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Measuring Vital Signs

Subjects : health-sciences, emergency-medicine

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. How do drugs affect pulse?
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.
96.5 to 97.5
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes

2. What should you do if you cannot determine BP by ausculation?
Tachypnea
Korotkoff sounds Phase IV: Muffling
the palpation method is used. put cuff over arm - feel the radial point to get the systolic pressure you cant get the diastolic this way.
fever

3. Difference between the apical and radial pulse - this requires two people to count the radial and apicial pulses at the same time to determine whether there is a what?
dyspnea
constant
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
uncooperative patient - children - combative patients - dementia

4. Elevated temperature
Systolic pressure
fever
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds

5. People most at risk for hypertension
men - African Americans - under a lot of stress - obese
Evaporation
72 bpm
Blood pressure increases because there is more volume of blood in the vascular system.

6. How does emotional stress raise the body's temperature?
120-139/80-89
The emotions increase hormone secretion - and the body activities required for this increase heat production.
hypoxia
Acute anxiety stimulate the nervous system - raising the pulse.

7. 1st stage of fever is?
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
Pulse
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.

8. 3rd stage of fever?
Brachial
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.
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
60 to 70 mL

9. An example of nursing planning
hypoxia
Brachial
Temperature will remain below 102 degrees with use of hypothermia blanket
Radial

10. Newborn
+3
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
30-80
It uses large muscles in the body - which create body heat by burning up the glucose and fat in the tissues - muscle action generates heat and core temperature rises.

11. Head injury or any increased intracranial pressure will depress the respiratory center and result in?
shallow or slow breathing
dyspnea
97.5 to 99.5
Diaphoresis

12. An example of a nursing diagnoses
Diaphoresis
Crisis
wheeze
Hyperthermia related to infection or excessive heat exposure

13. Obtaining the correct size for a cuff for BP?
stridor
Respiration
It will also fall
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.

14. Difficult and labored breathing - can often be accompanied by flared nostrils - anxious appearance - and statements such as I cant get enough air.
72 bpm
Stroke volume
Nursing interventions to reduce fever
dyspnea

15. 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
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes
Nursing interventions to reduce fever
When an accurate temperature cant be obtained orally and a tympanic or temporal artery thermometer are not available. It may be used when there is nasal congestion or there has been nasal or oral surgery - the patient is unable to keep their mouth cl
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

16. The rate at which heat is produced when the body is at rest.
BMR
Korotkoff sounds Phase IV: Muffling
shallow or slow breathing
stridor

17. By measuring the blood pressure you obtain vital info about what?
thready
Diaphoresis
wheeze
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

18. The exchange of oxygen and carbon dioxide in the lungs and tissues and is initiated by the act of breathing.
Respiration
Korotkoff sounds Phase III: Knocking
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
Vascular resistance drops and the blood pressure decreases

19. What characteristics should be noted when checking the pulse?
Core Temperature
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
blood pressure is lowest in the morning. and higher in the afternoone
the rate - the rhythm - and volume

20. Substances tat cause fever
crackles
intermittent
pyrogens
It uses large muscles in the body - which create body heat by burning up the glucose and fat in the tissues - muscle action generates heat and core temperature rises.

21. The pulse rate multiplied by the stroke volume. This is the amount of blood pumped by the left ventricle in 1 minute. Averaging at about 5mL per minute.
Apical
Diaphoresis
Cardiac Output
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

22. Sex BP?
lysis
Vascular resistance drops and the blood pressure decreases
Korotkoff sounds Phase III: Knocking
males have higher bp - until menopause then they are the same

23. A normal - relaxed breathing pattern
pyrexia
Korotkoff sounds Phase II Swishing
blood pressure is lowest in the morning. and higher in the afternoone
Eupnea

24. How does menstrual cycle and pregnancy raise the body's temperature?
blood pressure is lowest in the morning. and higher in the afternoone
Korotkoff sounds Phase V: Silence
hypoxemia
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.

25. Increased or rapid breathing results from te presence of fever and a number or diseases. breathing rate increased about 4 breaths for each degree increase in temperature.
Pulse
Tachypnea
temperature - pulse - respiration - blood pressure - and pain level.
Cheyenne-Stokes

26. 3 yr old
raises BP.
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes
72 bpm
20-30

27. How do emotions increase the pulse rate?
hypoxia
Acute anxiety stimulate the nervous system - raising the pulse.
Pons and Medulla of the brainstem
Stimulants increase the pulse rate. Depressants decrease the pulse rate.

28. When should rectal temperatures NOT be used?
cardiac patients or patients who have had rectal surgery.
Nursing interventions to reduce fever
Posterior tibial
20-30

29. When the vascular walls lose elasticity - as with arteriosclerosis and aging what happens to BP?
pyrexia
It increases to push the blood through more rigid pathways.
The pulse rate gradually diminishes from birth to adulthood
96.5 to 97.5

30. Air movemtn causes heat to be transferred from the skin to the air molecules.
about 1 degree lower than oral temperatures
stridor
systolic pressure indicated by faint - clear sound that gradually grow louder.
Convection

31. Hearing
Stroke volume
when it is difficult to find or to count the radial pulse - or for patients with heart conditions for one full minute by placing stethoscope on the heart to count for a full minute.
Pedal pulse
ausculatation

32. What happens to the blood if overhydration occurs?
Blood pressure increases because there is more volume of blood in the vascular system.
left Sims position
constant
postoperative patients wo have been cooled during surgery - newborn infants whose skin is exposed to cool room temperatures - elderly or debiliated patients - and those exposed to cold temperatures for prolonged periods.

33. Symptoms of hypoxia
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
Tall - slender people mayy ave a slower pulse rate than short - stout persons
Brachial
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds

34. Normal body temperature ranges?
Biot's respirations
140-159/90-99
dyspnea
97.5 to 99.5

35. How does external respiration occur?
Blood pressure increases because there is more volume of blood in the vascular system.
Posterior tibial
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
Respiration

36. Increased rate and depth with panting and long grunting exhalation. Often seen with patients with acidosis and renal failure.

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37. Average pulse rate for an adult
from drug therapy - a neurologic problem or dehydration.
the BP goes up because more pressure is needed to push the thicker fluid through the vascular system.
pyrexia
72 bpm

38. Stage 1 hypertension
pyrexia
Respiration
140-159/90-99
shallow or slow breathing

39. Are infants blood pressure low or high?
Korotkoff sounds Phase II Swishing
crackles
temperature - pulse - respiration - blood pressure - and pain level.
low

40. Fast - deep respirations with abrupt pauses

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41. Those at risk for hypothermia include
Temperature will remain below 102 degrees with use of hypothermia blanket
postoperative patients wo have been cooled during surgery - newborn infants whose skin is exposed to cool room temperatures - elderly or debiliated patients - and those exposed to cold temperatures for prolonged periods.
ausculatation
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.

42. Signs and symptoms of shock
constant
the rate - the rhythm - and volume
men - African Americans - under a lot of stress - obese
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.

43. Bend of knee
hyperoxia
popliteal
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.
Increases as body tries to remove excess heat

44. Shallow for two or three breaths with a period of variable apnea. occur in patients with increased intracranial pressure.

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45. 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
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
Hyperventilation
60 to 70 mL
Feeble

46. respirations become faster and deeper - then slower and shallower wit a period of apnea - called the death rattle.
Cheyenne-Stokes
by placing the flat part of the first fingers against the tendon - or cord - on the thumb inside of the inner wrist and ten rolling the fingers slightly outward into the little trough on the thumb inside the wrist.
When an accurate temperature cant be obtained orally and a tympanic or temporal artery thermometer are not available. It may be used when there is nasal congestion or there has been nasal or oral surgery - the patient is unable to keep their mouth cl
bradypnea

47. How should respirations be counted?
thready
140-159/90-99
Biot's
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.

48. How is shock caused?
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
Hyperthermia related to infection or excessive heat exposure
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
16-20

49. The temperature of the deep tissues of the body
The pulse rate gradually diminishes from birth to adulthood
140-159/90-99
Core Temperature
tachycardia

50. Blood pressure for any adult should be no higher than
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
blood pressure is lowest in the morning. and higher in the afternoone
Tachypnea
120/80