Vital Signs Flashcards

Question

What things could raise BP?

Answer 1

the supine position may elevate the blood pressure readings by as much as 8 mmHg. If the back is not supported or if the legs are crossed, the readings may also be significantly elevated. If the arm is supported below the level of the heart or the arm is not supported so that the patient must use isometric exercise to maintain the position of the arm, the blood pressures will be elevated. If the arm is supported above the level of the heart, the blood pressure readings will be falsely low. Variations in room temperature, state of patient activity, alcohol or nicotine consumption, caffine intake, bladder distension, talking and background noise may all contribute to significant deviations in measured blood pressures.

Answer 2

T. The “ideal” cuff should have a bladder length that is 80% and a width that is at least 40% of the arm circumference. Ex. For arm circumference of 22 to 26 cm, the cuff should be “small adult” size: 12X22 cm

Answer 3

Phase 1 (systolic) and phase 5 (diastolic) Korotkoff sounds are best heard using the bell of the stethoscope over the palpated brachial artery in the antecubital fossa. Excessive pressure on the bell of the stethoscope will cause the blood pressure to be read lower than it actually is.

Answer 4

The white coat effect occurs when the blood pressure recorded by a physician or nurse is higher than the reading done without the physician or nurse present. When patients take their blood pressures at home (ambulatory monitoring), blood pressures may often be normal.

Answer 5

Within 3 minutes from lying or sitting to quiet standing: - Decrease in Systolic blood pressure of 20mmHG - Decrease in Diastolic blood pressure of 10mmHG - Increase in Heart Rate of 20 Can be seen in early or chronic phases of blood loss or dehydration. Should test when someone presents with symptoms of dizziness, light-headedness, but vital signs are normal

Answer 6

Hyperpnea is an increased depth of breathing, usually associated with metabolic acidosis. It is also known as Kussmaul’s breathing.

Answer 7

High BMIs are associated with cardiac disease, Type II diabetes, increased mortality from cancer and many others. Body fat distribution is also important in assessing the patient’s risks for disease. An increased waist circumference indicates increased risk as opposed to a pear shape body with increased hip size. Waist circumferences for men > 102 cm (40 inches) and for women > 88 cm(35 inches) is considered upper body obesity.

Answer 8

o Diurnal variation: minimum at 6AM, highest at 4 – 6 PM • Can fluctuate from 0.5 – 2 oF o Menstruation: morning temps are generally lower during the 2 weeks prior to ovulation, with a further drop just prior to ovulation, followed by a subsequent rise coincident with ovulation. o Age: • baseline temperature is lower in the elderly • Infants and young children generally have higher temperatures than older children and adults. This relates to the greater surface-area-to-body-weight ratio and the higher metabolic rate of infants and small children. • For each decade increase in age, average temperature in adulthood decreases by 0.08°C (0.14°F)

Answer 9

pulmonary artery

Answer 10

neutropenic

Answer 11

Fever is characterized by a resetting of the thermoregulatory center of the hypothalamus to maintain a higher core body temperature in response to endogenous (pyrogenic cytokines) ± exogenous pyrogens Hyperthermia is an abnormal elevation of body temperature that occurs without a change in the hypothalamic thermoregulatory set point.

Answer 12

Fever in adults is generally defined as temperature in excess of the 99th percentile of maximum oral temperature for healthy adults. This is a morning temperature of 37.2 oC (98.9 oF) or an evening temperature of 37.7 oC (99.9 oF). In practice, a value of 100 oF or more is generally considered a fever.

Answer 13

fever over 41.5C (106.7F)- usually due to CNS hemorrhage

Answer 14

increased metabolic rate, water loss, pulse, RR, decreased Fe and Zn availability

Answer 15

little variation (up to 0.5 F) from day to day Classic example: lobar pneumonia

Answer 16

temperature returns to normal between exacerbations • Classic example: malaria • Quotidian: exacerbations daily • Tertian: recurs every 48 hours (i.e., fever is seen every third day) • Quartan: every 72 hours (i.e., q4th day)

Answer 17

Vary at least 0.5 oF each day, but do not return to normal. • Classic example: typhoid fever

Answer 18

(Pel-Ebstein): periods of fever lasting days interspersed by equally long afebrile periods • Hodgkin’s disease

Answer 19

Intermittent or remittent fevers with wide swings in temperature, usually greater than 2.5 oF per day. Classic example: pyogenic abscess

Answer 20

o Seriously ill newborns o Elderly patients o Uremic patients o Patients receiving antipyretic treatment (steroids, NSAIDs, etc) o Immunocompromised patients (e.g., HIV, neutropenia, immunosuppressant medications) Note that hypothermia can occur in response to infection, especially overwhelming infections such as septic shock. When observed in this setting, hypothermia predicts worse clinical outcomes.

Answer 21

* Classically occurs 7-10 days after the introduction of the drug * Therefore, drug histories should always include recently administered drugs, not just current * Fever pattern may be sustained * Skin rash not common * Peripheral eosinophilia not common * Absence of systemic manifestations

Answer 22

Fever is a sign of underlying disease. Treatment of a fever should not be confused with treatment of the underlying cause. Diagnosis and treatment of the cause of the fever is the primary goal.

Answer 23

• Hyperthermia is an elevation of core body temperature occurs secondary to excessive heat production or exposure and/or inadequate heat loss (heat stroke, malignant hyperthermia, hyperthyroidism) o Does not involve pyrogens and the hypothalamic thermoregulatory set point is unchanged. o Can be rapidly fatal and does not respond to antipyretic agents o Diagnosis is usually suggested by preceding events, such as heat exposure or treatment with drugs known to interfere with thermoregulation • Clinical syndromes include: • exposure (heat stroke), • malignant hyperthermia (anesthetics and muscle relaxants), • drug intoxications (anticholinergics, adrenergics [including drugs of abuse]), • neuroleptic malignant syndrome (major tranquilizers), • serotonin syndrome

Vital Signs Flashcards

(49 cards)