Health Sciences Chapter 19: Vital Signs

Questions and Answers

When would each of the following cuffs be used to measure blood pressure? Match the type of cuff to its usage:

Child = For children and for adults with small arms. Adult = For adults with average-sized arms. Thigh = For measurement of blood pressure at the thigh or for adults with large arms.

Explain how to determine the proper cuff size for a patient.

The inner inflatable bladder of the cuff should encircle at least 80% (but no more than 100%) of the arm circumference and should be wide enough to cover two-thirds of the distance from the axilla to the antecubital space.

What may occur if blood pressure is taken using a cuff that is too small or too large?

With a cuff that is too small, the reading may be falsely high; with a cuff that is too large, the reading may be falsely low.

How should the blood pressure be measured if the patient's arm circumference is greater than 50cm (20 inches)?

The patient's blood pressure can be measured using the forearm and radial artery with an appropriately sized cuff positioned midway between the elbow and wrist over the radial pulse. Signup and view all the answers

List the five phases included in Korotkoff's sounds and describe what type of sound is heard during each phase: Phase I: The first clear tapping sound, which gradually increases in intensity. Phase II: The sounds have a __________ quality.

murmuring or swishing Signup and view all the answers

List five advantages of an automated blood pressure monitor.

Device automatically determines inflation pressure, no manual inflation/deflation required, brachial artery location not needed, stethoscope not required, less susceptible to noise. Signup and view all the answers

Define a vital sign.

Objective guidepost that provides data to determine a patient's state of health. Signup and view all the answers

What are the four vital signs?

Temperature, pulse, respiration, and blood pressure; another indicator of a patient's health status is pulse oximetry reading. Signup and view all the answers

What general guidelines should be followed when measuring vital signs?

Be familiar with the normal ranges for all vital signs, ensure that all equipment is in proper working condition, minimize factors that may affect the measurements, and use an organized approach. Signup and view all the answers

List four ways in which heat is produced in the body.

Voluntary and involuntary muscle contractions, cell metabolism, fever, and strong emotional states. Signup and view all the answers

List four ways in which heat is lost from the body.

In the urine and feces, in moisture droplets from the lungs, through perspiration, conduction, convection, and radiation. Signup and view all the answers

What is the normal body temperature range?

97°F to 99°F (36.1°C to 37.2°C) Signup and view all the answers

What is the average body temperature?

98.6°F (37°C) Signup and view all the answers

What is a fever?

Body temperature that is above normal, or 100.4°F (38°C). Signup and view all the answers

How do diurnal variations affect body temperature?

The temperature of the body is lowest in the morning before metabolism and muscle contractions increase. Signup and view all the answers

How do emotional states affect body temperature?

They increase the body temperature. Signup and view all the answers

How does vigorous physical exercise affect body temperature?

It increases the body temperature. Signup and view all the answers

What symptoms occur with a fever?

Increased pulse and respiratory rate, warm to the touch, flushed appearance, increased thirst, loss of appetite, headache, and malaise. Signup and view all the answers

Describe the following fever patterns: Continuous fever, Intermittent fever, Remittent fever.

Continuous fever: body temperature fluctuates minimally but always remains elevated. Intermittent fever: temperature alternately rises and falls and returns to normal or becomes subnormal. Remittent fever: wide range of temperature fluctuations occur, all of which are above normal. Signup and view all the answers

What is the subsiding stage of a fever?

When the temperature returns to normal. Signup and view all the answers

What five sites are used for taking body temperature?

Mouth, axilla, rectum, ear, and forehead. Signup and view all the answers

List three instances in which the axillary site for taking body temperature would be preferred over the oral site.

When taking temperature in toddlers and preschoolers, in mouth-breathing patients, and in patients with oral inflammation or who have undergone oral surgery. Signup and view all the answers

Why does the rectal method for taking body temperature provide a very accurate temperature measurement?

The rectum is highly vascular, providing the most closed cavity. Signup and view all the answers

When can the rectal method be used to take body temperature?

When taking body temperature in infants and young children, unconscious patients, or mouth-breathing patients, and when greater accuracy is desired. Signup and view all the answers

When can the aural method be used to take body temperature?

When taking body temperature in children younger than 6 years of age, in uncooperative patients, and in patients unable to have the temperature taken orally. Signup and view all the answers

How does a temperature taken through the rectal and axillary methods compare (in terms of degrees) with a temperature taken through the oral method?

A temperature taken with the rectal method measures approximately 1°F higher than the oral method; axillary measures approximately 1°F lower. Signup and view all the answers

List and describe the four types of thermometers available for taking body temperature.

Electronic thermometer: consists of interchangeable oral and rectal probes attached to a battery-operated portable unit. Tympanic membrane thermometer: consists of a handheld device with a sensor probe. Temporal artery thermometer: consists of a probe attached to a portable unit. Chemical thermometer: contains chemicals that are heat sensitive; includes disposable thermometers and temperature-sensitive strips. Signup and view all the answers

Describe the advantages of a tympanic membrane thermometer.

Prevents the transmission of microorganisms from one patient to another. Signup and view all the answers

Explain how a tympanic membrane thermometer measures body temperature.

It detects thermal energy that is naturally radiated from the body and calculates body temperature from this energy. Signup and view all the answers

Explain how to clean the lens of a tympanic membrane thermometer.

Gently wipe the surface with an antiseptic wipe and immediately dry with a cotton swab. Allow at least 5 minutes before taking a temperature. Signup and view all the answers

What is the purpose of placing a probe cover on a tympanic membrane thermometer?

The probe cover protects the lens and provides infection control. Signup and view all the answers

List three reasons why the temporal artery is a good site to measure body temperature.

The temporal artery is easily accessible and located close to the skin surface; it has a steady flow of blood, providing an accurate measurement. Signup and view all the answers

How does the temperature obtained through the temporal site compare with oral, rectal, and axillary body temperatures?

The temporal artery reading is 1°F higher than oral temperature, about the same as rectal temperature, and 2°F higher than axillary temperature. Signup and view all the answers

List four factors that can result in an inaccurate temporal artery temperature reading.

Dirty probe lens, sweating of the patient's forehead, too rapid scanning of the forehead, and failure to keep the button pressed while scanning. Signup and view all the answers

Where should a chemical thermometer be stored? Explain why.

In a cool area and away from direct sunlight to avoid higher temperature readings. Signup and view all the answers

What causes the pulse to occur?

When the left ventricle of the heart contracts, blood is forced into the aorta, creating a pulse wave. Signup and view all the answers

What is the unit of measurement for pulse rate?

Beats per minute. Signup and view all the answers

How does physical activity affect the pulse rate?

It increases the pulse rate temporarily. Signup and view all the answers

What is the most common site for taking the pulse?

Radial artery. Signup and view all the answers

List two reasons for taking the pulse at the apical pulse site.

Difficulty in feeling the pulse; the pulse is irregular or must be measured in infants or children under 3 years of age. Signup and view all the answers

Where is the apex of the heart located?

In the fifth intercostal space at the junction of the left midclavicular line. Signup and view all the answers

When is the brachial artery used as a pulse site?

When taking blood pressure and measuring pulse in infants during cardiac arrest; when assessing circulation to the lower arm. Signup and view all the answers

When is the carotid artery used as a pulse site?

When measuring pulse in children and adults during cardiac arrest or during exercise. Signup and view all the answers

When is the femoral artery used as a pulse site?

When measuring pulse in infants and children; during cardiac arrest or assessing circulation to the lower leg. Signup and view all the answers

What two pulse sites can be used to assess circulation to the foot?

Posterior tibial and dorsalis pedis. Signup and view all the answers

List two reasons for measuring the pulse rate.

To establish the patient's baseline rate and to assess the pulse rate after special procedures or in disease processes. Signup and view all the answers

State the normal range for a pulse rate for an adult.

60 to 100 beats per minute. Signup and view all the answers

What is the normal pulse range for the following age groups: Infant, Toddler, Preschooler, School-age, Adult after age 60?

Infant: 120 to 160 beats per minute; Toddler: 90 to 140 beats per minute; Preschooler: 80 to 110 beats per minute; School-age: 75 to 105 beats per minute; Adult after age 60: 67 to 80 beats per minute. Signup and view all the answers

What is the normal pulse range for a well-trained athlete?

40 to 60 beats per minute. Signup and view all the answers

What may cause tachycardia?

Hemorrhaging or heart disease, vigorous exercise, strong emotional states. Signup and view all the answers

How is apical-radial pulse taken?

Measurement of the apical pulse at the same time as the radial pulse for 1 full minute. Signup and view all the answers

What is a pulse deficit?

A pulse deficit exists when the radial pulse rate is less than the apical pulse rate. Signup and view all the answers

If the rhythm and volume of a patient's pulse are normal, the medical assistant records the information as _______________________.

Regular and strong. Signup and view all the answers

What is the purpose of respiration?

To provide for the exchange of oxygen and carbon dioxide between the atmosphere and the blood. Signup and view all the answers

What is the purpose of inhalation?

To take oxygen into the lungs. Signup and view all the answers

What is the purpose of exhalation?

To remove carbon dioxide from the body. Signup and view all the answers

What is included in one complete respiration?

One inhalation and one exhalation. Signup and view all the answers

The exchange of oxygen and carbon dioxide between the body cells and blood is known as _____________________.

Internal respiration. Signup and view all the answers

What is the name of the control center for involuntary respiration?

Medulla oblongata. Signup and view all the answers

Why must respiration be measured without the patient's awareness?

Because the patient can control his or her respiration. Signup and view all the answers

What is the normal respiratory rate (range) for a normal adult?

12 to 20 respirations per minute. Signup and view all the answers

What is the ratio of respirations to pulse beats?

One respiration to every four pulse beats. Signup and view all the answers

List two factors that can increase the respiratory rate.

Physical activity, strong emotional states, fever, certain medications. Signup and view all the answers

Describe a normal rhythm for respiration.

The rhythm should be even and regular, with equal pauses between inhalation and exhalation. Signup and view all the answers

What can cause hyperventilation?

Acute anxiety conditions such as panic attacks. Signup and view all the answers

What type of patient may experience hypopnea?

Individuals with sleep disorders. Signup and view all the answers

Where is cyanosis first observed?

In the nail beds and lips. Signup and view all the answers

What can cause cyanosis?

Advanced emphysema and cardiac arrest. Signup and view all the answers

What are two conditions in which dyspnea may occur?

Asthma, emphysema, vigorous physical exertion. Signup and view all the answers

Describe the character of normal breath sounds.

Quiet and barely audible. Signup and view all the answers

Describe the character of the following abnormal breath sounds: Crackles, Rhonchi, Wheezes.

Crackles: Dry or wet intermittent sounds that vary in pitch. Rhonchi: Deep, low-pitched rumbling sounds that are more audible during expiration. Wheezes: Continuous, high-pitched, whistling musical sounds heard during inspiration and expiration. Signup and view all the answers

What is the purpose of pulse oximetry?

To measure the oxygen saturation of hemoglobin in arterial blood. Signup and view all the answers

What is the function of hemoglobin?

Transports oxygen in the body. Signup and view all the answers

What is the oxygen saturation level of a healthy individual?

95% to 99%. Signup and view all the answers

What can occur if the oxygen saturation level falls between 85% and 90%?

Respiratory failure resulting in tissue damage. Signup and view all the answers

List three patient conditions that can cause a decreased SpO2 value.

Acute pulmonary disease, chronic pulmonary disease, cardiac problems. Signup and view all the answers

When can pulse oximetry be used for the short-term continuous monitoring of a patient?

When monitoring a patient experiencing an asthmatic attack or during minor office surgery. Signup and view all the answers

What is the purpose of the pulse oximeter power-on self-test (POST)?

To check internal systems of the oximeter to ensure they are functioning properly. Signup and view all the answers

What type of site must be used for applying a pulse oximeter probe?

Peripheral site that is highly vascular and where the skin is thin. Signup and view all the answers

How can dark fingernail polish cause a falsely low SpO2 reading?

The coating interferes with proper light transmission through the finger. Signup and view all the answers

How can patient movement cause an inaccurate SpO2 reading?

Motion affects the ability of light to travel from the LED to the photodetector. Signup and view all the answers

What type of patients may make it difficult to properly align the oximeter probe?

Thin patients, children, and patients with very large fingers. Signup and view all the answers

List three conditions that can cause poor peripheral blood flow.

Peripheral vascular disease, use of vasoconstrictor medications, severe hypotension, hypothermia. Signup and view all the answers

Why must a reusable oximeter probe be free of all dirt and grime before it is used?

Dirt and grime can interfere with proper light transmission, leading to inaccurate readings. Signup and view all the answers

What does blood pressure measure?

Pressure or force exerted by the blood on the walls of the arteries. Signup and view all the answers

Why is the diastolic pressure lower than the systolic pressure?

Diastolic pressure is recorded during the relaxation of the heart. Signup and view all the answers

What is considered normal blood pressure for an adult?

Less than 120/80 mm Hg. Signup and view all the answers

State the blood pressure range for each of the following: Prehypertension, Hypertension stage 1, Hypertension stage 2.

Prehypertension: Systolic 120 to 139 mm Hg and diastolic 80 to 89 mm Hg; Hypertension stage 1: Systolic 140 to 159 mm Hg and diastolic 90 to 99 mm Hg; Hypertension stage 2: Systolic 160 mm Hg or more and diastolic 100 mm Hg or more. Signup and view all the answers

Why should blood pressure readings always be interpreted using the patient's baseline blood pressure?

A rise or fall of 20 to 30 mm Hg is significant even if still within the normal range. Signup and view all the answers

How does age affect blood pressure?

As age increases, blood pressure gradually increases. Signup and view all the answers

How do diurnal variations affect blood pressure?

Blood pressure is lower in the morning after sleep and increases throughout the day with metabolism and activity. Signup and view all the answers

What are the two types of stethoscope chest pieces and the use of each?

Diaphragm: for hearing high-pitched sounds; Bell: for hearing low-pitched sounds. Signup and view all the answers

What are the parts of a sphygmomanometer?

Manometer, inner inflatable bladder covered by a cuff, pressure bulb with a control valve. Signup and view all the answers

List the two types of sphygmomanometers.

Mercury and aneroid. Signup and view all the answers

Study Notes

Vital Signs Overview

Vital signs provide objective data to assess a patient's health.
Key vital signs include temperature, pulse, respiration, blood pressure, and pulse oximetry readings.

General Guidelines for Measurement

Familiarize yourself with normal ranges for vital signs.
Ensure all measurement equipment is functioning properly.
Minimize factors that may affect the readings.
Use a systematic approach during measurement.

Body Temperature

Normal range: 97°F to 99°F (36.1°C to 37.2°C); average: 98.6°F (37°C).
Fever: Body temperature above 100.4°F (38°C).
Body temperature varies daily, peaking in the afternoon and lowest in the morning.
Heat is produced through muscle activity, metabolism, fever, and emotional states.

Temperature Measurement Sites

Common sites: mouth, axilla, rectum, ear, forehead.
Rectal temperatures are generally 1°F higher and axillary temperatures 1°F lower than oral measures.
Axillary method preferred for young children and patients with oral issues.

Thermometers

Types: Electronic, tympanic, temporal artery, and chemical thermometers.
Tympanic thermometers minimize cross-contamination.

Pulse Measurement

Pulse is felt with each heartbeat due to blood being forced into the arteries.
Normal pulse rate for adults: 60 to 100 beats per minute.
Pulse rates vary by age group; infants have a higher normal range.

Blood Pressure

Measured in mm Hg; normal: less than 120/80 mm Hg.
Understanding phases of Korotkoff sounds is essential for accurate measurement.
Blood pressure is influenced by age, activity, and diurnal variations.

Respiratory Rate

Normal adult range: 12 to 20 breaths per minute.
One complete respiration consists of an inhalation and an exhalation.
Respiratory effort changes with physical exertion, emotions, and health conditions.

Oxygen Saturation

Measured with pulse oximetry to assess oxygen delivery to tissues.
Healthy oxygen saturation: 95% to 99%.
Low levels (85% - 90%) can indicate respiratory failure.

Key Factors Impacting Measurements

Factors such as environmental conditions, equipment cleanliness, and patient cooperation can affect accuracy.
Dark nail polish and motion may lead to inaccurate pulse oximetry readings.
Patient conditions can lead to poor blood flow affecting readings.

Korotkoff Sounds Phases

Phase I: First clear tapping sound, correlating with systolic pressure.
Phase II: Murmuring or swishing quality.
Phase III: Sounds are crisper.
Phase IV: Sounds become muffled.
Phase V: Sounds disappear, correlating with diastolic pressure.

Equipment for Measurement

Sphygmomanometers come in mercury and aneroid types.
Cuff size is crucial; the wrong size can lead to inaccurate blood pressure readings.

Patient Monitoring

Continuous monitoring with pulse oximetry is essential in acute situations, such as asthma attacks or during sedation.
Various methods are employed based on the patient's condition and age, ensuring accurate and effective monitoring of vital signs.### Automated Blood Pressure Measurement Devices
Automatically inflates cuff to approximately 30 mm Hg above systolic pressure for accurate readings.
Eliminates manual inflation and deflation which simplifies the measurement process.
Does not require localization of the brachial artery, enhancing user convenience.
Cuff bladder positioning over the brachial artery is not necessary, allowing for flexibility in use.
Utilizes electronic sensors to measure oscillations in the brachial artery, negating the need for a stethoscope and listening skills.
Less affected by external environmental noise compared to traditional manual devices, ensuring more reliable readings.
Digital display screens make blood pressure readings easy to interpret.
Can perform multiple blood pressure measurements in a session for more comprehensive monitoring.
Many devices are equipped with internal memory to store and track previous blood pressure measurements.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on vital signs through this flashcard quiz based on Chapter 19. Learn definitions, understand the four vital signs, and follow general guidelines for measurement. Perfect for health science students looking to reinforce their learning!