Vitals Flashcards
Normal pulse rate
Adolescents and adults 60/100 beats per min
Tachycardia
100-180 beats per min
Factors contributing to tachycardia
Decrease in BP Pain Condition resulting in poor oxygenation of blood (shock, heart failure, hemorrhage) Fever Hyperthyroidism Exercise Strong emotions medications
Bradycardia
Pulse rate below 60 beats per min
Sinus bradycardia
Slowing of the heart rate while also strengthening the force of contraction to the increase cardiac output
Nurse should immediately report bradycardia when patient
Difficult breathing Changes in level of consciousness Decreased BP ECG changes Angina
Pulse amplitudes
0 absent, unstable
+1 diminished weaker than expected
+2 beisk, normal
+3 bounding
Dysrhythmia
Irregular pattern of heart beats
Report immediately
Normal respiratory rates
12-20 per min
Eupnea
Normal respiration
Tachypnea
Increase in respiratory rate
Bradypnea
Decrease in respiratory rate
Apnea
Periods where there is no breathing
Dyspnea
Difficult of labored breathing
Rapid shallow respirations & appears anxious
Orthopnea
Condition in which ppl w/ dyspnea breath easier in sitting upright position
What to look for in respiration
Respiratory rate
Depth
Rhythm
Oxygenation of blood
Blood pressure
Force of moving blood against arterial walls
How is a cardiac output determined?
Stroke volume x heart rate
What increases BP
Increased cardiac output
What decreases BP
Weak contraction of the heart w/ decrease CO
Epinephrine
Sympathetic neurotransmitter released from adrenal gland to INCREASE heart rate & contractility = increasing CO
Renin-angiotensin-aldosterone system
Cause vasoconstriction in arteriales through angiotensinogen II
INCREASES sodium & water retention by kidneys to INCREASE circulatory fluid volume INCREASING BP long term
Vasopressin
Antidiuretic hormone ADH released from posterior pituitary by decreased blood volume & BP by increase of concentration of body fluids
Has direct vasoconstriction effect on blood vessels increasing peripheral resistance
Factors affecting BP
Age Circadian rhythm Gender Food intake Exercise Weight Emotional state Body position Race Drugs/meds
Normal blood pressures
Around 120 systolic AND 80 diastolic
Hypertension 140 and over(systolic) or 90 and over (diastolic)
Orthostatic hypotension
Decrease in systolic BP of 20mmhg or decrease in diastolic BP of 10mmhg witching 3 min of standing compared to BP from sitting of supine position
Nursing interventions for tachycardia
Monitor for pain, anxiety, restlessness, fatigue, low BP, low O2 saturation
Monitor for potential adverse effects of meds
Prevent injury
Bradycardia factors
Long term physical fitness Hypothermia Medications Changing positions Chronic severe pain Hypothyroidism Relaxation
Nursing interventions for bradycardia
Monitor for hypotension, chest pain, syncope, diaphoresis, dyspnea, & altered mental state
Monitor for potential effects
Prevent injury
Assessment of respiration’s includes;
Rate # of full inspirations and expirations in 1 min.
Depth amount of chest wall expansion in each breath
Rhythm observation of breathing intervals
Considerations of respirations
Age Sex Anxiety Smoking Body position Medications Neurological injury to brainstem Illnesses Impaired oxygen carrying capacity of the blood
Normal BP
Systolic of < 120
And
Diastolic of < 80
Prehypertension
Systolic of 120 - 139
Or
Diastolic of 80-89
Stage 1 hypertension
Systolic of 140-159
Or
Diastolic 90-99
Stage 2 hypertension
Systolic > 160
Or
Diastolic > 100
How do you determine whether BP is normal, prehypertension, or hypertension?
Base it off highest reading of two numbers and then categorize it
Considerations of blood pressure
Age Circadian rhythms Stress Ethnicity Sex Medications Exercise Exercise Obesity Family history
