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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 menstrual cycle and pregnancy raise the body's temperature?
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.
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
Brachial
absent

2. Newborn
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.
constant
stridor
30-80

3. Head injury BP?
raises BP.
males have higher bp - until menopause then they are the same
carotid
The emotions increase hormone secretion - and the body activities required for this increase heat production.

4. The exchange of oxygen and carbon dioxide in the lungs and tissues and is initiated by the act of breathing.
Tachypnea
Respiration
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
the rate - the rhythm - and volume

5. Excessive sweat production
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
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
Diaphoresis
Temporal

6. BP at or lower 90/60.
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
hypotension
about 1 degree lower than oral temperatures
16-20

7. Whats the best position to take a rectal temperature?
Stroke Volume
left Sims position
The pulse rate increases at the rate of 7-10 beats for each degree of temperature
low

8. Side of wrist
systolic pressure indicated by faint - clear sound that gradually grow louder.
wheeze
hypertension
Radial

9. Hearing
Hypothermia
left Sims position
BMR
ausculatation

10. Inside ankle
It increases to push the blood through more rigid pathways.
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.
Posterior tibial

11. If blood becomes thicker - like when excessive blood cells are manufactured what happens to BP?
Korotkoff sounds Phase III: Knocking
the BP goes up because more pressure is needed to push the thicker fluid through the vascular system.
Eupnea
absent

12. When is apicial pulse used?
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.
12-20
Convection
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.

13. 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.
72 bpm
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.
apnea
Hypothermia

14. Korotkoff sounds Phase I: Tapping
systolic pressure indicated by faint - clear sound that gradually grow louder.
Hyperventilation
uncooperative patient - children - combative patients - dementia
oximetry

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.
hypoxia
It will also fall
remittent
popliteal

16. Barely palpable
Axillary.
Feeble
about 1 degree lower than oral temperatures
30-80

17. Measurement of oxygen
Irregular
oximeter
oximetry
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.

18. A normal - relaxed breathing pattern
Conduction
97.5 to 99.5
Pulse
Eupnea

19. The rate at which heat is produced when the body is at rest.
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
Dorsalis pedis
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
BMR

20. Heat is lost from the body by evaporation. resulting in a daily loss of 800mL of water from skin and lungs.
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
the BP goes up because more pressure is needed to push the thicker fluid through the vascular system.
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
Evaporation

21. Fever above 100.2 F
if its hot bp can lower because of vasodilation. if its cold it can rise because of vasoconstriction.
lysis
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
pyrexia

22. Does the respiration rate increase or decrease during fever?
Axillary.
Core Temperature
carotid
Increases as body tries to remove excess heat

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

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24. Bend of elbow
Brachial
140-159/90-99
Pons and Medulla of the brainstem
Relapsing

25. Air movemtn causes heat to be transferred from the skin to the air molecules.
It doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.
30-80
Korotkoff sounds Phase V: Silence
Convection

26. 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.
Tachypnea
cardiac patients or patients who have had rectal surgery.
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
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.

27. How does external respiration occur?
Korotkoff sounds
shallow or slow breathing
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
Systolic pressure

28. Low oxygen
20-30
pyrogens
+3
hypoxia

29. Weak and may be irregular
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.
Cardiac Output
thready

30. An example of a nursing diagnoses
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
Pedal pulse
crackles
Hyperthermia related to infection or excessive heat exposure

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

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32. Signs and symptoms of shock
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
fever
blood pressure is lowest in the morning. and higher in the afternoone
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.

33. While measuring the BP certain sounds may be heard that relate to the effect of the blood pressure cuff on the arterial wall.
hypoxia
Femoral
Korotkoff sounds
Tall - slender people mayy ave a slower pulse rate than short - stout persons

34. Heart
dyspnea
Apical
Cardiac Output
Stertor

35. Full and bounding (even beats wit strong force)
about 1 degree higher than oral temperatures
Brachial
+3
Hyperthermia related to infection or excessive heat exposure

36. 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.
It increases to push the blood through more rigid pathways.
hypoxemia
oximetry
+1

37. No pulse palpable or heard on ausculation
It will also fall
absent
The emotions increase hormone secretion - and the body activities required for this increase heat production.
96.5 to 97.5

38. Sex BP?
Cardiac Output
Biot's respirations
wheeze
males have higher bp - until menopause then they are the same

39. Elevated temperature
from drug therapy - a neurologic problem or dehydration.
fever
about 1 degree higher than oral temperatures
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.

40. Murmur or swishing sounds that increase as the cuff is deflated
Korotkoff sounds Phase II Swishing
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.
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
The pulse rate gradually diminishes from birth to adulthood

41. When should rectal temperatures be used?
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.
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
if its hot bp can lower because of vasodilation. if its cold it can rise because of vasoconstriction.
Biot's respirations

42. The temperature of the deep tissues of the body
Core Temperature
Evaporation
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
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

43. Disappearance of sound. (marks diastolic pressure in adults)
Korotkoff sounds Phase V: Silence
men - African Americans - under a lot of stress - obese
+3
Rhonchi

44. 3 yr old
20-30
Conduction
ausculatation
hypoxia

45. Substances tat cause fever
hypertension
bradypnea
pyrogens
Pedal pulse

46. Why would patients experience orthostatic hypotenstion?
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.
uncooperative patient - children - combative patients - dementia
Nursing interventions to reduce fever
from drug therapy - a neurologic problem or dehydration.

47. What are the 5 vital signs?
Radial
Axillary.
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.
temperature - pulse - respiration - blood pressure - and pain level.

48. The temperature is continuously elevated with less than 1 degree of variation within a 24-hour period.
^160/^100
Vascular resistance drops and the blood pressure decreases
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
constant

49. 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.
Kussmaul's respiration
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.
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes
Cardiac Output

50. People most at risk for hypertension
Kussmaul's respiration
Brachial
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
men - African Americans - under a lot of stress - obese