Lecture 2

Question 1

Internationally recognized vital signs

Answer 1

Temperature
Pulse
Blood pressure
Respiration Rate

Question 2

Other vital signs

Answer 2

Pain
Oxygen saturation
perceived exertion
gait speed
PA

Question 3

What can make a vital sign vary?

Answer 3

age, sex, body size, exercise tolerance, and health condition

Question 4

Why are vital signs important to PTs?

Answer 4

establish a baseline
establish goals of treatment & treatment plan
assess patient response to treatment
General knowledge of health status

Question 5

What are the minimum vital signs required for each visit?

Answer 5

blood pressure
heart rate

Question 6

Normal ranges for temperature

Answer 6

96.8 to 99.3 F
Mean: 98.6

Question 7

Normal ranges for respiration

Answer 7

12-20 respirations/minute

Question 8

Normal ranges for pulse

Answer 8

60-100 beats/minute

Question 9

Normal ranges blood pressure

Answer 9

Systolic < 120 mm Hg
Diastolic < 80 mm Hg

Question 10

Hyperthemia

Answer 10

fever, pyrexia > 100F
do not start exercise in person whose body temp is elevated prior to session

Question 11

Hypothermia

Answer 11

< 98.6 F
can start exercise program in person whose body temp is slightly lo prior to treatment

Question 12

Factors that affect body temp

Answer 12

Time of day
menstrual cycle
age
infection
environmental temp
PA
measurement site

Question 13

Time of day & temp

Answer 13

lowest in the early AM
highest late at night

Question 14

Menstrual cycle & temp

Answer 14

highest at ovulation

Question 15

Age & temp

Answer 15

decreases with aging

Question 16

Measurement site & temp

Answer 16

rectal > oral > axilla > ear/forehead

Question 17

Pulse

Answer 17

indirect measurement of left ventricle contraction

measured as movement of blood through an artery via palpation or auscultation

Question 18

Maximal heart rate

Answer 18

decreases with age
220 - age

Question 19

Factors affecting pulse

Answer 19

Age
Sex
ambient temp
infection
emotional state
medications
PA
fitness level

Question 20

Gender & pulse

Answer 20

men have a lower resting heart rate

Question 21

What does RHR tell us?

Answer 21

elevated RHR is linked to hypertension, hypercholesterolemia, hyperglycemia.

all-cause mortality is higher

Question 22

Tachycardia

Answer 22

precedes hypertension (HTN)
increased risk of arrhythmias, increased risk of atherosclerosis

greater than > 100 bpm

Question 23

Brachycardia

Answer 23

< 60 bpm

Question 24

Thready

Answer 24

weak and irregular force

Question 25

full 60 sec pulse

Answer 25

baseline, irregular rhythm, bradycardia

Question 26

RHR measure

Answer 26

patient should be resting for at least 5 minutes before measurements

Question 27

Pulse measurement sites

Answer 27

temporal carotid brachial radial femoral popliteal dorsal pedal posterior tibial

Question 28

Respiratory Rate (RR)

Answer 28

Depth Rhythm Sound (lack of sound indicates healthy)

Question 29

RR Factors

Answer 29

Pathology PA Fitness Emotional Status Altitude Volition (observation can increase)

Question 30

Tachypnea

Answer 30

increased RR

Question 31

Apnea

Answer 31

absence of breathing

Question 32

Dyspnea

Answer 32

labored or difficult breathing. NOT shortness of breath

Question 33

Orthopnea

Answer 33

easier breathing when seated or standing. Difficulty when laying down

Question 34

Causes of orthopnea

Answer 34

heart failure, COPD, sleep apnea, panic disorder

Question 35

Hypoxia

Answer 35

decreased oxygen to tissues

Question 36

Cyanosis

Answer 36

bluish or purplish tinge to skin Notoriously unreliable indicators. Skin pigment Ambient light Observar variability

Question 37

Blood pressure

Answer 37

pressure exerted by the blood on the wall on the blood vessels arterial blood pressure (pressure in large arteries) Pressure of blood in other vessels is lower than pressure in arteries not static, very dynamic

Question 38

Systolic BP

Answer 38

peak pressure in larger arteries

Question 39

Diastolic BP

Answer 39

lowest pressure during resting phase of cardiac cycle

Question 40

Normal & Elevated BP

Answer 40

you have to have BOTH diastolic and systolic within ranges in order to qualify

Question 41

Hypertension, Stage 1 & 2

Answer 41

you can have one or the other within ranges for systolic and diastolic in order to qualify

Question 42

Factors affecting BP

Answer 42

Age Weight Emotional state Exercise/activity Fitness level Arm position

Question 43

Age & BP

Answer 43

increases with age b/c of decreased elasticity and lumen size of blood vessels

Question 44

Exercise & BP

Answer 44

SBP : increases DBP : can stay the same, increase (less than 10 mm Hg), decrease

Question 45

Arm position & BP

Answer 45

level of the right atrium/level of the heart

Question 46

Can BP be determined in one screening?

Answer 46

No. Average of 2 or more readings and 2 or more occasions

Question 47

Korotkoff's sounds

Answer 47

series of sounds heard through auscultation of artery produced as a result of changes in blood flow as cuff is deflated

Question 48

Phase 1 of K's sounds

Answer 48

As the cuff is deflated, pressure level at which the first faint clear tapping sounds are heard, which increases as the cuff is deflated no blood flow through brachial artery

Question 49

Phase 5 of K's sounds

Answer 49

Pressure level when last sound is heard. Diastolic pressure No pressure on brachial artery

Question 50

Cuff Size

Answer 50

width of cuff. Too narrow results in an overestimation of BP Too wide underestimates BP

Question 51

Getting accurate BP

Answer 51

empty bladder support back and feet legs uncrossed Correct cuff size Cuff on bare arm Arm at heart level No talking

Question 52

Pallor

Answer 52

abnormal loss of skin/mucous membrane color

Question 53

Diaphoresis

Answer 53

excessive or unusual sweating