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PT 620 Foundations 2 > Vitals Signs Review and Emergency Situations > Flashcards

Vitals Signs Review and Emergency Situations Flashcards

1
Q

when do we monitor vitals/why

A
  • assess readiness for PT session/exercise
  • during/after session to assess physiological response to exercise and continued stability
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2
Q

what are you looking for when assessing vitals

A

adverse reactions

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3
Q

when should vitals be taken in ICU and how

A

they should be taken continuously through arterial line or dinomap machine

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4
Q

what factors can impact accuracy of vitals

A

medications
pt positions
equipment (size of cuff)
pain
emotional state

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5
Q

how to document vitals

A

pt position
extremity
activity being performed (pre/post, moving, standing)

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6
Q

describe different BP values

A

normal: <120/<80
hypotension: <80/<60
elevated: 120-129/<80
HTN Stage 1: 130-139/80-90
HTN Stage2: >140/>90
hypertension crisis: >180/>120

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7
Q

describe effects exercise has on SBP and DBP

A

SBP should increase in linear fashion
DBP should remain stay or slight decrease

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8
Q

postural hypotension

A

orthostatic hypotension

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9
Q

when is orthostatic hypotension common following

A

trauma, blood loss, best rest, medications

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10
Q

describe requirements for orthostatic hypotension

A

> 20 mmHg decrease in SBP or >10 mmHg decrease in DBP on standing within in 3 minutes
(may also see subsequent increase in HR –> no longer a requirement)

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11
Q

sx of orthostatic hypotension

A

lightheadedness, diaphoresis, dizziness, confusion, blurred vision

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12
Q

how to measure orthostatic hypotension

A
  • pt lay down for 5 min
  • measure BP and HR in supine
  • ask pt to stand
  • repeat BP and HR at 1 and 3 minutes
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13
Q

describe values for HR

A

normal: 60-100
tachycardia: >100
bradycardia: <60

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14
Q

normal HR response to exercise

A

steady increase and should return to pre-exercise state in 3-5 minutes

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15
Q

what should you use to assess HR in patients on beta blockers

A

Borg RPE

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16
Q

what impact can arrythmias have on HR

A

can impact cardiac output

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17
Q

normal RR

A

12-18

18
Q

at what rate is exercise contraindicated for increased RR

A

> 50
45 = use caution

19
Q

what positions make breathing easier/harder

A

easier: sitting, standing
harder: supine

20
Q

normal SpO2

A

> 95%

21
Q

what does a low SpO2 indicate

A

decreased oxygen to peripheral tissues

22
Q

list how to manage seizures

A
  • call for help/rapid response team in hospital
  • stay with pt until seizure has ended
  • protect pt/comfort (pillow, clear area, roll on side)
  • monitor length of seizure (time of seizure and recovery)
  • stay calm
  • keep onlookers away
  • don’t forcibly hold pt down
  • don’t put anything in pt’s mouth
  • monitor respiratory status
23
Q

when to call 911 with seizures

A
  • > 5 minutes
  • one seizure occurs after another without person regaining consciousness
  • seizures closer together than usual for pt
  • breathing becoming more difficult/choking
  • seizure occurred in water
  • injury may have occurred
  • pt asks for medical help
24
Q

s/s of MI/cardiac arrest

A

chest pain
jaw pain
L arm pain
profuse sweating/indigestion

25
Q

what to do when suspecting MI/cardiac arrest

A
  • STOP activity and take vitals
  • call 911 or nurse/code/RRT
  • check ABCs
26
Q

CPR basics for adult 1-2 rescuers

A

ratio - 30:2
rate - 100-120 bpm
depth - 2-2.4 inches

27
Q

CPR basics for child/infant 1 rescuer

A

ratio - 30:2
rate - 100-120 bpm
depth - infant: 1.5 inches, child: 2 inches

28
Q

CPR basics for child/infant 2 rescuers

A

ratio - 15:2
rate - 100-120 bpm
depth - infant: 1.5 inches, child: 2 inches

29
Q

how to know if a pt is choking

A

unable to speak/get sound out
universal sign of hands to throat

30
Q

what to do if pt is choking and is responsive

A
  • perform abdominal thrusts in sitting/standing until object dislodged or pt loses consciousness
31
Q

what to do it pt is choking and unresponsive

A

lower to ground, begin CPR
- check mouth each time prepare to give rescue breath to see if item has become dislodged

32
Q

when is rescue breathing used

A

when the pt has stopped breathing, but still has a pulse

33
Q

what often precedes cardiac arrest

A

respiratory arrest

34
Q

how to deliver rescue breaths for adults and infants/children

A

adults: 1 breath every 5-6 sec
infants/kids: 1 breath every 2-3 sec

35
Q

what do you have to check for during each rescue breath

A

chest rising

36
Q

what should you do if the pt loses pulse during rescue breathing

A

begin CPR

37
Q

s/s of hypoglycemia

A

feeling shaky
nervous
sweating/chills/clamminess
irritability
confusion
increased HR
lightheadedness
hunger
nausea
blurred vision
headache

38
Q

normal fasting glucose levels and hypoglycemia levels

A

normal: 70-100 mg/dL
hypo: <70 mg/dL

39
Q

steps to take with hypoglycemia

A

15-15 rule: give 15g of carbohydrates and recheck every 15 minutes
- glucose tablets, 4 oz juice/regular soda, 1 tbsp sugar/honey/corn syrup, hard candy

40
Q

how to differentiate orthostatic hypotension vs hyperglycemia

A

take Bp
assess at different positions
give them orange juice

41
Q

when not to initiate PT

A
  • resting HR <50 or > 120
  • resting SPB <90 or >200
  • resting glucose < 70 or >200

be aware of pt trends
monitor sx and check with nursing

42
Q

when to terminate PT (relative contraindications)

A
  • HR increase > 20 bpm over resting HR (not proportionate to activity)
  • HR >120 and RPE of 13
  • RR > 35
  • SpO2 < 90%
  • decrease SBP with activity
  • HTN response: >250/>115

monitor sx and be aware of baseline/pt trends

PT 620 Foundations 2 (9 decks)

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