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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.
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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 does external respiration occur?
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
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
arrhythmia
higher

2. When the vascular walls lose elasticity - as with arteriosclerosis and aging what happens to BP?
Temperature will remain below 102 degrees with use of hypothermia blanket
It increases to push the blood through more rigid pathways.
Kussmaul's respiration
tachycardia

3. While measuring the BP certain sounds may be heard that relate to the effect of the blood pressure cuff on the arterial wall.
bradycardia
Korotkoff sounds
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
Eupnea

4. How do emotions increase the pulse rate?
Stroke Volume
Acute anxiety stimulate the nervous system - raising the pulse.
Diastolic pressure
Biot's respirations

5. How does size affect pulse?
Relapsing
Tall - slender people mayy ave a slower pulse rate than short - stout persons
oximeter
absent

6. If the cardiac output falls what will happen to the BP?
thready
It will also fall
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.
Feeble

7. Prehypertension
oximetry
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
120-139/80-89
Relapsing

8. Obtaining the correct size for a cuff for BP?
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.
Axillary.
Tall - slender people mayy ave a slower pulse rate than short - stout persons
bradypnea

9. Continuous dry - rattling sounds heard on ausculation of the lungs caused by partial obstruction.
palpate
Pulse
Rhonchi
Hypothermia

10. Side of neck
It doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.
Apical
carotid
the lungs

11. 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
Feeble
Korotkoff sounds
in the alveoli - tiny thin-walled sacs

12. 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?
Dorsalis pedis
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
Conduction
fever

13. How is shock caused?
Temporal
hypotension
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
tachycardia

14. Stress & emotions. BP?
higher
+1
raises BP.
Blood pressure increases because there is more volume of blood in the vascular system.

15. Drop in blood pressure when arising to a standing position.
pyrexia
orthostatic hypertension
Rhonchi
Eupnea

16. How does disease increase the body's temperature?
Stroke volume
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
absent
oximeter

17. How is pulse best found?
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.
Biot's
Radial
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

18. How cardiac contractions are normally initiated by the electrical impules emerging from what?
Pulse pressure
Sinoatrial node (SA NODE)
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.
oximetry

19. Average blood pressure should be
arrhythmia
The emotions increase hormone secretion - and the body activities required for this increase heat production.
Relapsing
120/70

20. respirations become faster and deeper - then slower and shallower wit a period of apnea - called the death rattle.
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.
Pulse
Cheyenne-Stokes
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

21. People most at risk for hypertension
Nursing interventions to reduce fever
Irregular
Axillary.
men - African Americans - under a lot of stress - obese

22. Murmur or swishing sounds that increase as the cuff is deflated
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
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.
Korotkoff sounds Phase II Swishing
hypoxia

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

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24. Symptoms of hypoxia
Apical
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
120/80
Radial

25. Whats the best position to take a rectal temperature?
left Sims position
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
Eupnea
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.

26. Taking axillary temperature
the lungs
the blood pressure will rise in order to push the blood along.
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.
Respiration

27. How does age affect pulse?
arrhythmia
The pulse rate gradually diminishes from birth to adulthood
thready
Biot's

28. Healthly adult
BMR
12-20
30-80
120/80

29. Difficult and labored breathing - can often be accompanied by flared nostrils - anxious appearance - and statements such as I cant get enough air.
Vascular resistance drops and the blood pressure decreases
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.
systolic pressure indicated by faint - clear sound that gradually grow louder.
dyspnea

30. Taking a rectal temperature
bradypnea
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
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

31. Weak and may be irregular
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
pyrogens
remittent
thready

32. The temperature is continuously elevated with less than 1 degree of variation within a 24-hour period.
Cardiac Output
120/80
constant
16-20

33. Weak and regular (even beats wit poor force)
Tall - slender people mayy ave a slower pulse rate than short - stout persons
crackles
Pedal pulse
+1

34. 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
fever
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.
+1

35. Louder knocking sound that occurs wit each heartbeat
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.
low
males have higher bp - until menopause then they are the same
Korotkoff sounds Phase III: Knocking

36. When the heart contracts How many mLs of blood is propelled into the aorta?
about 1 degree lower than oral temperatures
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
12-20
60 to 70 mL

37. Newborn
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
apnea
bradycardia
30-80

38. Fever above 100.2 F
pyrexia
lysis
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.
dyspnea

39. Are infants blood pressure low or high?
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
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
low
arrhythmia

40. How does increased body temperature increase the pulse?
Apical
Biot's respirations
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.
The pulse rate increases at the rate of 7-10 beats for each degree of temperature

41. Groin area
about 1 degree higher than oral temperatures
Femoral
oximeter
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.

42. Those at risk for hypothermia include
in the alveoli - tiny thin-walled sacs
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.
hypotension
higher

43. Air movemtn causes heat to be transferred from the skin to the air molecules.
Pulse
Pulse pressure
Convection
about 1 degree lower than oral temperatures

44. The exchange of oxygen and carbon dioxide in the lungs and tissues and is initiated by the act of breathing.
12-20
Stroke volume
the lungs
Respiration

45. Strong and regular ( even beats wit moderate force)
+2
Sinoatrial node (SA NODE)
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
Diaphoresis

46. An example of a nursing diagnoses
stridor
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.
Hyperthermia related to infection or excessive heat exposure
Korotkoff sounds

47. Abrupt decline in fever
Crisis
in the alveoli - tiny thin-walled sacs
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.
pyrexia

48. Elevated temperature
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
fever
lysis
about 1 degree lower than oral temperatures

49. Snoring sound produced when patients are unable to cough up secretions from the trachea or bronchi
Stertor
in the alveoli - tiny thin-walled sacs
The emotions increase hormone secretion - and the body activities required for this increase heat production.
Korotkoff sounds Phase III: Knocking

50. 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.
120/80
Tachypnea
Posterior tibial
120-139/80-89

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Measuring Vital Signs

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