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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. What affects does aging do to the heart rate?

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2. Weak and regular (even beats wit poor force)
Stroke Volume
+1
low
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.

3. High oxygen
hyperoxia
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.
pyrexia
Sinoatrial node (SA NODE)

4. How does external respiration occur?
the rate - the rhythm - and volume
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
popliteal
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

5. Excessive sweat production
constant
Acute anxiety stimulate the nervous system - raising the pulse.
Diaphoresis
about 1 degree higher than oral temperatures

6. Head injury BP?
raises BP.
Hyperventilation
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

7. 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.
Hyperventilation
hypoxemia
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.
Respiration

8. How does emotional stress raise the body's temperature?
Posterior tibial
The emotions increase hormone secretion - and the body activities required for this increase heat production.
BMR
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.

9. While measuring the BP certain sounds may be heard that relate to the effect of the blood pressure cuff on the arterial wall.
Korotkoff sounds
Apical
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
120/80

10. respirations become faster and deeper - then slower and shallower wit a period of apnea - called the death rattle.
+2
Cheyenne-Stokes
Diaphoresis
Korotkoff sounds Phase IV: Muffling

11. An example of nursing planning
Biot's respirations
constant
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.
Temperature will remain below 102 degrees with use of hypothermia blanket

12. The difference between the systolic pressure and the diastolic pressure
Dorsalis pedis
30-80
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.
Pulse pressure

13. An example of a nursing diagnoses
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.
Hyperthermia related to infection or excessive heat exposure
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
Pulse

14. Axillary temperature are
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
Crisis
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
about 1 degree lower than oral temperatures

15. The pressure wave causing te arterial walls in the vascular system each time the heart contracts to force blood into an already full aorta.
Temporal
Pulse
Diaphoresis
Systolic pressure

16. How should respirations be counted?
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.
Stroke volume
shallow or slow breathing
temperature - pulse - respiration - blood pressure - and pain level.

17. 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.
pyrogens
remittent
It doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.
97.5 to 99.5

18. Bend of elbow
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
Brachial
hypotension
96.5 to 97.5

19. How does age affect pulse?
The pulse rate gradually diminishes from birth to adulthood
lysis
shallow or slow breathing
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.

20. When the heart contracts How many mLs of blood is propelled into the aorta?
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
Hyperventilation
60 to 70 mL
Dorsalis pedis

21. Strong and regular ( even beats wit moderate force)
Crisis
left Sims position
Dorsalis pedis
+2

22. What should you do if you cannot determine BP by ausculation?
16-20
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.
The pulse rate gradually diminishes from birth to adulthood
Brachial

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

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24. Obtaining the correct size for a cuff for BP?
raises BP.
Blood pressure increases because there is more volume of blood in the vascular system.
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.
Rhonchi

25. Gas exchange in the blood occurs where?
+2
wheeze
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
in the alveoli - tiny thin-walled sacs

26. How cardiac contractions are normally initiated by the electrical impules emerging from what?
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
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.
Core Temperature
Sinoatrial node (SA NODE)

27. Symptoms of hypoxia
crackles
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
The pulse rate increases at the rate of 7-10 beats for each degree of temperature
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

28. Blood pressure for any adult should be no higher than
Axillary.
popliteal
men - African Americans - under a lot of stress - obese
120/80

29. When should rectal temperatures NOT be used?
shallow or slow breathing
cardiac patients or patients who have had rectal surgery.
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
Kussmaul's respiration

30. Hearing
constant
ausculatation
140-159/90-99
Nursing interventions to reduce fever

31. Louder knocking sound that occurs wit each heartbeat
Korotkoff sounds Phase III: Knocking
Tall - slender people mayy ave a slower pulse rate than short - stout persons
Feeble
bradycardia

32. 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
It will also fall
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.
120-139/80-89

33. Snoring sound produced when patients are unable to cough up secretions from the trachea or bronchi
Stertor
orthostatic hypertension
97.5 to 99.5
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.

34. The volume of blood pushed into the aorta per heartbeat.
Stroke volume
cardiac patients or patients who have had rectal surgery.
wheeze
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.

35. Healthly adult
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.
the lungs
12-20
BMR

36. Stage 1 hypertension
It doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
140-159/90-99
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.

37. Korotkoff sounds Ausculatatory gap:
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
It doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.
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

38. Shock - hemorrhage - low cardiac output - inadequate volume of blood?
^160/^100
lysis
males have higher bp - until menopause then they are the same
low BP

39. The rate at which heat is produced when the body is at rest.
BMR
The pulse rate gradually diminishes from birth to adulthood
systolic pressure indicated by faint - clear sound that gradually grow louder.
uncooperative patient - children - combative patients - dementia

40. Elevated temperature
stridor
fever
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.
Korotkoff sounds Phase V: Silence

41. A sudden change or muffling of the sound. (indicates diastolic pressure in children and some adults)
Korotkoff sounds Phase IV: Muffling
Systolic pressure
Hypothermia
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.

42. Abnormal - nonmusical sound heard on ausculation of the lungs during inspiration; also called rales. Sound like hair rubbed between the fingers next to the ears.
apnea
hypoxia
crackles
from drug therapy - a neurologic problem or dehydration.

43. How should baby's temperature be taken?
orthostatic hypertension
Pulse pressure
Axillary.
systolic pressure indicated by faint - clear sound that gradually grow louder.

44. 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.
pyrexia
uncooperative patient - children - combative patients - dementia
Hypothermia

45. Carbon dioxide is carried as bicarbonate ion in the blood until it reaches where?
Axillary.
the lungs
from drug therapy - a neurologic problem or dehydration.
raises BP.

46. Side of neck
Core Temperature
Femoral
carotid
palpate

47. Gradual return to a normal temperature
from drug therapy - a neurologic problem or dehydration.
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.
Stroke Volume
lysis

48. What will happen in febrile stage if temperature is very high or temperature stays for a long amount of time?
tachycardia
Dorsalis pedis
Pulse
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. How does increased body temperature increase the pulse?
The pulse rate increases at the rate of 7-10 beats for each degree of temperature
Dorsalis pedis
raises BP.
thready

50. Does the respiration rate increase or decrease during fever?
males have higher bp - until menopause then they are the same
Increases as body tries to remove excess heat
Brachial
Vascular resistance drops and the blood pressure decreases