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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. By measuring the blood pressure you obtain vital info about what?
hypotension
lysis
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes
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

2. What characteristics should be noted when checking the pulse?
The pulse rate gradually diminishes from birth to adulthood
the rate - the rhythm - and volume
males have higher bp - until menopause then they are the same
remittent

3. Breathing is an involuntary automatic function controlled by the respiratory center located where?
Pons and Medulla of the brainstem
pyrogens
Respiration
bradycardia

4. Normal body temperature ranges?
97.5 to 99.5
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
16-20
Rhonchi

5. Measurement of oxygen
Pedal pulse
palpate
oximetry
blood pressure is lowest in the morning. and higher in the afternoone

6. Gradual return to a normal temperature
Core Temperature
120-139/80-89
97.5 to 99.5
lysis

7. 2nd stage of fever is?
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
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.
hypotension
Pedal pulse

8. Continuous dry - rattling sounds heard on ausculation of the lungs caused by partial obstruction.
Rhonchi
crackles
Crisis
96.5 to 97.5

9. This affects the character of the pulse.
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
Stroke Volume
It increases to push the blood through more rigid pathways.
Cheyenne-Stokes

10. 3rd stage of fever?
hypoxia
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
raises BP.
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.

11. 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.
remittent
Irregular
Feeble
Tachypnea

12. Heat is lost from the body by evaporation. resulting in a daily loss of 800mL of water from skin and lungs.
Korotkoff sounds Phase III: Knocking
It doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.
Evaporation
Dorsalis pedis

13. Newborn
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.
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
Relapsing
30-80

14. Crowing sound on inspiration caused by obstruction of the upper air passages - as occurs in croup or laryngitis
hyperoxia
stridor
apnea
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

15. How do you measure the apical pulse?
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
Korotkoff sounds Phase II Swishing
72 bpm
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.

16. Pulse lower than 60 beats per minute
hypoxemia
bradycardia
pyrexia
about 1 degree lower than oral temperatures

17. Shock - hemorrhage - low cardiac output - inadequate volume of blood?
low BP
hypoxia
Stroke Volume
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.

18. How does physical exercise raise the body's temperature?
Sinoatrial node (SA NODE)
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.
Convection
Feeble

19. 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
ausculatation
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
hypotension

20. What happens to the blood if overhydration occurs?
Diaphoresis
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
Blood pressure increases because there is more volume of blood in the vascular system.
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. Disappearance of sound. (marks diastolic pressure in adults)
wheeze
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.
Korotkoff sounds Phase V: Silence
hypoxia

22. Slow and shallow breathing - leads to hypoxemia.
absent
bradypnea
16-20
Increases as body tries to remove excess heat

23. How do drugs affect pulse?
Hyperthermia related to infection or excessive heat exposure
Hyperventilation
Eupnea
Stimulants increase the pulse rate. Depressants decrease the pulse rate.

24. Weak and regular (even beats wit poor force)
The emotions increase hormone secretion - and the body activities required for this increase heat production.
Pulse pressure
+1
oximeter

25. Lobes in the lungs?
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.
lysis
3 in the right lung and 2 lobes in the left
hypotension

26. Korotkoff sounds Ausculatatory gap:
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
Axillary.

27. How do emotions increase the pulse rate?
Vascular resistance drops and the blood pressure decreases
Acute anxiety stimulate the nervous system - raising the pulse.
Apical
crackles

28. How cardiac contractions are normally initiated by the electrical impules emerging from what?
Axillary.
Korotkoff sounds Phase V: Silence
Sinoatrial node (SA NODE)
left Sims position

29. What are the 5 vital signs?
Blood pressure increases because there is more volume of blood in the vascular system.
temperature - pulse - respiration - blood pressure - and pain level.
hypertension
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.

30. Those at risk for hypothermia include
Stroke Volume
fever
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.
Tall - slender people mayy ave a slower pulse rate than short - stout persons

31. Taking axillary temperature
Pulse pressure
140-159/90-99
thready
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.

32. respirations become faster and deeper - then slower and shallower wit a period of apnea - called the death rattle.
Rhonchi
Cheyenne-Stokes
20-30
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.

33. Average blood pressure should be
120/70
bradycardia
uncooperative patient - children - combative patients - dementia
shallow or slow breathing

34. Side of neck
120/80
Feeble
carotid
Apical

35. Are infants blood pressure low or high?
low
Core Temperature
Dorsalis pedis
Diaphoresis

36. Bend of knee
popliteal
hypertension
Femoral
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.

37. 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.
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.
hypoxemia
Hyperthermia related to infection or excessive heat exposure
the blood pressure will rise in order to push the blood along.

38. 3 yr old
20-30
if its hot bp can lower because of vasodilation. if its cold it can rise because of vasoconstriction.
Feeble
30-80

39. If the cardiac output falls what will happen to the BP?
Stroke volume
120/70
Systolic pressure
It will also fall

40. Prehypertension
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
Crisis
120-139/80-89
the BP goes up because more pressure is needed to push the thicker fluid through the vascular system.

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

42. What affects does aging do to the blood pressure?
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
Nursing interventions to reduce fever
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
Axillary.

43. Healthly adult
120-139/80-89
+2
12-20
blood pressure is lowest in the morning. and higher in the afternoone

44. What pulse is checked to determine whether there is any blockage of circulation in the artery up to that point - especially in patients who have had cardiac catherization using the femoral artery for the insertion of the catheter or those who had sur
Pedal pulse
Korotkoff sounds Phase III: Knocking
120-139/80-89
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.

45. If blood becomes thicker - like when excessive blood cells are manufactured what happens to BP?
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.
60 to 70 mL
the BP goes up because more pressure is needed to push the thicker fluid through the vascular system.
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.

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

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47. Macine that measures oxygen in the blood by determining the percentage of hemoglobin that is bound with oxygen.
males have higher bp - until menopause then they are the same
oximeter
Pulse
the BP goes up because more pressure is needed to push the thicker fluid through the vascular system.

48. 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?
orthostatic hypertension
lysis
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
low BP

49. Snoring sound produced when patients are unable to cough up secretions from the trachea or bronchi
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.
low BP
Stertor
low

50. How is pulse best found?
if its hot bp can lower because of vasodilation. if its cold it can rise because of vasoconstriction.
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 rate - the rhythm - and volume
temperature - pulse - respiration - blood pressure - and pain level.