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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. State of insufficient oxygen
the rate - the rhythm - and volume
hypoxia
Nursing interventions to reduce fever
temperature - pulse - respiration - blood pressure - and pain level.

2. Weak and regular (even beats wit poor force)
Korotkoff sounds Phase IV: Muffling
Kussmaul's respiration
Femoral
+1

3. Rectal temperature are
dyspnea
thready
Korotkoff sounds Phase III: Knocking
about 1 degree higher than oral temperatures

4. Head injury or any increased intracranial pressure will depress the respiratory center and result in?
Tachypnea
absent
120/80
shallow or slow breathing

5. The volume of blood pushed into the aorta per heartbeat.
pyrexia
Increases as body tries to remove excess heat
Convection
Stroke volume

6. A normal - relaxed breathing pattern
if its hot bp can lower because of vasodilation. if its cold it can rise because of vasoconstriction.
Eupnea
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 doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.

7. While measuring the BP certain sounds may be heard that relate to the effect of the blood pressure cuff on the arterial wall.
apnea
bradypnea
Korotkoff sounds
Dorsalis pedis

8. Healthly adult
BMR
Kussmaul's respiration
12-20
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.

9. By measuring the blood pressure you obtain vital info about what?
20-30
Dorsalis pedis
Pulse
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

10. High oxygen
raises BP.
hyperoxia
higher
tachycardia

11. Crowing sound on inspiration caused by obstruction of the upper air passages - as occurs in croup or laryngitis
stridor
120-139/80-89
intermittent
Posterior tibial

12. Why would patients experience orthostatic hypotenstion?
Relapsing
Diaphoresis
bradycardia
from drug therapy - a neurologic problem or dehydration.

13. Carbon dioxide is carried as bicarbonate ion in the blood until it reaches where?
shallow or slow breathing
the lungs
tachycardia
+3

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

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

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16. How do you measure the apical pulse?
fever
+3
+1
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

17. Full and bounding (even beats wit strong force)
pyrexia
Crisis
16-20
+3

18. What affects does aging do to the respiratory rate?
Rhonchi
stridor
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
Hypothermia

19. Axillary temperature are
about 1 degree lower than oral temperatures
72 bpm
140-159/90-99
orthostatic hypertension

20. How does external respiration occur?
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
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.
Pedal pulse
tachycardia

21. 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.
cardiac patients or patients who have had rectal surgery.
blood pressure is lowest in the morning. and higher in the afternoone
hyperoxia

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

23. When should rectal temperatures be used?
Eupnea
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
Relapsing
Brachial

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

25. Gradual return to a normal temperature
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
Diastolic pressure
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
lysis

26. BP at or lower 90/60.
The pulse rate gradually diminishes from birth to adulthood
120/70
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
hypotension

27. What happens to the blood if overhydration occurs?
higher
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.
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
Blood pressure increases because there is more volume of blood in the vascular system.

28. Shock - hemorrhage - low cardiac output - inadequate volume of blood?
temperature - pulse - respiration - blood pressure - and pain level.
Korotkoff sounds
low BP
Irregular

29. Snoring sound produced when patients are unable to cough up secretions from the trachea or bronchi
+2
Conduction
Stertor
Pulse

30. When is apicial pulse used?
Biot's respirations
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.
from drug therapy - a neurologic problem or dehydration.
Feeble

31. 2nd stage of fever is?
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.
Pedal pulse
Pulse
Kussmaul's respiration

32. How does emotional stress raise the body's temperature?
The emotions increase hormone secretion - and the body activities required for this increase heat production.
intermittent
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
Increases as body tries to remove excess heat

33. When the vascular walls lose elasticity - as with arteriosclerosis and aging what happens to BP?
It increases to push the blood through more rigid pathways.
Brachial
Diastolic pressure
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.

34. How do drugs affect pulse?
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
Tachypnea
16-20
hypoxia

35. 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
arrhythmia
Pedal pulse
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
Pulse pressure

36. 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 doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.
fever
Nursing interventions to reduce fever
oximetry

37. Macine that measures oxygen in the blood by determining the percentage of hemoglobin that is bound with oxygen.
remittent
oximeter
Korotkoff sounds Phase IV: Muffling
Core Temperature

38. When the heart contracts How many mLs of blood is propelled into the aorta?
if its hot bp can lower because of vasodilation. if its cold it can rise because of vasoconstriction.
140-159/90-99
60 to 70 mL
The pulse rate gradually diminishes from birth to adulthood

39. What patients should not use a glass thermometer orally?
hypotension
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
uncooperative patient - children - combative patients - dementia
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.

40. Blood pressure for any adult should be no higher than
Pedal pulse
120/80
Pulse
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.

41. A sudden change or muffling of the sound. (indicates diastolic pressure in children and some adults)
low
Korotkoff sounds Phase IV: Muffling
Cardiac Output
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes

42. Elevated temperature
fever
Pons and Medulla of the brainstem
hypoxia
in the alveoli - tiny thin-walled sacs

43. Whats the best position to take a rectal temperature?
left Sims position
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
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds

44. Side of neck
Biot's respirations
Diaphoresis
dyspnea
carotid

45. What will happen in febrile stage if temperature is very high or temperature stays for a long amount of time?
oximeter
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
Rhonchi
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.

46. Stress & emotions. BP?
higher
Korotkoff sounds Phase II Swishing
apnea
The pulse rate gradually diminishes from birth to adulthood

47. Taking a rectal temperature
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.
Stroke Volume
Stroke volume
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.

48. Low oxygen
Tachypnea
hypoxia
Conduction
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

49. Head injury 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.
Vascular resistance drops and the blood pressure decreases
Feeble
raises BP.

50. This affects the character of the pulse.
Stroke Volume
stridor
20-30
120/70