Fundamentals Week 1

Front 1

BP goal for patient >/= 60

Back 1

<150/90

Front 2

BP goal for patient < 60

Back 2

< 140/90

Front 3

BP goal for patient > 18 with CKD (chronic kidney disease)

Back 3

140/90

Front 4

BPgoal for patient >18 with CKD or DM (diabetes mellitus)

Back 4

140/90

Front 5

Korotkoff’s Sounds

Back 5

1st sound- As you deflate the BP cuff, a sound that occurs during systole (systolic BP) ventricles contract

2nd sound- As you further deflate the cuff, a soft swishing sound caused by blood turbulence

3rd sound- Begins midway through the BP and is acrisp, sharp, rhythmic tapping sound

4th sound- Similar to the third sound, but softer,fading, blowing

5th sound- Silence, corresponding with diastole(diastolic BP)

Ventricles at rest

Front 6

Hypertension

Back 6

thesystolic BP consistently over 140 mm Hg or the diastolic BP consistently over90 mm Hg

Front 7

Hypotension

Back 7

theBP suddenly falls 20 mm Hg to 30 mm Hg below the patient’s normal BP or fallsbelow the low normal of 90/60 mm Hg

Front 8

Orthostatichypotension or postural hypotension

Back 8

whenposition changes result in a systolic pressure drop of 15 to 25 mm Hg or thediastolic pressure falls 10 mm Hg

Front 9

Normal temp range

Back 9

97°F to 100.8°F(36.1°C to 38.2°C)with some variation

Front 10

Changesin Temperature Can Occur Via

Back 10

-Conduction

-Convection

-Radiation

-Evaporation

Front 11

Afebrile

Back 11

withoutfever (98.6°F)

Front 12

Febrile

Back 12

fever(pyrexia) (>100°For 37.8°C)

Front 13

Hyperpyrexia

Back 13

Fever >105.8°F (41.0°C)

Front 14

Hyperthermia

Ex is heat exhaustion or heat stroke

Back 14

Exposureto high temperatures

Front 15

Hypothermia

Back 15

Exposure to low temperature (<95°For 35°C)

Front 16

Methods of taking temp

Back 16

1. Oral

2. Axillary

3. Tympanic

4. Rectal

5. Temporal

Front 17

Pulse

Back 17

- The“wave” that begins when the left ventricle contracts and ends when theventricle relaxes

- Eachcontraction forces blood into the already-filled aorta, causing increasedpressure within the arterial system

Front 18

Systole

Back 18

is the peak of the wave, or contraction of the heart

Front 19

Diastole

Back 19

is resting phase of the heart

Front 20

CommonPulse Sites

Back 20

- Apical:At the apex of the heart–Most accurate (taken for a full minute)

- Temporal:used when radial not accessible

- Carotid:used in cardiac arrest

- Brachial:measured BP

- Radial:used for pulse rate assessment

- Femoral:determines leg circulation

- Popliteal:determines leg circulation

- Posteriortibialis: determines foot circulation - Dorsalispedis:determines foot circulation

Front 21

PeripheralPulse Assessment

Back 21

•Strength:

–Absent or 0

–Weak or 1+ (may also be thready)

–Strong or 2+

–Bounding or 3+

•Equality:

–Equal strength bilaterally

–Weaker than opposite side

Front 22

Normal pulse

Back 22

60–100bpm(beats per minute)

Front 23

Bradycardia

Back 23

Rate <60bpm

Front 24

Tachycardia

Back 24

Rate>100 bpm

Front 25

TerminologyRelated to Normal Apical Pulse

Back 25

- S1: as the ventricular contraction begins,the tricuspid and bicuspid valves (AV valves) slam shut; the first heart sound;the longer, lower-pitched sound; the lubb of “lubb dupp”

- S2: as the ventricles begin relaxation,the pulmonary and aortic valves (semilunarvalves) close; a shorter, sharper sound; the dupp of “lubb dupp”

Front 26

Respiration

Back 26

- Theexchange of oxygen and carbon dioxide in the body

- Twoseparate processes

1. Mechanical

2. Chemical

Front 27

Mechanical

Back 27

- Pulmonary ventilation; breathing

- Active movement of air in and out of therespiratory system

Front 28

Chemical

Back 28

- Transport of oxygen and carbon dioxidethroughout the body

- Exchange of gases between capillaries andtissues

Front 29

Normal Respiration rate (Eupnea)

Back 29

between the rate of 12 and 20breathsper minute

Front 30

Apnea

Back 30

respirations cease or are absent

Front 31

Bradypnea

Back 31

respiratory rate below 12/minute

Front 32

Tachypnea

Back 32

respiratory rate above 20/minute

Front 33

Dyspnea

Back 33

labored or difficult breathing

Front 34

Stertorous

Back 34

noisy, snoring, labored respirations that are audible without a stethoscope

Front 35

Hypoxemia

Back 35

decreased oxygen level in blood

Front 36

Hypoxia

Back 36

decreased oxygen level in tissues

Front 37

Orthopnea

Back 37

difficulty breathing unless in upright position

Front 38

Stridor

Back 38

an audible high-pitched crowing sound that results from partial obstruction of the airways

-sometimes heard without stethoscope

Front 39

Factorsto Assess Regarding Respiratory Rate

Back 39

- Rateper minute

- Depth

- Rhythm

- Pattern

- Respiratoryeffort

Front 40

AbnormalBreath Sounds

Back 40

- Wheezes-->they need Nebs or MDIs (metered dose inhaler)

- Crackles or rales-->Think fluid removal

- Rhonchi(low pitch rattling)-->Encourage coughing and deep breathing

- Stridor-->Sometimes heard without use ofa stethoscope

Front 41

Wheeze

Back 41

high-pitched continuous musical sounds, usually heard on expiration

Front 42

Rhonchi

Back 42

low-pitched continuous sounds caused by secretions in the large airways

Front 43

Crackles

Back 43

discontinuous sounds usually heard on inspiration; may be high-pitched popping sounds or low-pitched bubbling sounds

Front 44

Stridor

Back 44

a piercing, high-pitched sound heard primarily during inspiration

Front 45

Stertor

Back 45

labored breathing that produces a snoring sound

Front 46

PulseOximetry

Back 46

- Noninvasive

- Estimatesarterial blood oxygen saturation (SpO2)

- Detectshypoxemia before clinical signs and symptoms

Front 47

Normal Pulse Oximetry

Back 47

SpO2 95-100%; < 70% life threatening

Front 48

fahrenheit to celsius

Back 48

T(°C) = (T(°F) - 32) × 5/9 -or-

T(°C) = (T(°F) - 32) / 1.8

Front 49

celsius to fahrenheit

Back 49

T(°F) = T(°C) × 9/5 + 32 -or-

T(°F) = T(°C) × 1.8 + 32