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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. Gas exchange in the blood occurs where?
fever
Irregular
in the alveoli - tiny thin-walled sacs
Vascular resistance drops and the blood pressure decreases

2. What happens whens vasoconstriction causes peripheral vascular resistance to rise?
the blood pressure will rise in order to push the blood along.
^160/^100
120-139/80-89
Stroke volume

3. Strong and regular ( even beats wit moderate force)
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
men - African Americans - under a lot of stress - obese
low BP

4. Carbon dioxide is carried as bicarbonate ion in the blood until it reaches where?
palpate
Vascular resistance drops and the blood pressure decreases
the lungs
bradypnea

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

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6. Why would patients experience orthostatic hypotenstion?
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
Korotkoff sounds Phase IV: Muffling
from drug therapy - a neurologic problem or dehydration.
60 to 70 mL

7. Head injury or any increased intracranial pressure will depress the respiratory center and result in?
oximetry
+1
Feeble
shallow or slow breathing

8. Normal body temperature ranges?
Blood pressure increases because there is more volume of blood in the vascular system.
Biot's respirations
97.5 to 99.5
Temperature will remain below 102 degrees with use of hypothermia blanket

9. How is shock caused?
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
Temporal
It increases to push the blood through more rigid pathways.
crackles

10. Barely palpable
The pulse rate increases at the rate of 7-10 beats for each degree of temperature
Sinoatrial node (SA NODE)
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.
Feeble

11. How do you measure the apical pulse?
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.
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
Stroke volume
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

12. Rectal temperature are
60 to 70 mL
pyrexia
Crisis
about 1 degree higher than oral temperatures

13. How should baby's temperature be taken?
Eupnea
Axillary.
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.
Conduction

14. The difference between the systolic pressure and the diastolic pressure
wheeze
left Sims position
Rhonchi
Pulse pressure

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

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16. When should rectal temperatures NOT be used?
hypoxia
Pedal pulse
wheeze
cardiac patients or patients who have had rectal surgery.

17. When is apicial pulse used?
Feeble
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
60 to 70 mL
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.

18. A sudden change or muffling of the sound. (indicates diastolic pressure in children and some adults)
Nursing interventions to reduce fever
wheeze
Tall - slender people mayy ave a slower pulse rate than short - stout persons
Korotkoff sounds Phase IV: Muffling

19. 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.
Blood pressure increases because there is more volume of blood in the vascular system.
wheeze
bradycardia

20. How does increased body temperature increase the pulse?
hypoxemia
arrhythmia
shallow or slow breathing
The pulse rate increases at the rate of 7-10 beats for each degree of temperature

21. right arm vs. left arm/ arm vs. leg BP?
blood pressure is lowest in the morning. and higher in the afternoone
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
variation of about 5-10 between arms. and a 10-40 difference in systolic pressure with leg & arm.

22. 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
Temporal
Nursing interventions to reduce fever
+2
Respiration

23. This affects the character of the pulse.
Pulse
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.
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
Stroke Volume

24. Blood pressure for any adult should be no higher than
Cheyenne-Stokes
120/80
pulse deficit - the radial pulse subtracted from the apical pulse equals the pulse deficit.
remittent

25. Weak and regular (even beats wit poor force)
fever
Hyperventilation
Temperature will remain below 102 degrees with use of hypothermia blanket
+1

26. Feel
palpate
Apical
Stroke volume
Tall - slender people mayy ave a slower pulse rate than short - stout persons

27. 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
restlessness & apprehension - confusion - dizziness - and change in level of consciousness - cyanosis or skin color changes - particularly around the mouth and in the nail beds
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
96.5 to 97.5

28. The pressure wave causing te arterial walls in the vascular system each time the heart contracts to force blood into an already full aorta.
Pulse
if its hot bp can lower because of vasodilation. if its cold it can rise because of vasoconstriction.
Increases as body tries to remove excess heat
shallow or slow breathing

29. Signs and symptoms of shock
30-80
+1
decrease BP - increase pulse rate - cold and clammy skin - dizziness - blurred vision - and apprehension.
apnea

30. How does age affect pulse?
The pulse rate gradually diminishes from birth to adulthood
Crisis
men - African Americans - under a lot of stress - obese
Sinoatrial node (SA NODE)

31. Subnormal body temperature the regulating center in the hypothalamus is greatly impaired when the temperature of the body falls below 94 degrees - at that point? sleepiness and coma are apt to develop.
wheeze
Hypothermia
hyperoxia
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.

32. Side of neck
carotid
Pulse
Conduction
30 seconds and multiplied by 2. unless the person is very sick or has resp. problems you should count for one full minute.

33. Head injury BP?
Temporal
raises BP.
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.
apnea

34. What characteristics should be noted when checking the pulse?
the rate - the rhythm - and volume
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
absent
dyspnea

35. Absence of breathing
temperature - pulse - respiration - blood pressure - and pain level.
fever
apnea
It increases to push the blood through more rigid pathways.

36. How does emotional stress raise the body's temperature?
60 to 70 mL
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.
hypertension
The emotions increase hormone secretion - and the body activities required for this increase heat production.

37. Substances tat cause fever
20-30
pyrogens
oximetry
lysis

38. Fever above 100.2 F
pyrexia
remittent
Body temperature drops before ovulation and rises 1 degree above normal during ovulation. During pregnancy the body temperature is slightly higher.
120-139/80-89

39. An example of nursing planning
Because fever is a protective defense mechanisms that the body uses to fight pathogens and their toxins the inflammatory response produces fevers.
Pedal pulse
Temperature will remain below 102 degrees with use of hypothermia blanket
The systolic blood pressure rises slightly because the arota and major arteries tend to harden with age. The diastolic pressure rises also.

40. Those at risk for hypothermia include
Stimulants increase the pulse rate. Depressants decrease the pulse rate.
30-80
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.
men - African Americans - under a lot of stress - obese

41. Korotkoff sounds Ausculatatory gap:
bradypnea
silence as cuff deflates for 30 to 40 mm Hg; common with hypertension and elderly patients
Korotkoff sounds Phase II Swishing
about 1 degree higher than oral temperatures

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.
3 in the right lung and 2 lobes in the left
crackles
tachycardia
fever

43. How do emotions increase the pulse rate?
Increases as body tries to remove excess heat
16-20
Acute anxiety stimulate the nervous system - raising the pulse.
120-139/80-89

44. The maximum pressure exerted on the artery during left ventricular contraction.
Hyperthermia related to infection or excessive heat exposure
about 1 degree lower than oral temperatures
Feeble
Systolic pressure

45. Obtaining the correct size for a cuff for BP?
Defervescence - lowering of the body temperature to normal. The person feels warm and the skin may be moist.
Nursing interventions to reduce fever
hemorrhage - vomiting - diarrhea - burns - and myocardial infarctions.
the proper cuff is 21% bigger than the diameter of the arm. the inflatable bladder should go around 3/4 of the arm.

46. Difficult and labored breathing - can often be accompanied by flared nostrils - anxious appearance - and statements such as I cant get enough air.
dyspnea
left Sims position
males have higher bp - until menopause then they are the same
3 in the right lung and 2 lobes in the left

47. Risk for prolonged hypertension
arrhythmia
permanent damage to the heart - the brain - the kidneys - and the retina of the eye - may cause strokes
ausculatation
Stimulants increase the pulse rate. Depressants decrease the pulse rate.

48. How is pulse best found?
bradypnea
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
It increases to push the blood through more rigid pathways.

49. How does external respiration occur?
oximeter
oximetry
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
in the alveoli - tiny thin-walled sacs

50. 3 yr old
Stroke Volume
120-139/80-89
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.
20-30

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Measuring Vital Signs

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