Intro to Vital Signs Lecture

Question 1

5-6 vital signs

Answer 1

1) Temp
2) Blood pressure
3) Respiration rate
4) Heart Rate
5) BMI
6) SOMETIMES Pulse ox

Question 2

Examples of what causes weight loss despite high food intake

Answer 2

• Diabetes mellitus
• Hyperthyroidism
• Bulimia

Question 3

Examples of what causes rapid weight gain

Answer 3

-Suggests changes in body fluid (not tissues), think heart failure

Question 4

Examples of what causes weight loss

Answer 4

• Depression
• Cancer
• drug use
• GI disease

Question 5

Temperature is regulated by the…

Answer 5

…hypothalamus

Question 6

Normal oral temp

Answer 6

98.6F/37c

Question 7

4 ways to measure temp

Answer 7

1) oral
2) Axillary
3) Rectal (patient unconscious, restless, cannot close mouth)
4) Tympanic membrane

Question 8

rectal temp tends to be…

Answer 8

…1 degree higher than oral

Question 9

Tympanic temp tends to be…

Answer 9

…1.4 degrees higher than oral

Question 10

Axillary temp tends to be…

Answer 10

…1 degree lower than oral

Question 11

Hypothermic thermometer

Answer 11

Accurate for temperatures a normal thermometer is not, below 94 degrees F

Question 12

Things that can cause a false reading on temp

Answer 12

• rigorous exercise
• mouth breathing
• smoking
• drinking fluids
• cerumen (ear wax)

Question 13

Noninfectious causes of pyrexia

Answer 13

• ovulation
• thyroid storm
• drug effect
• trauma
• cancer

Question 14

Hyperpyrexia

Answer 14

Fever greater than 104 degrees F, typically resulting from infection

Question 15

Hypothermia

Answer 15

Temp less than 95 degrees F, exposure to cold, shock, hypothyroidism, hypoglycemia

Question 16

2 exceptions to hyperpyrexia and hypothermia

Answer 16

Infants and elderly

Question 17

4 pulse sites and features of them

Answer 17

1) radial (easiest)
2) carotid (have to listen for presence of plaque that could be released by pressure)
3) femoral (inguinal region)
4) apical (on the heart, says nothing about perfusion)

Question 18

Carotid baroreceptor mechanism

Answer 18

Massaging of carotid can cause baroreceptor reflex to stimulate thanks to glossopharangeal nerve that results in a drastic drop in blood pressure and syncope episode

Question 19

Assessment of pulse

Answer 19

1) Rate (50-100 bpm)
2) Rhythm (regular/irregular - count an irregular for a full minute)
3) Correlation to systolic pressure
- carotid means at least 60-70
- radial and femoral means greater than 80mmHg

Question 20

Sinus tachycardia and causes

Answer 20

Rapid regular >100 beats, caused by

• heart disease
• fever
• exercise
• anemia
• dehydration
• hyperthyroidism
• drugs
• smoking

Question 21

Sinus bradycardia and causes

Answer 21

Slow regular <50 bpm, caused by

• heart disease
• hypothyroidism
• irregular electrolytes
• athlete

Question 22

Occasional irregularity

Answer 22

Occasional PAC/PVC, may be normal variation

Question 23

Irregular irregularity

Answer 23

Atrial fib, frequent PVC’s

Question 24

Regular irregularity

Answer 24

Mobitz 1 A/V block

Question 25

Weak pulse reaons

Answer 25

-Shock, MI, aoritc anyeurism

Question 26

Bounding pulse reasons

Answer 26

anxiety, fever, hyperthyroidism, pregnancy, anemia

Question 27

Pulsus alternans and cause

Answer 27

Alternating strong and weak pulse, indicates left ventricular heart failure

Question 28

Pulsus bisferiens and cause

Answer 28

Biphasic pulse, indicates aortic valve problem

Question 29

Dicrotic pulse and cause

Answer 29

2 distinguishable palpable pulses, indicates low cardiac output

Question 30

Pulsus parvus et tardus and cause

Answer 30

Pulse is weak and has late carotid upstroke, caused by aortic valve stenosis

Question 31

Pulsus paradoxus and cause

Answer 31

Typically SBP falls 3-10mm during inspiration, pulse gets weaker, caused by asthma, COPD, etc

Question 32

Regulator of O2 and CO2 in bloodstream

Answer 32

Brainstem - medulla oblongata, pons, midbrain

Question 33

Normal respiratory rate

Answer 33

12-18 per minute in adult

Question 34

Tachypenea and cause

Answer 34

Rapid, shallow breathing, caused by anxiety or restrictive lung disease

Question 35

Hyperpnea and cause

Answer 35

Rapid, deep breathing, caused by exercise, anxiety, infarct

Question 36

Hypopnea and cause

Answer 36

Shallow/infrequent breathing, caused by OSA, smoking, sedatives,

Question 37

Bradypnea and cause

Answer 37

Slow breathing <12bpm, caused by coma, drug induced, respiratory depression, increased ICP

Question 38

Kussmaul and cause

Answer 38

Fluctuating breathing rates, caused by metabolic acidosis

Question 39

Cheyne stokes and cause

Answer 39

Breaths with periods of apnea, seen in head injuries with brain tumors, or strokes

Question 40

Ataxic breathing and cause

Answer 40

Unpredicted irregularity, caused by respiratory depression, brain damage at medullary level

Question 41

Blood pressure

Answer 41

Measured by a sphyngmomanometer, peripheral measurement of cardiovascular function

Question 42

Pediatric vs thigh cuffs

Answer 42

Useful in those with small or extremely large arms

Question 43

Techniques to taking blood pressure

Answer 43

- Remove all garments - Avoid smoking/caffeine 30 min prior - Wait 5 min after sitting - No constriction of proximal arm - Quiet environment - Palpate brachial pulse - Apply cuff 1.5 cm proximal to brachial artery - Lock air vent - Palpate radial and inflate cuff simultaneously - As pulse disappears approaching systolic pressure - First sound is systolic BP, muffled sounds phase 4 korotkoff, disappearance = phase 5 diastolic BP - Take 2 readings, one in each arm

Question 44

Ausculatory gap

Answer 44

Silent period present between blood pressure reading between systole and diastole, indicative of arterial stiffness or carotid stenosis

Question 45

Pulse pressure

Answer 45

Diff between systolic and diastolic pressure

Question 46

Elevated pulse pressure

Answer 46

Greater pulse pressure than 60mmHg, predictor of heart attacks and other CV diseases

Question 47

Narrow pulse pressure

Answer 47

Less pulse pressure than 40mmHg, predictor of shock, cardiac tamponade,

Question 48

Orthostatic measurement

Answer 48

Measure heart rate and BP supine, sitting, and standing, normal variations include 10bpm rise heart rate, 10-15mmHg rise or fall in systolic pressure, 5 mmHg rise or fall in diastolic pressure

Question 49

Orthostatic hypotension

Answer 49

Pulse rising >20bpm, fall in sbp >20mmHg, fall in dbp >10mmHg

Question 50

Most common reason for orthostatic vital sign

Answer 50

-dehydration (hypovolemic)