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Measuring Vital Signs

Subjects : health-sciences, emergency-medicine

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Pulse above 100 beats per minute
tachycardia
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
Stertor
dyspnea

2. respirations become faster and deeper - then slower and shallower wit a period of apnea - called the death rattle.
determine if the patient has a known heart arrhythmia - perform hand hygiene - expose the left chest - warm the stethoscope in hand for a min or 2 - locate the apex of the heart by palpating for the 5th intercostal space at the midclavicular line. li
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.
Biot's
Cheyenne-Stokes

3. Stress & emotions. BP?
higher
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
Diastolic pressure
Eupnea

4. Gradual return to a normal temperature
bradypnea
96.5 to 97.5
lysis
hypotension

5. Weak and regular (even beats wit poor force)
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
Core Temperature
Cardiac Output
+1

6. By measuring the blood pressure you obtain vital info about what?
the effectiveness of the heart contractions - the amount of blood in the system - and the presence of any obstruction or interference of blood to the blood vessels
Blood pressure increases because there is more volume of blood in the vascular system.
place the thermometer in the center of the patients dry axilla. Ask patient to hold the arm tightly against the chest. Leave in place 3-8 minutes.
bradycardia

7. What patients should not use a glass thermometer orally?
uncooperative patient - children - combative patients - dementia
popliteal
the effectiveness of the heart contractions - the amount of blood in the system - and the presence of any obstruction or interference of blood to the blood vessels
Nursing interventions to reduce fever

8. When warm skin touches a cool object - heat is lost to the object.
the blood pressure will rise in order to push the blood along.
Korotkoff sounds Phase IV: Muffling
from drug therapy - a neurologic problem or dehydration.
Conduction

9. The volume of blood pushed into the aorta per heartbeat.
pyrogens
Stroke volume
Axillary.
Acute anxiety stimulate the nervous system - raising the pulse.

10. Feel
apnea
palpate
Core Temperature
Tall - slender people mayy ave a slower pulse rate than short - stout persons

11. Shock - hemorrhage - low cardiac output - inadequate volume of blood?
constant
Korotkoff sounds Phase IV: Muffling
low BP
pyrogens

12. A pattern of breathing in which there is an increase in the rate and the depth of breaths and carbon dioxide is expelled - causing te blood level of carbon dioxide to fall. this condition is seen after sever exertion - during high levels of anxiety o
Hyperventilation
+2
popliteal
hypoxia

13. Macine that measures oxygen in the blood by determining the percentage of hemoglobin that is bound with oxygen.
Dorsalis pedis
the rate - the rhythm - and volume
apnea
oximeter

14. Disappearance of sound. (marks diastolic pressure in adults)
Korotkoff sounds Phase V: Silence
+2
in the alveoli - tiny thin-walled sacs
The pulse rate increases at the rate of 7-10 beats for each degree of temperature

15. How does emotional stress raise the body's temperature?
low BP
The emotions increase hormone secretion - and the body activities required for this increase heat production.
120/80
Korotkoff sounds Phase II Swishing

16. Snoring sound produced when patients are unable to cough up secretions from the trachea or bronchi
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.
popliteal
Stertor
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.

17. How does the time of day (circadian rhythm) affect the body's temperature?

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18. Louder knocking sound that occurs wit each heartbeat
Feeble
Nursing interventions to reduce fever
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
Korotkoff sounds Phase III: Knocking

19. The difference between the systolic pressure and the diastolic pressure
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
Pulse pressure
lysis
Apical

20. Korotkoff sounds Phase I: Tapping
hypoxia
Dorsalis pedis
systolic pressure indicated by faint - clear sound that gradually grow louder.
Axillary.

21. How does age affect pulse?
Hypothermia
The pulse rate gradually diminishes from birth to adulthood
the BP goes up because more pressure is needed to push the thicker fluid through the vascular system.
intermittent

22. Korotkoff sounds Ausculatatory gap:
Stroke Volume
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
crackles
It doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.

23. Average blood pressure should be
intermittent
shallow or slow breathing
pyrogens
120/70

24. Obtaining the correct size for a cuff for BP?
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.
higher

25. Top of left foot
BMR
Dorsalis pedis
3 in the right lung and 2 lobes in the left
120/70

26. Decreased levels of oxygen in the blood - often seen in patients wo are under medical sedation - who are recovering from anesthesia or abdominal surgery - or who are in a weak or debiliated condition.
if its hot bp can lower because of vasodilation. if its cold it can rise because of vasoconstriction.
hypoxemia
72 bpm
cardiac patients or patients who have had rectal surgery.

27. 3rd stage of fever?
shallow or slow breathing
Hyperthermia related to infection or excessive heat exposure
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.
Evaporation

28. How does external respiration occur?
Stroke Volume
arrhythmia
1) ventilation - Which is the movement of air in and out of the lung. 2) dispersion of air throughout the bronchial tree of the lungs; 3) diffusion of oxygen and carbon dioxide molecules across the alveolar membranes; 4) perfusion - the movement of b
hypotension

29. Subnormal body temperature the regulating center in the hypothalamus is greatly impaired when the temperature of the body falls below 94 degrees - at that point? sleepiness and coma are apt to develop.
The body's temperature in the morning is usually low from inactivity of the muscles. The afternooon body temperature may be high-normal because of the body's metabolic processes - the patient's activity - and the temperature of the environment.
Hypothermia
oximeter
Stimulants increase the pulse rate. Depressants decrease the pulse rate.

30. Both strong and weak beats occur within 1 minute
120/80
palpate
Irregular
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.

31. Normal body temperature ranges?
Eupnea
120/70
97.5 to 99.5
Radial

32. The rate at which heat is produced when the body is at rest.
absent
Blood pressure increases because there is more volume of blood in the vascular system.
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
BMR

33. Abnormal - nonmusical sound heard on ausculation of the lungs during inspiration; also called rales. Sound like hair rubbed between the fingers next to the ears.
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
It will also fall
crackles
+2

34. Heart
Acute anxiety stimulate the nervous system - raising the pulse.
cardiac patients or patients who have had rectal surgery.
Apical
The pulse rate gradually diminishes from birth to adulthood

35. This affects the character of the pulse.
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.
oximetry
16-20
Stroke Volume

36. How does menstrual cycle and pregnancy raise the body's temperature?
dyspnea
oximetry
Pulse
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.

37. Taking axillary temperature
the rate - the rhythm - and volume
place the thermometer in the center of the patients dry axilla. Ask patient to hold the arm tightly against the chest. Leave in place 3-8 minutes.
from drug therapy - a neurologic problem or dehydration.
The pulse rate increases at the rate of 7-10 beats for each degree of temperature

38. Full and bounding (even beats wit strong force)
+3
dyspnea
97.5 to 99.5
Conduction

39. When should rectal temperatures NOT be used?
low
hypertension
cardiac patients or patients who have had rectal surgery.
Dorsalis pedis

40. right arm vs. left arm/ arm vs. leg BP?
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.
Axillary.
Vascular resistance drops and the blood pressure decreases
Temperature will remain below 102 degrees with use of hypothermia blanket

41. Side of wrist
72 bpm
Tachypnea
the lungs
Radial

42. How do you measure the apical pulse?
ausculatation
Hypothermia
place the thermometer in the center of the patients dry axilla. Ask patient to hold the arm tightly against the chest. Leave in place 3-8 minutes.
determine if the patient has a known heart arrhythmia - perform hand hygiene - expose the left chest - warm the stethoscope in hand for a min or 2 - locate the apex of the heart by palpating for the 5th intercostal space at the midclavicular line. li

43. 1st stage of fever is?
low
Temperature will remain below 102 degrees with use of hypothermia blanket
Onset - which may occur gradually or suddenly. the body responds to a pyrogen by trying to conserve and manufacture heat to raise the set point for core temperature. The person will feel cold - and will add clothes or covers - curl up in a ball - and
arrhythmia

44. What happens when vasodilation occurs?
constant
Apical
hypotension
Vascular resistance drops and the blood pressure decreases

45. Slow and shallow breathing - leads to hypoxemia.
males have higher bp - until menopause then they are the same
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
bradypnea
120-139/80-89

46. Whats the best position to take a rectal temperature?
left Sims position
120-139/80-89
Convection
Temperature will remain below 102 degrees with use of hypothermia blanket

47. The pressure wave causing te arterial walls in the vascular system each time the heart contracts to force blood into an already full aorta.
shallow or slow breathing
bradycardia
120/70
Pulse

48. How is shock caused?
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
Systolic pressure
bradypnea
Sinoatrial node (SA NODE)

49. A high temperature falls - usually in the morning - and again rises later in the day. The temperature never fails to normal in this type of fever until recovery occurs.
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
Hyperventilation
remittent
Febrile stage - the body temperature rises to a new set point established by the hypothalamus and remains there until there is a resolution to the cause of fever.

50. Encourage a large fluid intake - lower room temperature - increase air circulation - remove items of clothes - control or reduce the amount of body activity - carry out physicians orders
Nursing interventions to reduce fever
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
apnea
Relapsing