Vitals

Question 1

What are the four vital signs?

Answer 1

Temperature, pulse, respiration, and blood pressure

Question 2

What is the normal adult average temperature?

Answer 2

98.6 degrees Fahrenheit

Question 3

What is the range for normal body temperature?

Answer 3

96-99.6 degrees Fahrenheit

Question 4

When is normal body temperature the lowest?

Answer 4

During least activity (sleep)

Question 5

What age group tends to have higher fevers: children or adults?

Answer 5

Children

Question 6

What is the term to describe how most fevers vary during their course but don’t fully return to normal until they resolve?

Answer 6

Remittent

Question 7

What part of the nervous system regulates temperature?

Answer 7

Hypothalamus

Question 8

What are the three typical phases of a fever?

Answer 8

1 Chills (shivering/rigors)
2 Hot stage (set point of fever)
3 Sweating (heat dissipates)

Question 9

What occurs when a temperature rapidly rises from normal to fever level?

Answer 9

Febrile convulsions

Question 10

What type of fever occurs, resolves, then recurs again in a few days?

Answer 10

Relapsing (uncommon in the U.S.)

Question 11

What is the normal range for a fever?

Answer 11

Patient’s normal to 105 degrees Fahrenheit

Question 12

What is the range for hyperpyrexia?

Answer 12

Above 105 degrees Fahrenheit

Question 13

When a patient exhibits hyperpyrexia, what condition can be assumed?

Answer 13

Damage to hypothalamus or heat stroke

Question 14

Fevers are dangerous because of the possibility of what condition occurring?

Answer 14

Dehydration

Question 15

What is the rate of water loss to the amount able to be absorbed by the body during exercise?

Answer 15

Lose 22 oz of water every 20 minutes
Absorb 6 oz every 20 minutes
(22 loss:6 gain)

Question 16

What are the three phases of dehydration?

Answer 16

1 Heat cramps
2 Heat exhaustion
3 Heat stroke

Question 17

If a patient presents with cold, clammy, sweaty skin and symptoms of dizziness, faintness, headache, or rapid, shallow breathing, what stage of dehydration would you suspect he/she is in?

Answer 17

Heat exhaustion

Question 18

If a patient presents with hot dry skin and symptoms of dyspnea, arrhythmia, dilated pupils, possible seizures, coma, and even death, what stage of dehydration would you suspect he/she is in?

Answer 18

Heat stroke

Question 19

If a patient presents with involuntary muscle hypertonicity of the legs and abdomen, what stage of dehydration would you suspect he/she is in?

Answer 19

Heat cramps

Question 20

At what temperature do we see hyperthermia?

Answer 20

95 degrees Fahrenheit or less

Question 21

How much blood is pumped into the arteries with every heartbeat that is felt with a pulse?

Answer 21

5 tablespoons

Question 22

What three things are measured with the pulse?

Answer 22

Rate, rhythm, amplitude

Question 23

What is the normal range and average resting pulse?

Answer 23

60-90 beats per minute (72 average)

Question 24

What pulse range is indicative of bradycardia?

Answer 24

Less than 60 per minute

Question 25

What pulse range is indicative of tachycardia?

Answer 25

More than 100 per minute

Question 26

What is the physiologic tachycardia effect on pulse due to elevated temperature?

Answer 26

10 bp raise for every degree over 100

Question 27

What is the cause for pathologic tachycardia?

Answer 27

Oxygen deficit (examples = anemia, hemorrhage, shock, or congestive heart failure)

Question 28

What is the cause of physiologic tachycardia?

Answer 28

Normal response to exertion, anxiety, exercise, excitement or elevated temperature

Question 29

What is the common heart beat irregularity that is more prominent in children where the heart rate speeds up with each inspiration and slows again with expiration?

Answer 29

Sinus arrhythmia

Question 30

What is the common heart beat irregularity that involves disorganized electrical activity in the atria accompanied by a rapid, irregular ventricular response?

Answer 30

Atrial fibrillation

Question 31

What is the common heat beat irregularity that involves ventricular depolarization occurring earlier than expected resulting in occasional skipped beats?

Answer 31

Premature ventricular contraction (PVC's)

Question 32

Which common irregularity usually accompanies pre-existing heart disease and necessitates emergency care?

Answer 32

Atrial fibrillation

Question 33

What is the scale used to measure the amplitude of a pulse?

Answer 33

``` 0 absence 1 weak, feeble 2 expected/normal 3 full/increased 4 water-hammer, bounding ```

Question 34

What is the normal appearance of the contour of a pulse?

Answer 34

Smooth, domed-shaped wave

Question 35

How could pain or paresthesia of vascular origin be differentiated from that of neurologic origin?

Answer 35

1 check dermatome vs vascular distribution 2 check extremity warmth and skin color 3 check capillary refill time 4 compare peripheral pulse amplitude

Question 36

If one side of the body's peripheral pulse feels weaker than the other, one of what three things can be assumed?

Answer 36

Compression, constriction, or obstruction of an arterial lumen

Question 37

What condition could be apparent if a strong radial and weak or absent femoral pulses are found?

Answer 37

Coarctation of the aorta

Question 38

A bruit is heard best with what part of the stethoscope?

Answer 38

Bell

Question 39

What does the presence of a bruit mean?

Answer 39

Compressed, constricted, or partially obstructed arterial lumen

Question 40

How can venous insufficiency be assessed?

Answer 40

Inspect for swelling, varicosities, edema, erythema/cyanosis while patient is standing

Question 41

What is the normal adult respiratory rate?

Answer 41

12-20 breaths per minute

Question 42

What rate defines tachypnea?

Answer 42

More than 20 breaths per minute

Question 43

What is the rate at which breathing rate increases due to physiologic tachypnea from elevated temperature?

Answer 43

4 breaths per minute for every degree over 100

Question 44

What kinds of things can lead to pathologic tachypnea?

Answer 44

Hyperventilation, lung congestion/obstruction, airway constriction, rib/intercostals/pleural pain

Question 45

What rate defines bradypnea?

Answer 45

Less than 12 breaths per minute

Question 46

What is air-trapping?

Answer 46

Increasingly difficult and prolonged expulsion of air

Question 47

What is hyerpnea?

Answer 47

Deep labored breathing

Question 48

What is examples of deep and rapid breathing?

Answer 48

Hyperventilation and Kussmaul

Question 49

What is the term for an occasional deep breath?

Answer 49

Sigh

Question 50

What is hypopnea?

Answer 50

Abnormally shallow respirations

Question 51

What is dyspnea?

Answer 51

Distressful or uncomfortable breathing

Question 52

What is orthopnea?

Answer 52

Shortness of breath that begins or gets worse when lying down

Question 53

What is the palpatory systolic blood pressure?

Answer 53

Where the pulse is first FELT when releasing pressure from the cuff

Question 54

What is an auscultatory gap?

Answer 54

Transient period of silence of the Korotkoff sounds

Question 55

What are Korotkoff sounds?

Answer 55

Audible noises created by turbulent blood flow through the partially open lumen of the brachial artery

Question 56

What is the auscultatory systolic blood pressure?

Answer 56

Where the pulse is first HEARD while releasing pressure from the cuff

Question 57

What is the term for the point at which the blowing sounds become softer and begin to fade when listening for blood pressure?

Answer 57

First or mid-diastolic blood pressure

Question 58

What is the end diastolic blood pressure?

Answer 58

The point at which audible blowing sounds completely stop being heard

Question 59

In what kind of situation is the mid-diastolic BP used to denote diastolic BP?

Answer 59

High cardiac output conditions where sounds may be heard all the way to zero pressure

Question 60

What is the pulse pressure?

Answer 60

Difference between the systolic and diastolic pressures

Question 61

What is a better indicator of heart disease: systolic or diastolic BP alone or abnormal pulse pressure?

Answer 61

Abnormal pulse pressure (according to some studies)

Question 62

There should be no more than how many mmHg of difference between the systolic blood pressure in both arms?

Answer 62

10 mmHg

Question 63

Which arm can have a 5-10 mmHg difference in systolic blood pressure and why?

Answer 63

Right arm; due to additional bifurcation (Poiseuille's Law)

Question 64

Which are higher and why: leg or arm blood pressures?

Answer 64

Leg blood pressures; due to greater muscle mass

Question 65

If arm BP is higher than leg BP, what can we suspect?

Answer 65

Young people - coarctation of aorta | Elderly people - Stenosis of aorta

Question 66

What is the normal range for systolic blood pressure?

Answer 66

100-140 mmHg

Question 67

What is the normal range for diastolic blood pressure?

Answer 67

60-90 mmHg

Question 68

What usually increases systolic blood pressure?

Answer 68

Increased cardiac output

Question 69

What usually increases diastolic blood pressure?

Answer 69

Increased peripheral (arterial) resistance

Question 70

Strong emotion like anxiety raises what kind of blood pressure?

Answer 70

BOTH systolic and diastolic

Question 71

What should be the measurement for pulse pressure?

Answer 71

40 mmHg (+/- 10 mmHg)

Question 72

What does a wide pulse pressure indicate?

Answer 72

Additional arterial stretch with every heartbeat and wear and tear on the arteries

Question 73

What is the average adult normal blood pressure?

Answer 73

120/80 mmHg

Question 74

What should be the ideal width of the blood pressure cuff?

Answer 74

1/3-1/2 the circumference of the arm

Question 75

What kind of hypertension accounts for about 92% of cases?

Answer 75

Essential/idiopathic hypertension

Question 76

What kind of hypertension accounts for 8% of cases?

Answer 76

Secondary

Question 77

What is the top cause of secondary hypertension?

Answer 77

Adrenal disease (also hyperthyroidism, coarctation of aorta, polycythemia, preeclampsia)

Question 78

What are the blood pressure ranges for prehypertension?

Answer 78

``` Systolic = 120-139 mmHg Diastolic = 80-89 mmHg ```

Question 79

What percent of the adults in U.S. and Canada have high blood pressure?

Answer 79

25%

Question 80

What are examples of noninvasive activities that can help 75% of the hypertension cases in the U.S. and Canada?

Answer 80

Slow breathing exercises Concord grape juice Sodium reduction and weight loss Moderate exercise

Question 81

What is the treatment for stage 1 hypertension?

Answer 81

Diuretics

Question 82

What is the treatment for stage 2 hypertension?

Answer 82

Diuretics and medications

Question 83

What is the treatment for stage 3 hypertension?

Answer 83

Combination medications