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Foundations 1 > Week 3 Vital Signs > Flashcards

Week 3 Vital Signs Flashcards

1
Q

what is an indication?

A

a reason to do/perform a test

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2
Q

what is a contra-indication?

A

reason to avoid a test

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3
Q

before taking any vital signs what four steps should you perform?

A
  1. Hand hygiene
  2. identify self and patient (Name and DOB)
  3. inform patient of procedure
  4. ask patient about anything that will alter vitals (in last 30 min) and document them
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4
Q

what are two indications for taking a temperature?

A

determines if body temp within normal range, indicates pathological conditions

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5
Q

what are three contradictions for oral measurement of temp

A

uncoopoerative patient, oral lesions, respiratory distress

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6
Q

what is the coral body temp?

A

37 DC or 98.6 DF

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7
Q

what organ is the bodys thermostat?

A

hypothalamus

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8
Q

what are the non-invasive sites to take a temperature?

A

oral, axilla, rectal

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9
Q

the non-invasive sites give a ____ temperature

A

estimated

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10
Q

what is the most common and accessible location to take a temp?

A

oral

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11
Q

what is the most invasive (non-invasive site)

A

rectal

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12
Q

what is the most accurate site to take a non-invasive body temp

A

rectal

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13
Q

where is the oral probe placed to take a temperature?

A

sublingual pocket (under and off to the side of the tongue along the gum line

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14
Q

why is oral temp taken at teh sublingual pocket? t

A

the temp is generally higher and more accurate here

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15
Q

what is the normal range for an oral temp? what is a fever?

A

95.9 to 99.9 and 100.0 is a fever

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16
Q

what are some indication in taking a students pulse?

A

establishes cardiac rate and rhythm

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17
Q

what are some contradictions to taking a pulse?

A

in general there are none.

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18
Q

what is a peripheral pulse?

A

palpable pulse felt in an artery

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19
Q

what is a apical pulse

A

sound! lub dub

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20
Q

where is the most common area to take a peripheral pulse?

A

radial artery

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21
Q

where (other than radial) can you take a peripheral pulse? (3)

A

carotid, brachial and femoral artery

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22
Q

where do you listen to apical heart sounds?

A

the apex (lowest point of the heart) at the point of maximal impulse

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23
Q

if the pulse has a regular rhythm then…

A

count the beats for 30 sec and x2

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24
Q

if a pulse has an irregular rhythm then…

A

count the beats for 60 sec

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25
Q

what are the three characteristics of a pulse (palpable)

A

rate: bpm
rhythm: regular or irregular
strength: how the vessel feels against finger tips bounding, normal, weak, thready, absent

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26
Q

if a machine is used to take a pulse what characteristics are taken?

A

only the rate (bpm) not rhythm or strength characteristics

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27
Q

how do you locate the point of maximal impulse?

A

@ 5th intercostal space and mid clavicular line

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28
Q

what characteristics can you get from the apical pulse

A

rate, rhythm

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29
Q

what is the normal bpm for an adult?

A

60-100

30
Q

in general, while awake children have a ____ bpm than adults

A

higher

31
Q

what are the four vital signs?

A

pulse, temperature, respirations, blood pressure

32
Q

what are the indications (3) (reason to perform) respirations?

A

provide data to determine adequate ventilation, gas exchange and perfusion

33
Q

what are the (3) contraindicaitons to performing respirations?

A

not breathing, in respiratory distress, upper airway obstruction

34
Q

what controls breathing?

A

brainstem

35
Q

what is the difference between ventilation,, exchange, and perfusion

A

ventilation: mechanical movement of gasses
exchange: movement of O2 and CO2 between alveoli and RBCs
perfusion: distribution of RBCs to and from pulmonary capillaries

36
Q

in normal breathing describe (active/passive) inspiration and expiration

A

inspiration: active
expiration: passive

37
Q

what are the 3 measurement sites for respirations?

A
  1. watch the rise and fall of the chest
  2. watch the rise and fall of the abdomen
  3. put hands on upper back to feel rise and fall of chest
38
Q

one respiration is…

A

one inhalation and exhalation

39
Q

what are the characteristics of respiration you should note? (3)

A

rate: respirations per minute
rhythm: regular or irregular
depth: shallow or deep

40
Q

if the respiratory rate is fast then the depth will be

A

shallow

41
Q

most studies support that the normal adult respiratory rate is:

A

16-24 breaths/minute

42
Q

what is the most important measurement in all of clinical medicine?

A

blood pressure

43
Q

what is the most innacurately performed measurement in all of clinical medicine?

A

blood pressure

44
Q

what the the indications for doing a blood pressure? (3)

A

reflects overall state of hemodynamic interaction between CO and vascular resistance, is an independent risk factor for cardiovascular and renal disease, high BP may be asymptomatic.

45
Q

what are the contraindications for doing blood pressure? (4)

A

avoid placing a cuff in the presence of Arterio-venous fistula, mastectomy, swelling of lymph nodes, burns (select an alternate site to measure BP)

46
Q

what is the ambulatory setting?

A

a non-hospital setting

47
Q

define BP

A

the lateral pressure or force that blood exerts on the wall of the artery

48
Q

what is the usual site to measure blood pressure?

A

upper arm or brachial artery

49
Q

what are alternate (3) sites to measure BP?

A

forearm, thigh, lower leg

50
Q

what is auscultation?

A

the process of listening to the sounds of the heart

51
Q

what instruments are used to take BP

A

stethoscope, sphygmomanometer (BP cuff)

52
Q

how should a person be positioned when taking BP? (3)

A

sitting or lying at rest for five minutes

arm supported at heart level

feet flat and legs uncrossed

53
Q

what is the most frequent error in BP measurement?

A

using an inappropriately sized cuff (a cuff that is too small is used for a larger sized arm)

54
Q

when placing a BP cuff, the marking on the cuff goes over…

A

brachial artery

55
Q

how do you know if a cuff is the correct size?

A

the wide end of cuff should be 40% the arm circumference and 2/3 of the upper arm length (elbow to armpit)

56
Q

a cuff that is too large will cause…..

A

a false low reading

57
Q

a cuff that is too small will cause…..

A

a false high reading

58
Q

the cuff should be inflated to ____ above/below/at the patients ______

A

30 mmHg above baseline reading

59
Q

how fast should the cuff be deflated?

A

2-3 mm Hg/sec

60
Q

when taking a BP the end of the stethescope goes over the…..

A

brachial artery

61
Q

you should take blood pressures…..min apart

A

30 minutes apart

62
Q

when do you use the two step method for taking BP?

A

when you do not know a persons baseline BP?

63
Q

what are the steps of the two step method of BP?

A
  1. apply cuff and palpate artery (radial) distal to the cuff
  2. inflate cuff and note point at which pulse disappears
  3. continue palpating and inflate the cuff to 30 mmHg above the point at which pulse disappeared
  4. deflate the cuff (2-3 mmHg/sec) and note point at which pulse reappears (should be the same as when it disappeared, if not use the larger number) this is your systolic reading
  5. deflate the cuff fully and wait 30 seconds
  6. measure the BP with stethoscope going 30 mmHg above the palpated systolic
  7. first sound is the systolic, last sound is the diastolic pressure readings
64
Q

what are the normal systolic ranges?

A

90-140

65
Q

what are the normal diastolic ranges?

A

60-90

66
Q

adults are hypotensive when…

A

systolic is less than 90

67
Q

adults are hypertensive when…

A

greater than 140/90

68
Q

after you perform all vital sign tests what three things do you do next?

A

record all readings, report abnormal values to physician, perform hand hygiene

69
Q

what can a persons height and weight tell you?

A

general level of health

70
Q

what is one thing that can cause significant weight gain in one day?

A

cardiac issues

71
Q

what is BMI

A

body mass index, tells you how much you should weigh based on how tall you are

Foundations 1 (65 decks)

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