Vital Signs

Question 1

Why is regular evaluation of weight important?

Answer 1

• Change of weight indicative of volume overload/fluid balance in renal disease, liver disease, congestive heart failure
  
  • Loss of weight could be psychological or physical problem

Question 2

What is weight an indicator of in children/infants?

Answer 2

• overall health and nutrition
• weight loss=dehydration/serious illness in infant

Question 3

Pulse

Answer 3

The pressure of the arterial blood pushing against the wall of an artery as the heart beats and rests

Question 4

Where is pulse felt?

Answer 4

Temporal

Carotid

Brachial

Radial

Femoral

Popliteal

Dorsalis pedis

Question 5

Pulse rate

Answer 5

Number of beats per minute

Varies depending on age, sex, body size

Question 6

Normal Pulse rate for children (1-7, and over 7)

Answer 6

Children 1 to 7: 80-110 bpm

Children over 7: 70-100bpm

Question 7

Normal pulse rate for infants

Answer 7

Infants less than 1: 100-160 bpm

Question 8

What is the normal pulse rate for adults?

Answer 8

60-100 bpm

Question 9

Bradycardia

Answer 9

Pulse rates under 60 bpm

Trained athletes, people in sleep states/coma, under influence depressant drugs, med effects/problems with electrical conduction system of heart

Question 10

Tachycardia

Answer 10

Pulse rate over 100 bpm

Exercise, volume depletion (blood loss or dehydration), anxiety, shock, stimulant meds or illicit substances, fever

Question 11

What does tachycardia usually result from in children?

Answer 11

Fever/dehydration

Question 12

Pulse rhythm

Answer 12

regularity of the pulse or the spacing of beats, i.e. “regular” or “irregular”, should be noted next to pulse rate

Question 13

Respiratory Rate

Answer 13

Measures breathing of patient for one full cycle of inspiration and expiration

Should be observed and recorded without the patient’s knowledge of being watched; character of respirations should be noted too

Question 14

Normal respiratory rates in adults

Answer 14

12-20 rpm

Question 15

Normal respiratory rates in children

Answer 15

16-25 rpm

Question 16

Normal respiratory rates in infants

Answer 16

30-50 rpm

Question 17

Character of respirations

Answer 17

Can be deep, shallow, labored

Question 18

Dyspnea

Answer 18

Difficult or labored breathing

Due to pain, airway obstrution, poor oxygenation

Question 19

Tachypnea

Answer 19

Rapid respiratory rate

Occurs with airway disease, restriction of chest wall, electrolyte imbalances, poisonings, anxiety and exercise

Question 20

What is tachypnea the earliest indication of in otherwise healthy infants/children?

Answer 20

Serious illness

Question 21

Bradypnea

Answer 21

Slow respiratory rate

Due to medications, depressant drugs, supplemental oxygen, brain damage, electrolyte imbalances, obstructive sleep apnea, imminent death

Question 22

Blood pressure

Answer 22

measure of the pressure that the blood exerts on the walls of the arteries as the heart contracts or relaxes

Question 23

Systolic pressure

Answer 23

Pressure that occurs in the walls of the arteries when the heart is contracting and pushing blood into the arteries

(when sound is first heard)

Question 24

Normal systolic pressure for adults

Answer 24

100-130 mmHg

Question 25

Diastolic pressure

Answer 25

constant pressure in the walls of the arteries when the heart is at rest/between contractions Measured when the sounds stop

Question 26

Normal diastolic pressure adults

Answer 26

60-90 mm Hg

Question 27

Pulse pressure

Answer 27

difference between the systolic and diastolic pressure important indicator of the health/tone of arterial walls

Question 28

Normal pulse pressure adults

Answer 28

30-50 mmHg

Question 29

Narrow pulse pressure \<25

Answer 29

Seen in patients whose hearts are unable to pump strongly or are so ill that little blood is circulating

Question 30

Widened pulse pressure

Answer 30

\>50, normal during and after exercise At rest, may be sign of heart disease

Question 31

Hypertension

Answer 31

Blood pressure greater than 140 mmHg systolic or 90 mmHg diastolic on two or more conditions Causes: stress, anxiety, obesity, high salt intake, aging, kidney disease, thyroid deficiency, vascular conditions

Question 32

Factors that temporarily increase blood pressure

Answer 32

excitement, anxiety, nervous tension, stimulant drugs, exercise, eating Cuff too small (false high reading)

Question 33

Hypotension

Question 34

Methods for pulse and respirations

Answer 34

15 seconds x 4 Cuff has to cover 80% of arm circumference and be 2/3 of the distance from soulder to elbow Mark on cuff proximal to brachial artery Patient must be sitting, supine, uncrossed legs for five min or else too high BP

Question 35

Risks of hypertension

Answer 35

stroke, myocardial infarction, heart failure, retinopathy, chronic kidney disease CVD risk at 115/75 doubling with each increase of 20/10

Question 36

Prehypertension

Answer 36

120-138/80-89

Question 37

Patient centered lifestyle modifications of high blood pressure

Answer 37

Reduce BP by 5-20 mmHg per 10kg weight loss Low sodium diet reduces by 2-14 mmH Exercise reduces by 4-9 mmHg Alcohol consumption moderation decreases by 2-4 mmHg