Adult Health I Chap 32: Vital Signs (Potter & Perry 7Th Ed.)

Front 1

Asepsis

Back 1

Free of living pathogenic microorganisms

Front 2

List Vital signs

Back 2

Temp
BP
HR
RR
SpO2

Front 3

Normal Adult Temp Range (oC & oF)
Avg. Oral
Avg Rectal
Avg Axillary

Back 3

36-38 oC (98.6-100.4 oF)
37 (98.6)
37.5 (99.5)
36.5 (97.7)

Front 4

Noraml Adult HR Range

Back 4

60-100 / min

Front 5

Normal Adult RR Range

Back 5

12-20

Front 6

Normal Adult BP Range

Back 6

avg: <120/80

(30-50 mmHg)

Front 7

job of the hypothalmus

Back 7

controls body temp (thermostat)

Front 8

mechanisms of heat loss (3)

Back 8

vasodilation
sweating
inhibition of heat production

Front 9

Basal Metabolic Rate (BMR)

depends on: (2)

Back 9

Heat produced by body at absolute rest

1) Body surface area
2) Thyroid hormones (> = > BMR)

Front 10

Shivering > heat production by ___(range)_____ X normal

Back 10

4-5 times normal

Front 11

Radiation

Back 11

xfer of heat from body surface to other surface W/OUT direct contact

Front 12

Conduction

Back 12

xfer of heat WITH direct contact

Front 13

Convection

Back 13

xfer of heat by air movement

Front 14

how many mls evaporates from skin and lungs every day?

Back 14

600-900 mls/day

Front 15

Diaphoresis

Back 15

Visible perspiration (ususally on head and upper thorax)

Front 16

person's ability to control body temp depends on: (4)

Back 16

1) degree of temp extreme
2) ability to sense comfort
3) thought process/emotions
4) mobility (taking off clothes,etc)

Front 17

Factors affecting body temp (7) and relevant details

Back 17

1) Age (drops w/age)
2) Exercise (raises it)
3) Hormone level (women = more fluctuations)
4) Circadian Rhythm (chngs ~1 oC during 24 hrs)
5) Stress (< stress = < temp & metabolism
6) Environment (4 infants & elderly)
7) Temp alterations (fever,etc = chng hypothalmic set point)

Front 18

Normal Newborns's temp range?

Back 18

35.5-37.5 oC (95.9-99.5 oF)

Front 19

newborn looses _____?____% of heat through its head?

Back 19

30%

Front 20

temp reg. is irregular in kids until ____?____.

Back 20

puberty

Front 21

Human temp lowest btwn _____ & ______

Back 21

1 & 4 am

Front 22

Human temp highest at _____

Back 22

6 pm

Front 23

Pyrexia

Back 23

fever - heat loss mechanisms can't keep pace with excess heat production

Front 24

Pyrexia not harmful unless?

Back 24

temp above 39 oC (102.2 oF)

Front 25

Phases of Pyrexia (4)

Back 25

1) chills: pyrogens trigger immune sys, <temp = chills

2) Plateau: patient warm & dry

3) Flushed: vasodilation & diaphoresis

4) Afebrile: fever "breaks"

Front 26

Body's metabolism up _____% for every oC of up temp

Back 26

10%

Front 27

cellular hypoxia

Back 27

inadequete oxygen

Front 28

angina

Back 28

chest pain

Front 29

malignant hypothermia

Back 29

hereditary condition of uncontrolled heat production (when person get anethetic drugs)

Front 30

hyperthermia results from____

Back 30

overload of body's thermo reg mechanisms

Front 31

Those at risk for heatstroke ?

Back 31

very young
very old

cardio disease
hypothyroidism
diabetes
alcholism
on certain meds
those who exercise/work strenuously

Front 32

heatstroke vitals?
(temp & 4 signs)

Back 32

45 oC (113 oF)
hot, dry skin
no sweating
unconscious
fixed pupils

Front 33

Heat exhaustion

Back 33

profuse diaphoresis leads to excess H2O & electrolyte loss

Front 34

Hypothermia

Back 34

temp of 34 - <30 oC (3 stages)

Front 35

Frostbite signs

Back 35

white, waxy, firm to the touch

Front 36

How convert oF to oC?

Back 36

(F - 32) x 5/9

Front 37

How convert oC to oF?

Back 37

(9/5 x C) + 32

Front 38

Afebrile

Back 38

When a fever "breaks"

Front 39

Advantages of electronic thermometers? (3)

1 disadvantage?

Back 39

1) fast
2) easy to read
3) harder to break (good for kids)

1) expense

Front 40

if patient is lying on 1 side, use ____ ear for tympanic temp

Back 40

upper

Front 41

List those who shouldn't have oral temp taken?

Back 41

1) infants & small children
2) confused, unconscious, uncooperative

After:
1) oral surgery
2) Trauma
3) history of epilepsy
4) shaking chills

Front 42

advantages of oral temp?

Back 42

1) easy
2) comfortable
3) accurate
4) shows rapid change in core temp
5) reliable with intubated patients

Front 43

What methods are used to get newborn temps?

Back 43

Tympanic
Temporal artery
Skin strips

Front 44

Antipyretics

Back 44

Anti-fever drugs

Front 45

Interventions for patients with fever

Back 45

1) get blood cultures if ordered
2) min heat production (don't make them move)
3) max heat loss (remove clothes but not to shivering)
4) O2 therapy
5) fluids
6) control room temp

Front 46

Interventions for heatstroke

Back 46

1) move patient to cooler place
2) remove excess clothing
3) lay wet/cold towels on skin
4) use a fan
5) IV fluids
6) Irrigate stomach & bowel with cold liquid

Front 47

Interventions for Hypothermia

Back 47

1) remove wet clothes - replace with dry
2) wrap patient in blankets
3) lay skin to skin
4) drink hot liquids if conscious
5) cover head and neck

Front 48

Cardiac Output

Back 48

Blood pumped by the heart in 1 minute

Front 49

As heart rate increases, without change in stroke volume, BP will _____

Back 49

decrease

Front 50

Most common sites for HR assessment?

Back 50

radial
apical

Front 51

Best site to find infant's/child's HR?

Back 51

brachial or apical

Front 52

List the 5 "strength of pulse" names

Back 52

1) bounding
2) full
3) normal
4) diminished
5) absent

Front 53

Tachycardia

Back 53

apical pulse of more than 100 beats/minute

Front 54

Bradycardia

Back 54

Apical pulse rate of less than 60 beats/minute

Front 55

Normal HR ranges:
Infant
Toddler
Preschooler
School-age kid
Adolescent
Adult

Back 55

120-160
90-140
80-110
75-100
60-90
60-100

Front 56

Pulse deficit

Back 56

Difference between the apical and radial pulses

Often associated with abnormal rhythms

Front 57

dysrhythmia

Back 57

abnormal heart rhythm

An interval interrupted by an early or late beat or missed beat

Front 58

Sinus Dysrhythmia

Back 58

HR speeds with inhale, slows with exhale

Normal in kids

Front 59

Do Epinepherine, asthma, and COPD increase or decrease HR?

Back 59

increase

Front 60

Do negative chronotropic drugs (digitalis), beta-andregenic drugs and calcium channel blockers increase or decrease HR?

Back 60

decrease

Front 61

Respiration involves 3 processes:

Back 61

1) Ventilation (movnt of gases)
2) diffusion (movnt of O2 and CO2 btwn alveoli and RBCs)
3) perfusion (distribution of RBCs to & from pulmonary capillaries)

Front 62

What 3 things do you asses when taking respiratory rate?

Back 62

R Rate
R depth
R rhythm

Front 63

Normal RR ranges:

Newborn
Infant (6 months)
Toddler (2 yrs)
Child
Adolescent
Adult

Back 63

30-60
30-50
25-32
20-30
16-19
12-20

Front 64

Most important factor in control of Respiration?

How?

Back 64

level of CO2 in arterial blood

More CO2 = higher RR and depth

Front 65

hypoxmia

Back 65

low levels of arterial O2

Front 66

you breathe in ______mL of air during a normal, relaxed breath

This is called your __________

Back 66

~500 mL

Tidal volume

Front 67

Eupnea

Back 67

Normal, unlabored respiration

"resting breath"

Front 68

Drop in RR after head trauma indicates?

Back 68

injury to brain stem

Front 69

RR increase or decrease with anxiety?

Back 69

increase

Front 70

RR increase or decrease with smoking?

Back 70

increase

Front 71

RR increase or decrease with straight, erect posture?

Back 71

increase

Front 72

RR increase or decrease with opioid analgesics (general anesthetics, sedatives)?

Back 72

decrease

Front 73

RR increase or decrease with Cocaine or amphetamines?

Back 73

increase

Front 74

RR increase or decrease with anemia? (decreased hemoglobin levels)

Back 74

increase

(b/c the hemo can't carry as much O2 as you require, so you ahve to breathe more)

Front 75

RR increase or decrease with higher altitude?

Back 75

increase

Front 76

RR increase or decrease with abnormal blood cell disease (sickle-cell)?

Back 76

increase

Front 77

hyperpnea

Back 77

labored, deeper, faster breathing (RR > 20/minute)

Front 78

Apnea

Back 78

respiration stops for several seconds

Front 79

Cheyne-Stokes Respiration

Back 79

Hyperventilation & apnea switch off

RR & depth are irregular

Front 80

Kussmaul;s respiration

Back 80

abnormally deep, regular, fast

Front 81

Biot's respiration

Back 81

Shallow for 2-3 breaths, then irregular apnea

Front 82

Men and children tend to show more ___________ breathing than women

Back 82

diaphragmatic

women often use thoracic muscles instead - not efficient

Front 83

Normal SaO2?

Back 83

95-100%

Front 84

SaO2
SvO2
SaO2

SpO2

Back 84

saturation of hemoglobin
saturation of venous blood
saturation of arterial blood

pulse saturation

Front 85

SpO2's are less accurate when they are below _____%

When below, what action to take?

Back 85

70%

Move pulse Ox to earlobe - more accurate at lower saturations

Front 86

List interferences with the Pulse Ox (6)

Back 86

1) outside light
2) patient motion
3) Jaundice
4) intravascular dyes
5) nail polish
6) darker skin pigment

Front 87

Report an SpO2 reading lower than ____%

Back 87

90%

Front 88

Systolic pressure

Back 88

the maximum pressure exerted by the heart on the blood

Front 89

diastolic pressure

Back 89

the pressure of the blood remaining in the arteries after heart relaxes

Front 90

pulse pressure

Back 90

difference between the systolic and the diastolic

Front 91

Normal adult circulating blood volume?

Back 91

~ 5000 mL

Front 92

hematocrit

Back 92

% of RBCs in the blood

Front 93

When arteries are less elastic, systolic pressure is _____ more than diastolic

Back 93

elevated

Front 94

Normal BP in:

infant
1 mnth
1 yr
6
10-13
14-17
>18

Back 94

40
85/54
95/65
105/65
110/65
120/75
<120/80

Front 95

BP classifications:

Normal
Prehypertension
Stage 1 hypertension
Sage 2 hypertension

Back 95

<120 <80
120-139 80-89 (or)
140-159 90-99 (or)
>160 >100 (or)

Front 96

Stress ______ HR, Cardiac output, and vascular resistance

Back 96

increases

Front 97

hypertension is __________ in African Americans

Back 97

more common

Front 98

African Americans are _______ to get strokes or heart attacks

Back 98

more likely

Front 99

Anxiety raises BP as much as ______

Back 99

30 mm Hg

Front 100

After puberty, males have _______ BP females

After menopause, women have ___________ BP than men

Back 100

higher

higher

Front 101

blood pressure is highest between the times of _____________

Back 101

10 am - 6 pm

Front 102

Before measuring BP, ask if patient taking _____(4)___

Back 102

1) antihypertensives (increase BP)
2) opioids (lower BP)
3) vasoconstrictors (increase BP)
4) other cardiac meds (increase BP)

Front 103

If patient measured as having high BP, schedule another aptmnt in _______

Back 103

within 2 months

Front 104

Hypotension

indicates what?

Back 104

90 mmHg and lower

abnormal finding associated with illnes

Front 105

Hypotension can occur because? (3)

Back 105

1) dilation of the arteries in vascuar bed
2) loss of substantial amount of blood
3) failure of heart to pump adequately

Front 106

Hypotension associated with ___(6)___ is life threatening.

Back 106

1) pallor
2) mottled skin
3) clamminess
4) confusion
5) increased heart rate
6) decreased urine output

Front 107

Orthostatic hypotension

Back 107

hypotension that happens only when standing up

Front 108

Who is at risk for orthostatic hypotension? (4)

Back 108

1) dehydrated
2) anemic
3) have been on long bed rest
4) had recent blood loss

Front 109

can you delegate the taking of orthstatic BP measurements?

Back 109

no

Front 110

How do diuretics affect blood pressure?

Back 110

lower BP b/c lowers blood volume

by reducing reabsorption of H2O and sodium by kidneys

Front 111

How do Beta-andregenic blockers affect BP?

Back 111

Lower BP by reducing HR & cardiac output

B/c block restores sympathetic nerve impulses

Front 112

How do ACE inhibitors affect BP?

Back 112

lowers BP

by blocking conversion of Angiotensin I to II
prevents vasoconstriction
lowers blood volume

Front 113

How do ARBs affect BP?

Back 113

Lowers BP

by blocking binding of angiotensin II , which prevents vasoconstriction

Front 114

Invasive BP monitoring is used in ____ settings.

Back 114

intensive care

Front 115

in critically ill patients, its important to _____.

Back 115

compare BP in both arms/legs

Front 116

If unable to get BP reading,____

Back 116

try the doppler instrument to get the systolic only

Front 117

2 types of sphygmomanometers

Back 117

1) aneroid
2) mercury

Front 118

There is usually a difference of _____mmHg in BP between the arms

Back 118

5-10 mmHg

Front 119

the diastolic pressure is signalled by?

Back 119

the 5th korotkoff sound, or the disappearance of the heartbeat.

Front 120

if you deflate BP cuff to slowly, you may get_____

Back 120

false high Diastolic reading

Front 121

if you repeat BP readings too quickly, you may get ____

Back 121

a false high systolic reading

Front 122

do you ever need to record the #s for the other Karotkoff sounds?

Back 122

in patients with hypertension, the 4th korotkoff sound is beneficial

Front 123

can the measurement of BP by palpitation be delegated?

What kind of reading do you usually get?

Back 123

no - it is too difficult

only the systolic

Front 124

auscultory gap

Can cause?

Back 124

the temporary disappearance of sound and then the re-emergence of heartbeat while measuring BP

Underestimate systolic &
Overestimate diastolic

Front 125

BP in legs is measured for____?

Measurements tend to be___

Back 125

those with cardiac/BP abnormalities/too much stuff on arms

systolic 10-40 mmHg higher diastolic stays the same

Front 126

elctronic BP devices useful when?

their disadvantages?

Back 126

critically ill, unstable, or if BP requires frequent monitoring

easily screwed up with interference/make errors easily

Front 127

hypoxemia

Back 127

decreased partial pressure of oxygen in the blood

Front 128

what is the least invasive, most accurate method of obtaining the core temp rate?

Back 128

temporal artery

Front 129

Hypertension is diagnosed after___?

Back 129

2 separate readings, usually ~2 weeks apart