vitals

Question 1

When do we check for vitals ?

Answer 1

On admission
At beginning of each shift
Before and after procedure or treatment
Any time patient’s condition changes
Based on protocol or physician’s order
As often as necessary for patient safety
“Routine vitals” are about every 4 to 6 h (or as per protocol)

Question 2

4 main vital signs

Answer 2

RR
BP
Pulse
Temperature

Question 3

temperature

Answer 3

Adult Normal = 37 ℃
Regulated by the hypothalamus and is a balance of heat production and loss.
Affects metabolic rate
could be measured orally, axillary, rectal and ear

Question 4

fever

Answer 4

Elevation of temperature (febrile)
From normal activities (exercise) = hyperthermia
From disease (infection) = fever
Body temperature of >38.9 ℃ (102°F) usually indicates infection
Not all infections result in fever
Immunocompromised patients may not be able to generate fever despite infection

Question 5

hyperthermia

Answer 5

increase in metabolic rate
increase in 02 consumption and decrease in CO2 production
increase in RR and HR

Question 6

Hypothermia

Answer 6

decreases in metabolic rate
decrease in 02 consumption and CO2 production
decrease in RR and HR
body tries to maintain itself by shivering and peripheral vasoconstriction to generate heat.
slow and shallow breathing

Question 7

metabolic effects

Answer 7

increases temperature
O2 consumption and CO2 production increase 10% for each 1°C elevation in body temperature
Patients with limited respiratory function may develop respiratory failure in response to fever

Question 8

RR (respiratory rate)

Answer 8

rr>20 is called tachypnea
rr<12 is called bradypnea
asses pattern and depth
pattern- paradoxical chest movement or how deep and shallow their breath are

Question 9

apnea

Answer 9

absence of spontaneous ventilation

Question 10

eupnea

Answer 10

normal breathing (rate and depth are both normal)

Question 11

bradypnea

Answer 11

less than normal rate of breathing

Question 12

tachypnea

Answer 12

rapid rate of breathing

Question 13

hypopnea

Answer 13

decreased depth of breathing (small tidal volume)

Question 14

hyperpnea

Answer 14

increased depth of breathing with or without an increased rate.

Question 15

trends in the vital signs

Answer 15

Isolated measurement provides limited information
Normal VS for a patient depend on:
Age
Presence of chronic disease
Treatment protocols
Trend = baseline + measurements over time
Multiple-day graph

Question 16

BP

Answer 16

Adult Normal = 120/80 mmHg
Normal Range is:
90-130 systolic
60-85 diastolic
BP is the force exerted against the arterial walls
Pulse pressure = P systolic − P diastolic
Normal: 35 to 40 mm Hg
<30 mm Hg: poor peripheral perfusion

Question 17

pulsus paradoxus

Answer 17

Strength decreases with inspiration

Question 18

pulsus alternans

Answer 18

Strong and weak pulses