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21 Cards in this Set
- Front
- Back
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Vital Signs: 4 Cardinal Signs "provide basline assessment, reflect the body's status
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Temperature
Pulse Respirations Blood Pressure |
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State the Temperature Rationales:
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To determine if core temperature is within normal range
To provide baseline data for further evaluation To determine alterations in disease conditions |
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Temperature Assessment:1-5
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To determine; most appropriate method to obtain temp ie: oral, rectal axillary or tympanic (ear).
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Temperature Assessment:2-5
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Determine number of times temperature is to be taken daily.
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Temperature Assessment:3-5
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Track temp. fluctuation relative to time of day and age of client.
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Temperature Assessment: 4-5
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Compare with other vital signs to establish baseline data
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Temperature Assessment: 5-5
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Determine amount of time since client has ingested hot or cold liquids or has smoked.
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Fever is considered to be any abnormal elevation of body temperature (over 100.8*F-38.2*C?)
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Symptoms of Fever Include:Perspiration over the body surface, body warm to touch, chills and shivers, flushed face, convulsions in children especially, c\o malaise and fatigue, parched lips and dry skin
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Where is the temperature regulating centre in one's body?
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Hypothalamus-keeps CORE temperature constant.
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What are temperature receptors, and what are their responsibility
Temperature receptors? |
determine if the body is too hot or too cold, relay signals to the hypothalamus.
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what is a pulse deficit?
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When the peripheral pulse is weak, if felt, or skipped so that the radial pulse rate is less than the apical rate. The pulse wave is influenced by the elasticity of the larger vessels, blood volume, blood viscosity, and arteriolar and capillary resistance.
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When is CORE Temperature maintained?
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Core temp. is remained when: heat production = heat loss
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Temperature Receptors-Too Hot\Too Cold-Hypothalamus-Body Over heats (hyperthermia)- con't over-
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-Heat Sensitive neurons-Stimulate sweat glands-fluid released (sweat)-Heat Loss via evaporation-Cools
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Too hot-reduced vasoconstriction-^blood flow from core to surface-heat loss (via radiation and conduction)
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Heat production is stimulated by shivering and increase cellular metabolism.
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What is Hyper\Hypothermia?
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Hypothermia-a body temperature below the average normal range
Hyperthermia-" "much higher than normal range. |
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What is Set Point?
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the critical temp @ which the regulatory mechanisms "switch on" in an attempt to mnt'n CORE TEMP
Below S.T:heat-conserving and heat producing mech. are in action Above S.T: heat losing mechanism attempt to maintain temp |
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When is your temp. highest?
When is your body temp. lowest? this is called: CIRCADIAN |
H- 5-7pm
Low- 2am-6am |
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Pulse: is the index of the heats rate and rhythym.
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Apical pulse: the # of heart beats\min
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What is a Pulse Deficit?
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Apical - Radial Pulse +Pulse deficit. P.D can be noted in any situation where periperal is caused to be weak ex: irregular heart beat.
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What is the pulse wave influence by?
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Elasticity
Blood Volume Blood Viscosity Arteriolar\Capilary resitance |
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Pulse Rationales:
*determine if P.R is within normal range and if rhythym is regular *monitor and evaluate changes in client's status *reflect functioning of vital organs |
*Evaluate quality of corresponding arterial pulses
*Monitor and evaluate amplitude and contour of pulse wave and artery elasticity |
