What type of assessments are these for the following? 1. Temperature 2. Pulse 3. Respiration 4. BP

1. infection 2. cardiovascular 3. respiratory and metabolism 4. cardiovascular

Vital Signs Quiz - Lecture Notes Flashcards by Michelle Farrow

What are the four classic vital SIGNS?

Temperature
Pulse
Respiration
BP

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What type of assessments are these for the following?

Temperature
Pulse
Respiration
BP

infection
cardiovascular
respiratory and metabolism
cardiovascular

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What are two vital STATISTICS?

height and weight

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What is the “expected” body temperature based on an oral test?

97.2 to 99.9 degrees F

average 98.6

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Does temperature vary throughout the day? When it is usually the lowest?

yes, lower in early morning

may rise as much as 1 degree by early evening

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How much may temperature vary during menses and when does it peak?

varies by 1 degree F

peaking at ovulation

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At what temperature will an oral temp be considered a fever? What about an rectal or ear (aural) temp?

oral temp above 100.4 degrees F

rectal or ear temp above 101 degrees F

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Will people that are tachypneic usually have a higher or lower temperature?

lower temperature

tachypneic = fast breathers

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What must we be aware of that may cause a Factitious fever?

recent ingestion of hot or cold substances

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What is the most common cause of a fever? What are some other reasons?

infection

inflammatory conditions or autoimmune conditions; like lupus, RA, scleroderma

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What type of fever is described as having a daily elevated temperature and it returns to baseline, but not to normal?

Remittent Fever

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What type of fever is described as having intermittently elevated temperature that returns to baseline and to normal?

Intermittent Fever (Periodic Fever)

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If someone has an Intermittent Fever, what are some possible conditions that may be causing this?

PFAPA Syndrome
Hodgkin’s Syndrome
Relapsing Fever
Malaria
Rat Bite Fever
Cyclic Neutropenia

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What is a self-induced fever called?

Factitious fever

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What type of fever consists of multiple febrile attacks lasting about 6 days, separated by afebrile periods?

Relapsing Fever

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What type of fever is accompanied by chills, RUQ pain, and jaundice?

Charcot’s intermittent fever

due to stones obstructing common duct

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What type of fever is characterized by a daily afternoon spike, often with facial flushing, and usually seen with TB?

Hectic Fever

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What type of fever has some duration w/o remissions, usually seen with gram - sepsis or CNS damage?

Continued or Sustained Fever

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What type of fever is it when the febrile period last no more than one or two days?

Ephemeral fever

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What is a FUO (fever of unknown origin) that has a temp of 100.4 F for 3 weeks or longer without an identifiable cause?

Essential Fever

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What is an Essential fever MC due to in adults? What is least commonly due to?

infection

caner, autoimmune diseases, drug reactions

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What is a temp that is greater than 105 F caled?

Hyperpyrexia

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What must a temp be above to be considered Hyperpyrexia?

105 F

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What usually causes Hyperpyrexia?

CNS disorders of thermoregulating centers usually from heat stroke, CVA, brain injury after cardiac arrest

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What is it called when a body temp is below 98.6 F?

Hypothermia

What can cause temperatures lower than normal?

chronic renal failure and patients receiving antipyretics (acetaminophen) and NSAIDs

Will someone in chronic renal failure have a higher or lower temp?

lower--> Hypothermia

Generally speaking, how much does the bpm change for every degree increase in temp?

increased by 10 bpm

What conditions may not follow the general rule of the bpm increasing by 10 when the temp increases by 1?

Typhoid fever, mycoplasmal pneumonia

What is systole?

when the right ventricle contracts to force blood into pulmonary artery

Where does stroke volume occur?

when left ventricle contracts, forcing volume of blood through aortic valve into aorta

What are the arterial pulses the result of?

ventricle systole (ejection of blood from LV into aorta)

What is the equation for Cardiac Output?

CO = SV x R(heart rate)

What is the CO a measure of?

the heart's ability to adapt to a changing environment

What is considered normal pulse rate?

60-100 bpm

When is it considered Bradycardia? Tachycardia?

Bradycardia = below 60 Tachycardia = above 100

What artery is most accessible that is closet to the heart?

the carotid artery

Describe when the pulse is felt.

as a forceful wave that is smooth and rapid on the ASCENDING portion of the wave

What is felt of the pulse on the descending wave?

becomes domed, less steep, and slower

What are the pulses in the extremities evaluating?

the sufficiency of the entire ARTERIAL CIRCULATION

What are proximal pulses better for evaluating?

HEART ACTIVITY

What are the four modifiers/descriptors/characteristics for a pulse?

- Rate (bpm) - Rhythm (regular vs irregular) - Amplitude (0-4) - Contour (pliable, if not hardened by atherosclerosis)

What is the scale that pulse amplitude is felt on?

``` 0-4 4 = bounding 3 = full, increased 2 = expected 1 = diminished, barely palpable 0 = absent, not palpable ```

T/F. Pulse amplitude is compared to other vessels.

FALSE-- it is described as expected for THAT VESSEL,--- NOT compared to other vessels

What is respiration the measure of?

a full respiratory cycle (from inhalation to exhalation)

What are the three components we evaluate for Respiration?

- Rate - Rhythm (regular or irregular) - Depth (shallow, moderate, deep)

What is the normal adult respiration per minute?

12-20 breaths per minute

What are the major abnormalities with respiration?

``` increases = tachypnea decreases = bradypnea ```

What can get tachypnea and why is it a big deal?

MC in elderly with COPD

What patients may we see Bradypnea in?

MC with hypothyroidism CNS lesions, sedative or narcotic use

What patients will we commonly observe Pursed-lip breathing?

COPD-- usually emphysema

Why may we see Pursed-lip breathing in someone with emphysema?

they have reduced lung elasticity and alveolar hyperinflation --> therefore higher risk for airway closure and air trapping pursed-lip breathing will increase intra-airway pressure by inducing auto-PEEP (pos. end-expiratory pressure)--> preventing airway closure

What other describing signs may we see with Pursed-lip breathing?

wheezing or grunting

What is the increase in rate and the tidal volume of respiration called? Describe what type of respiration this produces.

Hyperpnea--> rapid and deep

What is Kussmaul breathing a classic form of?

Hyperpnea (increase in rate and tidal volume)

What type of breathing will we see patients with metabolic acidosis (diabetic acidosis)?

Kussmaul breathing

What type of breathing is hyperventilation?

Hyperpnea -- to compensate for pH

What is the mnemonic for Kussmaul breathing that may cause it?

``` MAKE UP a List: M = methanol poisoning A = aspirin intoxication K = ketoacidosis E = ethylene glycol ingestion U = uremia P = paraldhyde administration L = lactic acidosis ```

What type of breathing is characterized by shallow respirations?

hypopnea

What is a hallmark of impending respiratory failure or of obesity?

hypo-ventilation -- aka Pickwickian Syndrome

What type of breathing is Pickwickian Syndrome?

Hypopnea (shallow respirations)

What type of breathing will a patient with excessive daytime sleepiness and elevated CO2 have?

Pickwickian Syndrome

What is the absence of respiration for at least 20 seconds while the patient is awake or 30 seconds while the patient is asleep?

Apnea

What means upright respiration?

Orthopnea

What individuals is Orthopnea MC seen in?

patients with CHF

What is an earlier sign for a patient that may be leading into CHF?

when sitting upright pools blood in dependent areas, thereby decreasing venous return (swollen legs)

How many North American Adults are affected by Hypertension?

1 in 5

Describe Phase 1 of the Korotkoff sounds.

the first appearance of faint, repetitive, clear tapping sounds that gradually increase in intensity for at least two consecutive beats in the SYSTOLIC BP

Describe Phase 2 of the Korotkoff sounds.

brief period may following during which sounds SOFTEN and acquire a swishing quality

What is it called when in SOME patients sounds may disappear altogether for a short time?

Auscultatory gap

When does the auscultatory gap occur?

when the sounds disappears b/w systolic and diastolic pressures

What is the importance of the ausculatatory gap?

unles the systolic pressure is palpated first, it may be underestimated

Describe Phase 3 of the Korotkoff sounds.

the return of sharper sounds, become crisper to regain

Describe Phase 4 of the Korotkoff sounds.

distinct, muffling sounds which become soft and blowing in quality = mid-diastolic pressure

Describe Phase 5 of the Korotkoff sounds.

point at which all sounds finally disappear completely = diastolic BP (end-diastolic pressure)

Which phase is the mid-diastolic pressure in?

phase 4

What phase is the systolic BP in?

Phase 1

What phase is the diastolic BP (end-diastolic pressure) in?

phase 5

When does systole occur? (heart chambers involved, valves?)

ventricles contract and tricuspid and mitral (AV) valves close

What is the measure of CO and how hard the heart is working to eject the blood (SV)?

systole

When does diastole occur? (heart chambers involved, valves?)

ventricles relax and tircuspid and mitral valves open

What is the measure of the peripheral vascular resistance?

diastolic pressure | resting resistance

What is the "Classic" range of BP?

120/80

What do we consider normal systolic range to be? What about normal diastolic range?

systolic = 100-140 mmHg diastolic = 60-90 mmHg

What what BP measurement is considered hypertension?

greater than 140 systolic AND/OR greater than 90 diastolic

T/F. Hypertension can be Dx on one measurement of BP.

FALSE-- you should NOT Dx HTN on one measurement

What is the most prevalent risk factor in heart failure, stroke, and kidney failure?

systolic hypertension

At what BP is it classically considered Hypotension?

under 90/60

What does "ortho-" mean?

upright

What is a fall in systolic BP of 20 mHg or more called?

orthostatic systolic hypotension

What is a fall in diastolic BP of 10 mmHg or more called?

Orthostatic diastolic hypotension

What is a rise in diastolic BP to 98 mmHg or higher called?

Orthostatic diastolic hypertension

What is a fall in pulse pressure to 18 mmHg or lower?

Orthostatic narrowing of pulse pressure

What is an increase in heart rate of 28 bpm or to greater than 110 b/min?

Orthostatic postural tachycardia

How do we get Pulse Pressure? What is a normal range?

systolic - diastolic pressures 30-40mmHg

What is a widened (high) pulse pressure (over 40 mmHg) a best blood pressure marker for?

cardiovascular disease

How frequently should you take the BP?

initial visit if BP elevated above 140/90--> take a second after 1-2 mins

How frequent should BP be measured for sustained blood pressure elevation?

at least once at each visit on the same arm

T/F. It is sufficient enough to take pulses on one arm.

False-- always palpate pulses bilaterally

What should we allow a variation for in BP b/w both arms?

10 mmHg

Vital Signs Quiz - Lecture Notes Flashcards

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