Questions and Answers
What is the correct pulse pressure if the blood pressure reading is 140/102 mm Hg?_______________
38
Place the following statements in correct order concerning the orthostatic method of assessing blood pressure.
The measurement is taken with the patient lying down. = 1 The nurse assesses the blood pressure in the sitting position. = 3 The measurement is taken when the patient is standing. = 1 The nurse documents the blood pressure readings. = 4
Weight loss of 1 kg indicates a fluid loss of how much?________________
1 liter
Study Notes
Temperature Readings
- Expected oral temperature during antibiotic therapy: 100.6°F (38.1°C) when rectal temperature is 101.6°F (38.7°C).
- Postpartum temperature fluctuations: classified as intermittent if elevated in the evening and normal in the morning.
- Normal oral temperature: 37°C (98.6°F), reported as afebrile if at this level.
Pulse Assessment
- Most accurate pulse assessment post-myocardial infarction: apical pulse.
- Tachycardia definition: heart rate exceeding 100 beats per minute, as seen in anxiety-related palpitations.
- Pulse deficit: calculated as the difference between radial and apical pulse rates, indicating heart perfusion efficiency.
Respiratory Rates
- Normal respiratory rate range for adults: 12 to 20 breaths per minute; higher rates indicate respiratory issues.
Blood Pressure Standards
- Diagnosis of hypertension requires blood pressure readings above 140/90 mm Hg at two visits.
- Pulse pressure calculated as the difference between systolic (140 mm Hg) and diastolic (102 mm Hg) pressures: 38 mm Hg.
- Systolic pressure recorded at the first Korotkoff sound during blood pressure measurement.
Patient Assessment and Management
- Immediate action for abnormal sitting blood pressure: question the patient about symptoms.
- Apical site preferred for checking pulse rate in infants and patients where accuracy is a priority.
- Vital signs assessment documentation is crucial for consistent patient monitoring.
Temperature Affecting Factors
- Smoking can artificially elevate vital signs, including temperature, pulse, respiratory rate, and blood pressure.
- An increase in dyspnea reports in patients with emphysema is defined as difficulty breathing.
Monitoring Techniques
- Best artery for self-monitoring pulse at home: radial artery.
- Appropriate method for core temperature measurement: tympanic and temporal methods are preferred over axillary or oral.
Weight and Fluid Monitoring
- Daily weight measurement in patients on diuretics helps monitor fluid loss; a weight loss of 1 kg corresponds to a loss of approximately 1 liter of fluid.
Equipment Considerations
- Importance of selecting appropriate-sized blood pressure cuffs; cuffs that are too small can yield inaccurately high readings.
Patient Education
- Educate patients on factors that can elevate pulse, such as fever and acute pain, ensuring they understand their implications on health status.
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Description
Test your knowledge on vital signs with this quiz focused on Chapter 12. From temperature readings to common scenarios, sharpen your understanding of patient assessments. Perfect for nursing students and healthcare professionals.