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Questions and Answers
What is the primary function of the respiratory centre in the Medulla Oblongata?
What is the primary function of the respiratory centre in the Medulla Oblongata?
What best describes a high-pitched sound during respiration?
What best describes a high-pitched sound during respiration?
How is oxygen saturation expressed?
How is oxygen saturation expressed?
Which respiratory assessment technique focuses on the rhythm, rate, and depth of breathing?
Which respiratory assessment technique focuses on the rhythm, rate, and depth of breathing?
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What is the nature of expiration in the respiratory process?
What is the nature of expiration in the respiratory process?
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What is the normal range for low grade pyrexia?
What is the normal range for low grade pyrexia?
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Which factor does NOT affect body temperature?
Which factor does NOT affect body temperature?
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What is the definition of tachycardia?
What is the definition of tachycardia?
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Which of the following is a correct method for measuring temperature?
Which of the following is a correct method for measuring temperature?
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What characterizes bradycardia?
What characterizes bradycardia?
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What is hyperpyrexia defined as?
What is hyperpyrexia defined as?
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Why is monitoring pulse important?
Why is monitoring pulse important?
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Which of the following describes a regular pulse rhythm?
Which of the following describes a regular pulse rhythm?
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Study Notes
Vital Signs - INEWS Scoring Key
- Respiratory Rate (bpm): Scored based on breaths per minute (bpm). Ranges from ≤58 to ≥25
- SpO2 (%): Oxygen saturation levels. Ranges from ≤91% to ≥96%. Inspired oxygen (FiO2) is also considered
- Systolic BP (mmHg): Blood pressure. Ranges from ≤90 to ≥250mmHg
- Heart Rate (bpm): Heart beats per minute. Ranges from ≤40 to ≥250bpm
- ACVPU/CNS Response: Assessment of Alert, Voice, Pain, Unresponsive state. Scored by response
- Temperature (°C): Body temperature. Ranges from ≤35.0°C to ≥39.1°C
Temperature Regulation
- Hypothalamus: The temperature control center in the brain
- Influencing Factors: Infection, inflammatory response, allergies, environment, brain stem damage, and medications (e.g., ecstasy, anesthetic agents)
- Measurement: Thermoflash or tympanic methods
- Pyrexia (Fever): Significant rise in body temperature, often a sign of infection. There are different grades (low, moderate/high, and hyperpyrexia) with specific ranges in Celsius
- Nursing Interventions: close monitoring of vital signs, specimen collection, environment modification (e.g., changing clothing, room ventilation), hydration, and medication administration
Pulse Assessment
- Pulse Sites: Locations where the pulse can be palpated (e.g., temporal, carotid, brachial, radial, femoral, popliteal, posterior tibial, dorsalis pedis).
- Normal Pulse Rate: Ranges differ by age group, from 60-100 bpm in adults to 100–180 in infants.
- Measurements: Rate, rhythm and volume (strength) of the pulse.
- Tachycardia: heart rate faster than normal.
- Bradycardia: heart rate slower than normal
- Recording: Record pulse rate by placing dots on graph and connect the dots forming a line to indicate trend
- INEWS Value: Assigned a numerical value (0, 1, 2, or 3) based on the pulse trend
Respiration Rate
- Mechanism: Controlled by the respiratory center in the brain stem. Breathing involves inspiration (inhaling) and expiration (exhaling). Major muscles (intercostals and diaphragm) facilitate this process
- Assessment: Observing the rhythm, rate, and depth of breathing.
- Normal Respirations: Eupnoea denotes normal rate/rhythm. Other conditions (e.g. tachypnoea, bradypnoea, apnea) also matter.
- Recording: Record respiratory rate by placing dots on graph and connecting the dots to form a line describing the trend
Pulse Oximetry and Oxygen Saturation
- Measurement: Measures the percentage of oxygen bound to hemoglobin in the blood (SpO2).
- Normal Values: Typically 95-100%. Hypoxia is <90%, life-threatening <70%
- Factors affecting Accuracy: Factors affecting measurement accuracy (e.g., vasoconstriction, nail polish, shivering).
- Interpretation: Used to assess oxygenation status. Can detect issues like hypoxia, infections, respiratory emergencies
Blood Pressure
- Systolic Pressure: Peak pressure during ventricular contraction
- Diastolic Pressure: Pressure when the ventricles relax
- Normal Ranges: Ranges for adults (typically 120/80 mmHg)
- Factors affecting Blood Pressure: Factors that influence blood pressure (e.g., cardiac output, systemic vascular resistance, posture, hydration)
- Recording: Record blood pressure values using numerical notation.
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Description
This quiz covers the key components of vital signs assessment, including respiratory rate, blood pressure, heart rate, and temperature regulation. It also explores the physiological factors influencing temperature, such as the role of the hypothalamus and responses to infections. Test your knowledge on these essential topics in health monitoring.
