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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. Both strong and weak beats occur within 1 minute
Korotkoff sounds
hypertension
Irregular
^160/^100

2. Slow and shallow breathing - leads to hypoxemia.
bradypnea
Cheyenne-Stokes
Temperature will remain below 102 degrees with use of hypothermia blanket
The pulse rate gradually diminishes from birth to adulthood

3. What are the 5 vital signs?
Feeble
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
temperature - pulse - respiration - blood pressure - and pain level.
Irregular

4. Are infants blood pressure low or high?
Radial
3 in the right lung and 2 lobes in the left
about 1 degree higher than oral temperatures
low

5. Average blood pressure should be
Vascular resistance drops and the blood pressure decreases
120/70
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.
Tall - slender people mayy ave a slower pulse rate than short - stout persons

6. If blood becomes thicker - like when excessive blood cells are manufactured what happens to BP?
the BP goes up because more pressure is needed to push the thicker fluid through the vascular system.
Acute anxiety stimulate the nervous system - raising the pulse.
60 to 70 mL
about 1 degree lower than oral temperatures

7. Blood pressure for any adult should be no higher than
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
Irregular
120/80

8. The difference between the systolic pressure and the diastolic pressure
Pulse pressure
Vascular resistance drops and the blood pressure decreases
Kussmaul's respiration
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.

9. Measurement of oxygen
dehydration - delirium - and convulsons may occur. Dehydration will occur because of lost with perspiration and more rapid breathing. Delirium and convulsions may occur because neurologic function is affected when the temperature in the brain rises.
intermittent
Hyperthermia related to infection or excessive heat exposure
oximetry

10. Louder knocking sound that occurs wit each heartbeat
Korotkoff sounds Phase III: Knocking
lysis
thready
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

11. The lower pressure exerted on the artery when the heart is at rest inbetween contractions.
hypotension
30-80
The pulse rate increases at the rate of 7-10 beats for each degree of temperature
Diastolic pressure

12. While measuring the BP certain sounds may be heard that relate to the effect of the blood pressure cuff on the arterial wall.
Pulse
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
Korotkoff sounds

13. Full and bounding (even beats wit strong force)
Pulse
+3
orthostatic hypertension
The pulse rate increases at the rate of 7-10 beats for each degree of temperature

14. Substances tat cause fever
Korotkoff sounds Phase IV: Muffling
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
pyrogens
tachycardia

15. 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.
Core Temperature
about 1 degree lower than oral temperatures
Blood pressure increases because there is more volume of blood in the vascular system.
remittent

16. Axillary temperature are
temperature - pulse - respiration - blood pressure - and pain level.
about 1 degree lower than oral temperatures
The pulse rate gradually diminishes from birth to adulthood
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.

17. Hearing
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.
stridor
Biot's respirations
ausculatation

18. Korotkoff sounds Phase I: Tapping
systolic pressure indicated by faint - clear sound that gradually grow louder.
the BP goes up because more pressure is needed to push the thicker fluid through the vascular system.
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes
fever

19. The temperature of the deep tissues of the body
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
Core Temperature
the rate - the rhythm - and volume
intermittent

20. How does physical exercise raise the body's temperature?
+2
Radial
Stertor
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 temperature is continuously elevated with less than 1 degree of variation within a 24-hour period.
96.5 to 97.5
Pedal pulse
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
constant

22. 3rd stage of fever?
thready
Korotkoff sounds Phase II Swishing
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.
constant

23. Macine that measures oxygen in the blood by determining the percentage of hemoglobin that is bound with oxygen.
oximeter
Korotkoff sounds
Korotkoff sounds Phase III: Knocking
hypoxia

24. Signs and symptoms of shock
low BP
Cardiac Output
Tall - slender people mayy ave a slower pulse rate than short - stout persons
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.

25. Rectal temperature are
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
Systolic pressure
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
about 1 degree higher than oral temperatures

26. How is shock caused?
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
^160/^100
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.

27. The maximum pressure exerted on the artery during left ventricular contraction.
Pulse pressure
Systolic pressure
Diastolic pressure
orthostatic hypertension

28. A sudden change or muffling of the sound. (indicates diastolic pressure in children and some adults)
Cheyenne-Stokes
dyspnea
in the alveoli - tiny thin-walled sacs
Korotkoff sounds Phase IV: Muffling

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

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30. No pulse palpable or heard on ausculation
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
Core Temperature
absent
16-20

31. Heart
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
Apical
popliteal
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

32. How does menstrual cycle and pregnancy raise the body's temperature?
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
thready
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
Irregular

33. What will happen in febrile stage if temperature is very high or temperature stays for a long amount of time?
uncooperative patient - children - combative patients - dementia
Posterior tibial
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
dehydration - delirium - and convulsons may occur. Dehydration will occur because of lost with perspiration and more rapid breathing. Delirium and convulsions may occur because neurologic function is affected when the temperature in the brain rises.

34. Those at risk for hypothermia include
+1
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.
low BP
Relapsing

35. Prehypertension
120-139/80-89
Evaporation
+2
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.

36. This affects the character of the pulse.
Stroke Volume
Rhonchi
Radial
lysis

37. How is pulse best found?
16-20
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.
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.
Posterior tibial

38. State of insufficient oxygen
hypoxia
Diastolic pressure
3 in the right lung and 2 lobes in the left
arrhythmia

39. Whats the best position to take a rectal temperature?
left Sims position
Korotkoff sounds Phase II Swishing
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.
pyrogens

40. How does disease increase the body's temperature?
men - African Americans - under a lot of stress - obese
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.

41. The pressure wave causing te arterial walls in the vascular system each time the heart contracts to force blood into an already full aorta.
Pons and Medulla of the brainstem
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.
Pulse
It doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.

42. When should rectal temperatures be used?
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
Systolic pressure
16-20
from drug therapy - a neurologic problem or dehydration.

43. When should rectal temperatures NOT be used?
hypertension
remittent
stridor
cardiac patients or patients who have had rectal surgery.

44. High BP
120-139/80-89
hypertension
Core Temperature
stridor

45. What affects does aging do to the heart rate?

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46. Breathing is an involuntary automatic function controlled by the respiratory center located where?
absent
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
Pons and Medulla of the brainstem
Korotkoff sounds Phase IV: Muffling

47. Diurnal variation BP?
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
blood pressure is lowest in the morning. and higher in the afternoone
Core Temperature
low

48. An example of a nursing diagnoses
+3
hypotension
Hyperthermia related to infection or excessive heat exposure
dehydration - delirium - and convulsons may occur. Dehydration will occur because of lost with perspiration and more rapid breathing. Delirium and convulsions may occur because neurologic function is affected when the temperature in the brain rises.

49. Alternating rise and fall of the temperature.
Stroke volume
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
intermittent

50. When warm skin touches a cool object - heat is lost to the object.
in the alveoli - tiny thin-walled sacs
hypertension
Evaporation
Conduction