin be differentiated from that of neurologic origin?

A

1 check dermatome vs vascular distribution
2 check extremity warmth and skin color
3 check capillary refill time
4 compare peripheral pulse amplitude

36
Q

If one side of the body’s peripheral pulse feels weaker than the other, one of what three things can be assumed?

A

Compression, constriction, or obstruction of an arterial lumen

37
Q

What condition could be apparent if a strong radial and weak or absent femoral pulses are found?

A

Coarctation of the aorta

38
Q

A bruit is heard best with what part of the stethoscope?

A

Bell

39
Q

What does the presence of a bruit mean?

A

Compressed, constricted, or partially obstructed arterial lumen

40
Q

How can venous insufficiency be assessed?

A

Inspect for swelling, varicosities, edema, erythema/cyanosis while patient is standing

41
Q

What is the normal adult respiratory rate?

A

12-20 breaths per minute

42
Q

What rate defines tachypnea?

A

More than 20 breaths per minute

43
Q

What is the rate at which breathing rate increases due to physiologic tachypnea from elevated temperature?

A

4 breaths per minute for every degree over 100

44
Q

What kinds of things can lead to pathologic tachypnea?

A

Hyperventilation, lung congestion/obstruction, airway constriction, rib/intercostals/pleural pain

45
Q

What rate defines bradypnea?

A

Less than 12 breaths per minute

46
Q

What is air-trapping?

A

Increasingly difficult and prolonged expulsion of air

47
Q

What is hyerpnea?

A

Deep labored breathing

48
Q

What is examples of deep and rapid breathing?

A

Hyperventilation and Kussmaul

49
Q

What is the term for an occasional deep breath?

A

Sigh

50
Q

What is hypopnea?

A

Abnormally shallow respirations

51
Q

What is dyspnea?

A

Distressful or uncomfortable breathing

52
Q

What is orthopnea?

A

Shortness of breath that begins or gets worse when lying down

53
Q

What is the palpatory systolic blood pressure?

A

Where the pulse is first FELT when releasing pressure from the cuff

54
Q

What is an auscultatory gap?

A

Transient period of silence of the Korotkoff sounds

55
Q

What are Korotkoff sounds?

A

Audible noises created by turbulent blood flow through the partially open lumen of the brachial artery

56
Q

What is the auscultatory systolic blood pressure?

A

Where the pulse is first HEARD while releasing pressure from the cuff

57
Q

What is the term for the point at which the blowing sounds become softer and begin to fade when listening for blood pressure?

A

First or mid-diastolic blood pressure

58
Q

What is the end diastolic blood pressure?

A

The point at which audible blowing sounds completely stop being heard

59
Q

In what kind of situation is the mid-diastolic BP used to denote diastolic BP?

A

High cardiac output conditions where sounds may be heard all the way to zero pressure

60
Q

What is the pulse pressure?

A

Difference between the systolic and diastolic pressures

61
Q

What is a better indicator of heart disease: systolic or diastolic BP alone or abnormal pulse pressure?

A

Abnormal pulse pressure (according to some studies)

62
Q

There should be no more than how many mmHg of difference between the systolic blood pressure in both arms?

A

10 mmHg

63
Q

Which arm can have a 5-10 mmHg difference in systolic blood pressure and why?

A

Right arm; due to additional bifurcation (Poiseuille’s Law)

64
Q

Which are higher and why: leg or arm blood pressures?

A

Leg blood pressures; due to greater muscle mass

65
Q

If arm BP is higher than leg BP, what can we suspect?

A

Young people - coarctation of aorta

Elderly people - Stenosis of aorta

66
Q

What is the normal range for systolic blood pressure?

A

100-140 mmHg

67
Q

What is the normal range for diastolic blood pressure?

A

60-90 mmHg

68
Q

What usually increases systolic blood pressure?

A

Increased cardiac output

69
Q

What usually increases diastolic blood pressure?

A

Increased peripheral (arterial) resistance

70
Q

Strong emotion like anxiety raises what kind of blood pressure?

A

BOTH systolic and diastolic

71
Q

What should be the measurement for pulse pressure?

A

40 mmHg (+/- 10 mmHg)

72
Q

What does a wide pulse pressure indicate?

A

Additional arterial stretch with every heartbeat and wear and tear on the arteries

73
Q

What is the average adult normal blood pressure?

A

120/80 mmHg

74
Q

What should be the ideal width of the blood pressure cuff?

A

1/3-1/2 the circumference of the arm

75
Q

What kind of hypertension accounts for about 92% of cases?

A

Essential/idiopathic hypertension

76
Q

What kind of hypertension accounts for 8% of cases?

A

Secondary

77
Q

What is the top cause of secondary hypertension?

A

Adrenal disease (also hyperthyroidism, coarctation of aorta, polycythemia, preeclampsia)

78
Q

What are the blood pressure ranges for prehypertension?

A 
Systolic = 120-139 mmHg
Diastolic = 80-89 mmHg
79
Q

What percent of the adults in U.S. and Canada have high blood pressure?

A

25%

80
Q

What are examples of noninvasive activities that can help 75% of the hypertension cases in the U.S. and Canada?

A

Slow breathing exercises
Concord grape juice
Sodium reduction and weight loss
Moderate exercise

81
Q

What is the treatment for stage 1 hypertension?

A

Diuretics

82
Q

What is the treatment for stage 2 hypertension?

A

Diuretics and medications

83
Q

What is the treatment for stage 3 hypertension?

A

Combination medications

Physical Diagnosis I Exam One (4 decks)

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