Red Flags, Vitals, and Lines

Question 1

What can vital signs give us info on?

Answer 1

• how a person’s cardio/pulmonary system and status as well as how other systems are working
• how a person is responding to exercise and therapy

Question 2

What are normal ranges for adults? (BP, RR, HR, O2)

Answer 2

BP: 120/80
RR: 12-20 breaths per minute
HR: 60-100 beats per minute, average 60
O2: 100%

Question 3

What is blood pressure?

Answer 3

the force that blood exerts on a vessel wall

Question 4

Pressure is highest in ______ than _____

Answer 4

arteries (top number)

veins (bottom number)

Question 5

What is the control center for blood pressure?

Answer 5

lower pons and upper medulla

Question 6

What factors influence blood pressure?

Answer 6

• blood volume
• diameter and elasticity of the arteries
• cardiac output
• age
• physical activity
• Valsalva maneuver
• orthostatic hypotension

Question 7

What is hypertension? (range)

Answer 7

> 140/90

Question 8

What is prehypertension? (range)

Answer 8

129-130/80-89

Question 9

What is hypotension? (range)

Answer 9

systolic less than 100

Question 10

What is a medical emergency for BP?

Answer 10

> 180/110

Question 11

What is respiratory rate?

Answer 11

functions to supply the body and organs with oxygen and remove carbon dioxide

Question 12

What are some factors that can impact RR?

Answer 12

• age
• body size and structure
• exercise
• body position
• environment
• stress
• pharmacology

Question 13

What is heart rate measuring?

Answer 13

wave of blood in the artery created by contraction of the left ventricle during a cardiac cycle

Question 14

What is pulse?

Answer 14

when the blood is forced out of the heart into a systemic system

Question 15

What is bradycardia?

Answer 15

slow heart rate, below 60 bpm

Question 16

What is tachycardia?

Answer 16

fast heart rate, greater than 100 bpm

Question 17

What are some factors that can influence HR?

Answer 17

• age
• gender
• stress
• exercise
• medications
• heat and fever

Question 18

What is intracranial pressure?

Answer 18

the pressure exerted by fluids inside the skull and on the brain tissue

Question 19

What can happen if ICP is too high?

Answer 19

brain can herniate

Question 20

What are signs of high ICP?

Answer 20

vomitting, headache

Question 21

What is normal ICP?

Answer 21

4-15 mmHg

Question 22

What is mild hypertension ICP?

Answer 22

20-30 mmHg

Question 23

What is severe hypertension ICP?

Answer 23

> 39 mmHg

Question 24

What is hemoglobin measuring?

Answer 24

the amount of hemoglobin in RBCs that transports O2 throughout the body

Question 25

What are hemoglobin norms for males?

Answer 25

14-17 g/dL

Question 26

What are hemoglobin norms for females?

Answer 26

12-16 g/dL

Question 27

What are the exercise restrictions on hemoglobin?

Answer 27

< 8 g/dL no exercise 8-10 g/dL light exercise >10 g/dL resistive exercise

Question 28

What is hematocrit measuring?

Answer 28

% of RBCs throughout body

Question 29

What are norms of hematocrit for males?

Answer 29

40-51%

Question 30

What are norms of hematocrit for females?

Answer 30

36-47%

Question 31

What are the exercise restrictions on hematocrit?

Answer 31

< 25% no exercise > 25% light exercise > 35% resistive exercise

Question 32

What does the international normalizing ratio (INR) measure?

Answer 32

how well your blood clots

Question 33

What is normal INR?

Answer 33

.8-1.2

Question 34

WHat are the exercise restrictions with INR?

Answer 34

4: no increase in intensity 4-5: no resistance 5-6: no exercise >6: bed rest

Question 35

What are the red flags of vitals?

Answer 35

- BP > 180/90 mmHg - Labored breathing - O2 less than 90% - ICP > 39 mmHg - anemia: hemoglobin < 8 g/dL - when in double ALWAY ask and seek MD guidance

Question 36

What does an arterial catheter measure?

Answer 36

arterial blood pressure in real time

Question 37

Where does the arterial catheter go?

Answer 37

directly in the artery

Question 38

Is an arterial catheter or BP more accurate?

Answer 38

Arterial catheter

Question 39

What will happen if the arterial catheter is pulled?

Answer 39

Heavy bleeding, physicians have to replace it

Question 40

What can be limited depending on placement of the arterial catheter?

Answer 40

ROM (hip or wrist) - in the hip limit to 60-80 degrees of hip flexion, which may limit the ability to sit

Question 41

What does an external ventricular drain measure?

Answer 41

ICP

Question 42

What does an external ventricular drain... drain?

Answer 42

CSF

Question 43

What needs to be done before mobilizing a patient with a EVD?

Answer 43

consult with healthcare

Question 44

What is a bolt?

Answer 44

real time measure of ICP - hole drilled into the skull to measure

Question 45

What kind of patient typically has a bolt?

Answer 45

TBI

Question 46

What should we know about patients with Bolts?

Answer 46

typically too unstable to mobilize so PROM may be only option

Question 47

Why are patients with a bolt unable to participate in movement?

Answer 47

low GCS

Question 48

What is a swan-ganz catheter?

Answer 48

inserted into the neck and goes down large vein through the vena cava into the right atrium

Question 49

What does a central venous catheter (central line) do?

Answer 49

delivers medication directly into the circulatory system

Question 50

What is a peripherally inserted central catheter (PICC)?

Answer 50

peripherally inserted into the vein and goes directly to heart. Used with longer course antibiotics.

Question 51

Should we pull on central or PICC lines?

Answer 51

NO

Question 52

What can pulling a central line cause?

Answer 52

arrhythmias or pneumothorax

Question 53

What is a ventalator?

Answer 53

- used for people who cannot breathe on their own - usually and endotrachial tube

Question 54

When do patients usually get a tracheostomy?

Answer 54

if on vent for more than 14-21 days - the tube goes to a hole in their neck directly itno the trachea

Question 55

What do patients with a vent or trach have an increased likelihood to do?

Answer 55

de sat - watch O2!

Question 56

If vent settings are high, high risk of ________

Answer 56

barotrauma

Question 57

Vents are not very ____

Answer 57

portable

Question 58

What is a high flow nasal cannula?

Answer 58

a way to give high amounts of oxygen to a patient without intubating

Question 59

What should we consider with a high flow nasal cannula?

Answer 59

how much buffer room - can mobilize if they are not near max settings that would tax cardiopulmonary system

Question 60

What is the next step after a high flow nasal cannula?

Answer 60

intubation

Question 61

What is a fecal management system?

Answer 61

collects fecal matter into a bag and ofter with c-diff

Question 62

What is a foley catheter?

Answer 62

urine collection and gravity dependent - can be foley, external or suprapubic

Question 63

Why could an SCI have problems with a foley catheter?

Answer 63

can often be noxious and cause autonomic dysreflexia

Question 64

Why do we not want to pull a Foley catheter?

Answer 64

messy, easy to pull, hurts

Question 65

What should we do with a foley catheter when performing PT?

Answer 65

keep below waistline

Question 66

What is a nasogastric tube?

Answer 66

through the nose to stomach feeding tube, short term solution

Question 67

What is a percutaneous endoscopic gastrostomy (PEG)?

Answer 67

directly into the abdomen feeding tube, and a long term solution, common in patients with more severe injuries

Question 68

If someone has a feeding tube they are likely _____

Answer 68

NPO

Question 69

When is a feeding tube easy to pull?

Answer 69

when the patient is aggitated