Medical Surgical Nursing Vital Signs Discussion
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Questions and Answers

Which type of thermometer captures heat emitted by the skin over the temporal artery?

  • Temporal artery thermometer (correct)
  • Tempa-Dot thermometer
  • Disposable single-use thermometer
  • Tympanic membrane thermometer

    • What affects the accuracy of readings from the temporal artery thermometer?

  • Patient's state of consciousness
  • Amount of pain
  • Technique and cleanliness of the device (correct)
  • Facility policy

    • Under what condition should oral temperature not be taken?

  • When the patient is able to close their mouth around the temperature probe
  • After the patient has taken hot or cold foods or liquids
  • When waiting 15-30 minutes is not possible
  • In patients with a broken jaw that is wired closed (correct)

    • How long should the probe remain in the sublingual pocket for oral temperature measurement?

    <p>1 minute</p> Signup and view all the answers

    What is a characteristic of disposable single-use thermometers?

    <p>They measure body temperature within 10 seconds</p> Signup and view all the answers

    Which route is a frequent method for estimating core body temperature?

    <p>Tympanic membrane</p> Signup and view all the answers

    What is the definition of Vital Signs?

    <p>They reflect the health status of a person and often vary by age</p> Signup and view all the answers

    Which of the following is NOT a component of Vital Signs?

    <p>Mental alertness</p> Signup and view all the answers

    What is the balance that temperature represents in relation to Vital Signs?

    <p>Balance between heat produced and lost</p> Signup and view all the answers

    Why are Vital Signs important in patient care?

    <p>They help identify normal patterns for patients and changes in patient status</p> Signup and view all the answers

    What is the main purpose of taking Vital Signs?

    <p>To monitor normal patterns for patients and detect changes in patient status</p> Signup and view all the answers

    Why are Vital Signs considered an important component of health care?

    <p>Because they reflect the health status of a person and often vary by age</p> Signup and view all the answers

    What is the significance of Phase I of the Korotkoff sounds?

    <p>It marks the beginning of faint tapping sounds and indicates systolic pressure</p> Signup and view all the answers

    What is the auscultatory gap as mentioned in the text?

    <p>The temporary disappearance of sounds in Phase I and during Phase II</p> Signup and view all the answers

    What characterizes Phase III of the Korotkoff sounds?

    <p>Loud sounds as the blood flows freely through the open artery</p> Signup and view all the answers

    What distinguishes Phase IV of the Korotkoff sounds?

    <p>Abrupt muffled sounds with a soft blowing sound</p> Signup and view all the answers

    Which phase of Korotkoff sounds represents the last sound before continuous silence and is used to define diastolic pressure?

    <p>Phase V</p> Signup and view all the answers

    When does the muffled or swishing sound that may disappear for up to 40mmHg long then reappear occur?

    <p>During Phase II of Korotkoff sounds</p> Signup and view all the answers

    What does the abrupt muffled sound with a soft blowing sound in Phase IV indicate?

    <p>Diastolic pressure</p> Signup and view all the answers

    What are the Korotkoff sounds in Phase III primarily caused by?

    <p>Blood flowing freely through an open artery</p> Signup and view all the answers

    What is the primary symptom associated with orthostatic hypotension?

    <p>Pallor</p> Signup and view all the answers

    What is the main cause of orthostatic hypotension?

    <p>Dehydration</p> Signup and view all the answers

    What is the recommended nursing intervention for a patient with orthostatic hypotension?

    <p>Teaching and helping patient to arise and move slowly</p> Signup and view all the answers

    How is orthostatic hypotension assessed?

    <p>By measuring and recording blood pressure and pulse in different positions</p> Signup and view all the answers

    What is the significance of a decrease in SBP of > 20 mmHg or a decrease in DBP of > 10 mmHg within 3 minutes of standing?

    <p>It indicates orthostatic hypotension</p> Signup and view all the answers

    What can be a potential cause of orthostatic hypotension?

    <p>Certain classes of medications</p> Signup and view all the answers

    What factors should a nurse consider when choosing the site for temperature assessment?

    <p>The patient's state of consciousness and amount of pain</p> Signup and view all the answers

    What is a characteristic of the Temporal Artery thermometer?

    <p>It measures body temperature by capturing heat emitted by the skin over the temporal muscle</p> Signup and view all the answers

    What should a nurse do before taking an oral temperature if a client has been taking hot or cold foods or liquids, or smoking or chewing gum?

    <p>Wait for 30-45 minutes before taking the temperature</p> Signup and view all the answers

    What is the purpose of the Disposable single-use thermometer?

    <p>To provide a non-breakable temperature measurement within seconds</p> Signup and view all the answers

    What is essential for assessing temperature through the oral route?

    <p>The probe must remain in the sublingual pocket for the full period of measurement</p> Signup and view all the answers

    What is an important consideration when assessing temperature through the tympanic membrane?

    <p>The presence of earwax or foreign objects in the ear canal</p> Signup and view all the answers

    Which factors may decrease Basal Metabolic Rate (BMR)?

    <p>Following a very low-calorie diet and prolonged fasting</p> Signup and view all the answers

    What is the main purpose of Body Mass Index (BMI)?

    <p>To provide an estimation of relative risk for heart disease, diabetes, and hypertension</p> Signup and view all the answers

    What does a high BMI value indicate?

    <p>Overweight or obesity</p> Signup and view all the answers

    When is Waist circumference used as a measure?

    <p>As an initial assessment of nutritional status for adults and children</p> Signup and view all the answers

    What is the significance of Ideal Body Weight (IBW)?

    <p>It is an estimate of optimal body weight for optimal health</p> Signup and view all the answers

    How are Height and weight tables commonly used?

    <p>To define optimal body weight for infants and children</p> Signup and view all the answers

    What do higher Basal Metabolic Rates (BMRs) in men result from?

    <p>Larger muscle mass compared to women</p> Signup and view all the answers

    What is the purpose of Body Mass Index (BMI) chart?

    <p>To determine the ideal body weight for adults and children</p> Signup and view all the answers

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