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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.
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. Taking axillary temperature
30-80
pyrogens
Hypothermia
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.

2. Prehypertension
Korotkoff sounds Phase V: Silence
120-139/80-89
Systolic pressure
oximetry

3. Symptoms of hypoxia
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
pyrogens
BMR
The pulse rate gradually diminishes from birth to adulthood

4. Alternating rise and fall of the temperature.
Pulse pressure
Diastolic pressure
intermittent
pyrexia

5. Shock - hemorrhage - low cardiac output - inadequate volume of blood?
Nursing interventions to reduce fever
bradycardia
low BP
carotid

6. When should rectal temperatures be used?
120/80
Axillary.
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
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.

7. Sex BP?
males have higher bp - until menopause then they are the same
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
the lungs

8. How cardiac contractions are normally initiated by the electrical impules emerging from what?
Sinoatrial node (SA NODE)
Relapsing
Diaphoresis
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. The exchange of oxygen and carbon dioxide in the lungs and tissues and is initiated by the act of breathing.
Feeble
Nursing interventions to reduce fever
Respiration
about 1 degree higher than oral temperatures

10. What patients should not use a glass thermometer orally?
hypertension
97.5 to 99.5
uncooperative patient - children - combative patients - dementia
Core Temperature

11. Adolescent
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 palpation method is used. put cuff over arm - feel the radial point to get the systolic pressure you cant get the diastolic this way.
72 bpm
16-20

12. Average pulse rate for an adult
Hyperventilation
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
low
72 bpm

13. When should rectal temperatures NOT be used?
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
cardiac patients or patients who have had rectal surgery.
Cheyenne-Stokes
absent

14. How does disease increase the body's temperature?
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
higher
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes
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.

15. Groin area
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.
hypoxemia
120/80
Femoral

16. Those at risk for hypothermia include
It increases to push the blood through more rigid pathways.
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
the rate - the rhythm - and volume
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.

17. Substances tat cause fever
120-139/80-89
Stroke Volume
pyrogens
12-20

18. High BP
Core Temperature
hypertension
Korotkoff sounds Phase IV: Muffling
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients

19. What happens whens vasoconstriction causes peripheral vascular resistance to rise?
Relapsing
Hyperthermia related to infection or excessive heat exposure
the blood pressure will rise in order to push the blood along.
Stimulants increase the pulse rate. Depressants decrease the pulse rate.

20. A sudden change or muffling of the sound. (indicates diastolic pressure in children and some adults)
remittent
Eupnea
low BP
Korotkoff sounds Phase IV: Muffling

21. What affects does aging do to the respiratory rate?
Brachial
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
Diastolic pressure
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

22. Obtaining the correct size for a cuff for BP?
shallow or slow breathing
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.
about 1 degree higher than oral temperatures

23. The lower pressure exerted on the artery when the heart is at rest inbetween contractions.
hyperoxia
Diastolic pressure
Biot's respirations
Pulse

24. 3 yr old
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
The pulse rate increases at the rate of 7-10 beats for each degree of temperature
Nursing interventions to reduce fever
20-30

25. Disappearance of sound. (marks diastolic pressure in adults)
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
Korotkoff sounds Phase V: Silence
thready
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds

26. An example of a nursing diagnoses
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.
intermittent
Hyperthermia related to infection or excessive heat exposure
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.

27. right arm vs. left arm/ arm vs. leg BP?
BMR
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.
12-20
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.

28. Measurement of oxygen
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
uncooperative patient - children - combative patients - dementia
hypoxemia
oximetry

29. 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
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
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.
16-20

30. How should baby's temperature be taken?
ausculatation
140-159/90-99
hypoxia
Axillary.

31. Fast - deep respirations with abrupt pauses

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32. Rectal temperature are
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.
about 1 degree higher than oral temperatures
oximeter
It increases to push the blood through more rigid pathways.

33. 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.
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
Stroke 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
Tachypnea

34. Are infants blood pressure low or high?
low
arrhythmia
from drug therapy - a neurologic problem or dehydration.
Sinoatrial node (SA NODE)

35. BP at or lower 90/60.
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
hypotension
raises BP.

36. Diurnal variation BP?
Stroke Volume
intermittent
Stertor
blood pressure is lowest in the morning. and higher in the afternoone

37. Irregular pulse - a period of normal rhythm broken by periods of irregularity or skipped beats.
hypertension
Korotkoff sounds Phase V: Silence
arrhythmia
Tachypnea

38. State of insufficient oxygen
Pulse pressure
hypoxia
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
tachycardia

39. Top of left foot
males have higher bp - until menopause then they are the same
Dorsalis pedis
Biot's
It may rise slightly as decreases in vital capacity and respiratory reserve occur.

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

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41. How is pulse best found?
+2
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 IV: Muffling
from drug therapy - a neurologic problem or dehydration.

42. When warm skin touches a cool object - heat is lost to the object.
It doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.
Conduction
in the alveoli - tiny thin-walled sacs
hypoxia

43. 1st stage of fever is?
Evaporation
The pulse rate increases at the rate of 7-10 beats for each degree of temperature
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
wheeze

44. Drop in blood pressure when arising to a standing position.
orthostatic hypertension
The emotions increase hormone secretion - and the body activities required for this increase heat production.
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes
Pons and Medulla of the brainstem

45. 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.
Posterior tibial
72 bpm
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.

46. No pulse palpable or heard on ausculation
absent
wheeze
Diaphoresis
140-159/90-99

47. Slow and shallow breathing - leads to hypoxemia.
Core Temperature
bradypnea
Brachial
Blood pressure increases because there is more volume of blood in the vascular system.

48. How does menstrual cycle and pregnancy raise the body's temperature?
Biot's
apnea
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
Irregular

49. How should respirations be counted?
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.
apnea
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.

50. Head injury or any increased intracranial pressure will depress the respiratory center and result in?
Convection
Cheyenne-Stokes
shallow or slow breathing
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