Vital Signs Flashcards
Temperature
- 4-37.5 C (avg. 37.0)
- 5-99.5 F (avg. 98.6)
Compared to oral temp:
Rectal: 1 F or 0.5 C higher
Axillary: 1 F or 0.5 C lower
Pulse
60-100 bpm
Note: Rate, Rhythm, and Strength
HR slows with age; when bp low, PR usually increased; hemorrhage inc HR; 1 min apical for Digoxin, BBlockers, <2 yrs age
Respirations
12-20 breaths/min
Note: Rate, Depth, Pattern, and Sounds
Count for 30 secs. 1 min for irregular respirations or very ill.
Increased RR Causes: Inc level of CO2 or lower O2 level, Pain
Decreased RR Causes: Head Injury; Inc ICP; Opiods, Age
Blood Pressure
120/80
Prehypertension: S: 120-139 or D: 80-89
Stage 1: S: 140-159 or D: 90-99
Stage 2: S: 160+ or D: 100+
Inc. with age; After puberty Male > Female; After menopause Female > Male; Wait 30 mins after smoking or exercising
Orthostatic Changes of bp and Pulse: Measure 1-3 mins after changing positions
Leg: Cuff around thigh and steth on popliteal artery
Oxygen Saturation
95-100%
Sensor: Place on finger, toe, nose, ear lobe, or forehead; will alert to hypoxia prior to clinical signs appearing
Pain Assessment
Acute: Usually associated with an injury, midical condition, or surgical procedure; lasts hours to a few days
Chronic: Usually associated with long-term or chronic illnesses or disorders; may continue for months/years
Phantom: Occurs after the loss of a body part (amputation); may be felt in the amputated part for years after the amputation
Highly subjective; patient to describe in tems of degree, quality, area, and frequency; ask what alleviates/worsens; use number or face scale
Manifestation in Older Patient: Sleep disturbances, changes in gait and mobility, dec. socialization, depression
Nonverbal Indicators: Moaning; Crying; Irritability; Restlessness; Grimacing/Frowning; Inability to sleep; Rigid posture; Inc bp/HR/RR; Nausea; Diaphoresis
Heat/Cold Tx: Use a barrier; 15-30 mins
