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KNPE 355 > week 2: vital signs > Flashcards

week 2: vital signs Flashcards

1
Q

parts of a clinical interview

A
  1. preparation
  2. initiation
  3. exploration
  4. closing/termination
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2
Q

preparation

A

the setting
- ensure privacy
- eliminate distractions
- ensure clients comfort
- where will you be in relation to the client
- maintain an attentive body position

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3
Q

initiation

A

introduce yourself
clean hands
inform the client about session and gather consent

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4
Q

exploration

A

ask questions that will set the context for the interview (open-ended questions)

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5
Q

closing/termination

A

summarize the information provided
devise a problem list with priorities
determine short and long term goals
create plan of action

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6
Q

SOAP notes

A

subjective, objective, analysis/assessment, plan

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7
Q

before beginning a clinical skills task

A

introduce yourself (first and last name)
hand hygiene
confirm clients name and preferred name
provide overview of the session
gather informed consent

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8
Q

what are vital signs

A

measures of the bodys core ability to stay alive
- pumping blood through the heart
- breathing
- maintaining core temperature
they are the most frequently measured objective data for monitoring vital body functions and are often the most important indicator for patients changing condition

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9
Q

four main vital signs

A
  • respiration
  • pulse/ heart rate (HR)
  • blood pressure (BP)
  • temperature
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10
Q

three other vital signs

A
  • pulse ox
  • pain rating scales
  • level of perceived exertion
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11
Q

what are vital signs used to establish

A
  • baseline physiological information to guide exercise program development
  • physiological response to activity to guide continuation, modification, or discontinuation of a program
  • patients/clients immediate health risk
  • emergency cardiac or respiratory interventions
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12
Q

heart rate

A

goal is to determine the clients physiological response to activity
to obtain an accurate picture of clients cardiac response to activity

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13
Q

how to assess HR

A
  • resting HR (5 mins before activity)
  • activity HR (during or immediately following activity)
  • recovery HR (1 - 5 mins post-activity)
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14
Q

what is heart rate

A

an indirect measure of the rate and rhythm of the contraction of the left ventricle

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15
Q

what characteristics measure HR

A
  1. rate (bpm)
  2. rhythm
  3. intensity
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16
Q

measuring HR at carotid

A
  • stand on same side of the carotid artery (not across)
  • don’t press too hard
  • massage like actions can decrease HR and produce bradychardia
  • dont palpate - may cut off blood supply to the brain
17
Q

measuring HR at radial and brachial

A
  • support left arm on stable surface at level of the heart with elbow extended and forearm supinated
  • using 2+3rd digits, palpate gently for the brachial pulse (medially above elbow crease) and radial pulse (1-2cm above wrist crease lateral to the flexor tendon)
  • measure number of beats in 1 min
18
Q

HR safety
**

A
  • HR increase ~10bpm per 1 MET
  • should decrease by at least 12 during 1st min of recovery
  • should decrease by 22 by end of 2nd min of recovery
19
Q

respiratory rate characterization

A
  1. rate: # of breaths per min
  2. pattern: eupnea, tachypnea, bradypnea, apnea
  3. mechanics
20
Q

RR mechanics

A

inspiratory to expiratory ratio (I:E)
- normal is 1:2 or 1:3

21
Q

blood pressure

A

a physiological variable which reflects the effects of CO, peripheral vascular resistance and haemodynamic factors
- an indirect measure of the pressure inside an artery caused by blood flow through the artery
- recorded as mmHg

22
Q

systolic vs diastolic pressures

A

systolic: the pressure at the time of the contraction of the left ventricle
diastolic: the pressure at the time of ventricular filling (resting pressure)

23
Q

5 phases of blood pressure sounds (Korotkoff’s)

A

phase 1: first clear tapping sound heard, faint at first but increasing (initial flow through the artery as the constriction of artery is released - systolic)
phase 2: softer sound (no clinical significance)
phase 3: louder and more crisp sound (no clinical significance)
phase 4: sound is muffled (first diastolic BP - useful during exercise assessment)
phase 5: cessation of sound (diastolic BP)

24
Q

BP errors of measurement

A
  • inappropriate cuff size
  • tested arm unsupported
  • legs crossed while sitting
  • unsupported sitting
  • arm that is not level with the heart
  • rapid deflation of the cuff
  • equipment malfunction
  • auditory errors due to incorrect placement of equipment
25
Q

BP safety
**

A
  • SBP increases with increasing workloads at rate of ~10mmHg per 1 MET
  • normally no change in DBP or slight decrease during exercise
  • post exercise SBP returns to pre-exercise levels or lower by 6 mins of recovery
26
Q

when to stop exercise with BP findings
**

A
  • systolic greater than 250
  • diastolic greater than 115
  • drop is SBP more than 10 from baseline
  • failure of SBP to increase with the increasing workload
27
Q

oxygen saturation

A
  • percent saturation of arterial O2 (SpO2) = estimate of how much O2 is travelling through your body in the RBC’s
  • 95-100%
  • pulse ox
  • hypoxemia = decrease in SpO2 greater than or equal to 5%
28
Q

RPE borg and CR10 scale

A

borg: 6 (no exertion) - 20 (maximal effort)
CR10: 0 (no exertion) - 10 (maximal effort)

29
Q

vital signs environmental factors

A
  • age
  • PA
  • emotional status
  • physiological status (meds)
  • clinician accuracy
  • equipment accuracy
  • environmental temperature, barometric pressure, humidity
30
Q

heart rate rhythm documentation

A
  • regular: heart beats at a fixed interval
  • regular-irregular: heart rate that occasionally skips a beat
  • irregular-irregular: highly disorganized heart beat
31
Q

heart rate intensity documentation

A

0: absent
1: weaker than expected or thready; may be difficult to palpate
2: normal; able to palpate with normal pressure
3: bounding, may be able to see pulsation; doesn’t disappear with palpation

KNPE 355 (13 decks)

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