Vitals Quiz 1 SG PDF

**Vitals Quiz 1 -- 30 multiple choice questions - vitals, general observations, signs and symptoms** **[Washing hands ]** - **When do you need to wash your hands** You should wash your hands immediately before touching a patient to take their vital signs; this is considered standard prac...

**Vitals Quiz 1 -- 30 multiple choice questions - vitals, general observations, signs and symptoms** **[Washing hands ]** - **When do you need to wash your hands** You should wash your hands immediately before touching a patient to take their vital signs; this is considered standard practice in healthcare to prevent the spread of germs and maintain hygiene - **When to use gloves** You should wear gloves when taking vitals if you anticipate coming into contact with a patient\'s bodily fluids, such as blood, mucous membranes, or open wounds, even if the patient appears healthy; this includes situations like checking vital signs on a patient with a wound dressing that might be compromised or when taking blood pressure on a patient with visibly moist skin. **[Vital signs ]** - **[Pulse]** - **Know how to correctly measure pulse** - **Know the normal pulse range and what is an abnormal value** - **Normal Adult Pulse**: 60-100bpm - **Normal PEDs** pulse is based on age: - Newborn: 100-160 - 0-5 months: 90-150 - 6-12 months: 80-140 - 1-3 yo: 80-130 - 3-5 yo: 80-120 - 6-10 yo: 70-110 - 11-14 yo: 60-105 - **Abnormal pulse** (tachycardia): greater than 100bpm - **Abnormal pulse** (bradycardia): less than 66bpm - **Know the causes of bradycardia and tachycardia** - **Tachycardia** Fast Pulse (greater than 100bpm) - Related to inefficient pumping of blood to the body. Can be caused by: - Infection, anxiety, pain, pregnancy, hypovolemia (low blood volume), dehydration, hypo/hypertension, hyperthyroidism, damage to electrical centers of heart (tachyarethemia), stress, caffeine, medications, and electrolyte imbalance - **Bradycardia** Slow Pulse (less than 66bpm) - Related to insufficient pumping of blood to the body. Can be caused by: - Heart block, damage to heart tissue, hypothyroidism, electrolyte imbalance, hypertension, sleep apnea, inflammatory/autoimmune disease, hemochromatosis, degeneration/damage to electrical system in heart, medications, changes due to aging - **[Respirations ]** - **Know how to correctly measure respiration** - The rate is usually measured when a person is at rest and simply involves counting the number of breaths for one minute by counting how many times the chest rises. - Respiration rates may increase with fever, illness, and other medical conditions. - Do not alert pt to the fact that we are watching their breathing. Once done with pulse, go right into respirations. - **Know the normal respiratory rate** - **Normal Adult Respiration:** 12-20 respirations per minute - **Normal Pediatric Respiration:** - 0-1: 30-60 - 1-3: 24-40 - 3-6: 22-34 - 6-12: 18-30 - **Know the causes of bradypnea and tachypnea** - **Tachypnea** rapid, shallow breaths (respirations \>20 per minute) - Causes: - Often caused by a build-up of CO2, pH changes, or mental/emotional causes - Pain, Fever, Shock, Respiratory Illness/Disease, Dehydration, Heart Disease, Hyperthyroidism, Anxiety - **Bradypnea** slow respirations (respirations less than 8-10 per minute) - **Causes:** - Uremia, Increased Intracranial Pressure, Excessive Sedation (alcohol or drugs), sleep disorders (such as sleep apnea) - **[Temperature]** - **Know how to take an accurate reading** Normal temps: - 98.2°F + or -- 1.3 degrees - Or between 96.9°F to 99.5°F - Normally effected by menstrual cycle, time of day, activity level, age - use a clean digital thermometer and place the probe under the patient\'s tongue (oral method), ensuring their mouth is closed and they are breathing through their nose; for infants or situations where oral measurement is not feasible, use the rectal method by gently inserting the thermometer into the rectum after applying lubrication; always follow proper hygiene practices and consult with the patient\'s medical history before choosing a method. - Temporal thermometers vary, but they tend to be 0.5 -- 1 degrees lower than oral temp ------------------------ -------------- ----------------- Axillary/Forehead (°F) Oral (°F) Rectal/Ear (°F) 98.4--99.3 99.5--99.9 100.4--101 99.4--101.1 100--101.5 101.1--102.4 101.2--102 101.6--102.4 102.5--103.5 102.1--103.1 102.5--103.5 103.6--104.6 103.2--104 103.6--104.6 104.7--105.6 ------------------------ -------------- ----------------- - **Know what constitutes a fever** Temperature above 100.4 degrees F - **Know the common cause of hypothermia** temperature below 95 degrees F Caused by: - Exposure to the elements - inability to produce enough heat to compensate for losses - insufficient heating or excessive air conditioning - elderly and infants most susceptible - **[Blood Pressure]** - **Know how to correctly position the patient, choose the correct cuff size, and the steps of taking blood pressure including how quickly to deflate the cuff** - The patient should be relaxed in a chair with feet flat on the floor and back supported (no exam tables!) - The patient should be seated for 3-5 minutes before first reading - The patient should avoid caffeine, exercise, and smoking for at least 30 minutes before measurement - No talking, laughing, moving during reading - Measurement should be taken on bare skin - Use the correct size cuff index line should fall within reference range - Support the patient's arm at heart level - Position the middle of the cuff on the patient's upper arm at the level of the right atrium (midpoint of the sternum) - inflate cuff to 200 mm Hg to avoid ausculatory gap - Deflate the cuff pressure 2-5 mm Hg/s and listen for Korotkoff sounds - Record SBP and DBP to the nearest even number noting the time most recent BP medication was taken if applicable - Use an average [\>]2 readings obtained on [\>] 2occasions to estimate BP - **Systolic** the pressure in arteries when heart contracts and pumps blood. The first number in blood pressure readings. Ex: **120**/80 mmHg - **Diastolic** the bottom number in a blood pressure reading. Measures the pressure in arteries when the heart rests between beats. Ex: 120/**80** mmHg - **Know the meaning of the auscultatory gap and how to avoid it** - Most common in hypertensive patients - Related to increased arterial stiffness and atherosclerosis - Related to pooling of venous blood - Most likely in the obese arm - Particularly if cuff is pumped slowly - Or if BP is taken repeatedly without adequate time between readings - **Know how long to wait before retaking BP on the same arm** 1-2 minutes - **Know the current BP guidelines (2017 ACC/AHA)** **Systolic BP** **Diastolic BP** **2017 ACC/AHA** ----------------- ----- ------------------ ------------------ \ - Lifestyle factors smoking, not enough physical activity, little sleep, health conditions, eating a diet high in salt and low in potassium can increase your risk - \ - Dizziness - Fainting - Lack of Concentration - Blurred vision - Nausea - Cold, clammy, pale skin - Rapid, Shallow Breathing - Fatigue - Weakness - Depression - Thirst - **Know how to diagnose orthostatic hypotension** - A sudden (\< 3min) fall of greater than 20/10 mm Hg in BP when rising - Change from lying to standing - Therefore, BP & pulse can be measured first with pt supine x 5 min then have pt stand & repeat after 2-5 minutes - Lack of body's ability to compensate for changes in blood flow with gravity - Increases with age - Associated with diseases of low cardiac output, low cerebral perfusion - Associated with many medications - **Know what is an acceptable difference in blood pressure between arms** - A difference of 5-10 mmHg is OK - Any more than that -- VASCULAR BLOCKAGE **[Signs vs Symptoms ]** - **Signs** Objective and observable evidence of a disease that can be seen or measured by others. For example, a fever or bleeding are signs.  - **Symptoms** Subjective evidence of a disease that is perceived by the patient. For example, pain or fatigue are symptoms.