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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. Inside ankle
males have higher bp - until menopause then they are the same
Sinoatrial node (SA NODE)
Posterior tibial
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.

2. Drop in blood pressure when arising to a standing position.
orthostatic hypertension
Blood pressure increases because there is more volume of blood in the vascular system.
Femoral
Irregular

3. Gradual return to a normal temperature
Acute anxiety stimulate the nervous system - raising the pulse.
absent
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
lysis

4. What affects does aging do to the respiratory rate?
It may rise slightly as decreases in vital capacity and respiratory reserve occur.
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
It increases to push the blood through more rigid pathways.
Kussmaul's respiration

5. Disappearance of sound. (marks diastolic pressure in adults)
The emotions increase hormone secretion - and the body activities required for this increase heat production.
30-80
Axillary.
Korotkoff sounds Phase V: Silence

6. Are infants blood pressure low or high?
hyperoxia
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
low
crackles

7. Barely palpable
Feeble
palpate
It doesn't change in a healthy elderly patient but the pattern rhythm may be slightly irregular.
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

8. Lobes in the lungs?
3 in the right lung and 2 lobes in the left
bradypnea
Posterior tibial
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.

9. People most at risk for hypertension
ausculatation
Irregular
cardiac patients or patients who have had rectal surgery.
men - African Americans - under a lot of stress - obese

10. What happens when vasodilation occurs?
Vascular resistance drops and the blood pressure decreases
20-30
hypotension
Nursing interventions to reduce fever

11. How does emotional stress raise the body's temperature?
The emotions increase hormone secretion - and the body activities required for this increase heat production.
Femoral
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.
uncooperative patient - children - combative patients - dementia

12. right arm vs. left arm/ arm vs. leg BP?
from drug therapy - a neurologic problem or dehydration.
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.
Tachypnea
the BP goes up because more pressure is needed to push the thicker fluid through the vascular system.

13. What patients should not use a glass thermometer orally?
Stertor
uncooperative patient - children - combative patients - dementia
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
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

14. Obtaining the correct size for a cuff for BP?
Convection
tachycardia
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.

15. How should baby's temperature be taken?
It will also fall
tachycardia
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
Axillary.

16. Korotkoff sounds Ausculatatory gap:
Biot's respirations
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
BMR
Cardiac Output

17. Groin area
It increases to push the blood through more rigid pathways.
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
Femoral
16-20

18. The pressure wave causing te arterial walls in the vascular system each time the heart contracts to force blood into an already full 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
Pulse
systolic pressure indicated by faint - clear sound that gradually grow louder.
the lungs

19. Pulse lower than 60 beats per minute
temperature - pulse - respiration - blood pressure - and pain level.
lysis
stridor
bradycardia

20. The exchange of oxygen and carbon dioxide in the lungs and tissues and is initiated by the act of breathing.
The pulse rate increases at the rate of 7-10 beats for each degree of temperature
low BP
Diastolic pressure
Respiration

21. Stage 2 hypertension
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.
hypertension
^160/^100
Korotkoff sounds Phase V: Silence

22. Whisting sound of air forced past a partial obstruction - as found in asthma or emphysema.
wheeze
72 bpm
140-159/90-99
thready

23. Average pulse rate for an adult
crackles
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.
^160/^100
72 bpm

24. What should you do if you cannot determine BP by ausculation?
males have higher bp - until menopause then they are the same
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.
systolic pressure indicated by faint - clear sound that gradually grow louder.
Pons and Medulla of the brainstem

25. Bend of elbow
Respiration
intermittent
Brachial
Systolic pressure

26. Pulse above 100 beats per minute
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.
blood pressure is lowest in the morning. and higher in the afternoone
Kussmaul's respiration
tachycardia

27. Murmur or swishing sounds that increase as the cuff is deflated
+2
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
It will also fall
Korotkoff sounds Phase II Swishing

28. Shallow for two or three breaths with a period of variable apnea. occur in patients with increased intracranial pressure.

29. respirations become faster and deeper - then slower and shallower wit a period of apnea - called the death rattle.
Cheyenne-Stokes
in the alveoli - tiny thin-walled sacs
Sinoatrial node (SA NODE)
Temperature will remain below 102 degrees with use of hypothermia blanket

30. When should rectal temperatures NOT be used?
cardiac patients or patients who have had rectal surgery.
males have higher bp - until menopause then they are the same
Korotkoff sounds
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.

31. Sex BP?
3 in the right lung and 2 lobes in the left
crackles
72 bpm
males have higher bp - until menopause then they are the same

32. Adolescent
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
16-20
Dorsalis pedis
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.

33. Whats the best position to take a rectal temperature?
hypertension
raises BP.
ausculatation
left Sims position

34. An example of nursing planning
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.
Temperature will remain below 102 degrees with use of hypothermia blanket
Conduction
Rhonchi

35. Elevated temperature
120-139/80-89
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
fever
3 in the right lung and 2 lobes in the left

36. A pattern of breathing in which there is an increase in the rate and the depth of breaths and carbon dioxide is expelled - causing te blood level of carbon dioxide to fall. this condition is seen after sever exertion - during high levels of anxiety o
Korotkoff sounds Phase IV: Muffling
blood pressure is lowest in the morning. and higher in the afternoone
ausculatation
Hyperventilation

37. 3 yr old
bradypnea
+1
Stroke volume
20-30

38. The temperature falls to normal and then rises again in a repeating pattern.
Korotkoff sounds Phase III: Knocking
stridor
Stroke Volume
Relapsing

39. How does increased body temperature increase the pulse?
the blood pressure will rise in order to push the blood along.
The emotions increase hormone secretion - and the body activities required for this increase heat production.
The pulse rate increases at the rate of 7-10 beats for each degree of temperature
dyspnea

40. Those at risk for hypothermia include
about 1 degree lower than oral temperatures
20-30
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.

41. Fever above 100.2 F
pyrexia
in the alveoli - tiny thin-walled sacs
Axillary.
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.

42. Risk for prolonged hypertension
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes
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
cardiac patients or patients who have had rectal surgery.
the blood pressure will rise in order to push the blood along.

43. How does menstrual cycle and pregnancy raise the body's temperature?
Kussmaul's respiration
left Sims position
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients

44. 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.
Tachypnea
Biot's
Cardiac Output
20-30

45. Alternating rise and fall of the temperature.
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
Pedal pulse
intermittent

46. The difference between the systolic pressure and the diastolic pressure
Wash hands - don gloves - lubricate probe - Insert .5 to 1.5 inches. Hold in place for 3 to 5 minutes.
Pulse pressure
oximetry
Eupnea

47. Signs and symptoms of shock
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
tachycardia
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
Nursing interventions to reduce fever

48. What are the 5 vital signs?
Cheyenne-Stokes
Nursing interventions to reduce fever
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.
temperature - pulse - respiration - blood pressure - and pain level.

49. When should rectal temperatures be used?
^160/^100
remittent
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

50. The average temperature in the older adult
96.5 to 97.5
Femoral
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.