Certification Exam
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| What are purpose of vital signs? | they reflect the function of 3 body processes necessary for life
Body temp
respiration
heart function
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| What do vital signs include? | Temperature
Pulse
Respiration
Blood Pressure
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| What is body body temperature? | a balance between heat production and heat loss in conjunction with each other
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| Hypothalmus? | maintains and regulates body temperature
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| What is body body temperature? | a balance between heat production and heat loss in conjunction with each other
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| Hypothalmus? | maintains and regulates body temperature
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| Normal temperture range for: Rectal Oral Axillary Tympanic Membrane | Rectal: 98.6-100.6F
Oral: 97.6-99.6F
Axillary: 96.6-98.6F
Tympanic Membrane 98.6F
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| What does afebrile and febrile mean | Afebrile-without a fever
Febrile-with fever
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| Intermittent Fever | fluctuating fever that returns to or below baseline then rises again
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| Remittent Fever | fluctuating fever that remains elevated. it does not return to baseline temperature
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| Continuous Fever | a fever that remains constant above the baseline
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| Which site for taking temperature is most common? Least common? | Oral is most common. Axillary is least common and is taken when no other site can be used
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| When taking a patients temperature which site would have a least accurate reading ? | Axillary
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| Oral temperature are not taken in the following patients | infants and children less than 6 years old
Patients who had surgery of facial neck nose or mouth injury
Patients recieving oxygen
those with nasogastric tubes
patients with convulsive seizures
hemiplegic patients
patient with altered mental status
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| Rectal temperatures should not be taking on the following patients | patients with heart disease
patients with diarrhea
patients with rectal disease or disorder
patients who has had rectal surgery
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| MA should wait 30 minutes before taking the patients temperature if? | the patients had been eating, drinking or smoking
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| How do you take an axillay temperature? | the underarm should be dry and clean. the thermometer should be held in place for 5-10 minutes
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| Tympanic temperature is done on what kind of patient? Why | child or confused patients. a covered probe is inserted into the ear canal and temperature is measured within seconds (1-3 secs)
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| Tympanic temperatures should not be taken on the following patients. | Patients who have an ear disorder
patients with ear drainage
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| Normal pulse rate for an adult? Normal heart rate for infants | 60-100 bpm
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| Site most commonly used for taking the pulse? | radial artery count for 60secs
can be counted for 30 secs and multiplied by two (only if the pulse is regular)
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| Most accurate site for taking a pulse? | apical pulse. taken over the apex of the heart with a stethoscope.
used on infants , children, and pt with irregular heart rate
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| tachycardia | fast heart rate of more than 100bpm
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| bradycardia | slow heart rate less than 60bpm
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| What is respiration rate? how is it counted? | number of respiration per minute. One inspiration and one expiration counts as one respiration and should be counted for 60 seconds
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| Normal adult respiration rate? | 12-20 per minute
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| Apnea | temporary or complete absence of breathing
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| tachypnea | respiration rate of greater than 40 per minute.It is transient in newborns
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| bradypnea | decreased number of respirations . this occurs during sleep and may be due to certain diseases
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| respiratory rhythm | pattern of breathing. this can vary with age infants have regular breathing while adults have regular
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| Orthopnea | inability to breath unless in upright position
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| Cheyne Stokes | regular pattern of irregular breathing
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| What does depth of respiration refer to? | amount of air that is inspired and expired during each respiration
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| Hypoventilation | reduced amount of hair is entering the lungs, resulting in decreased oxygen and increased carbon dioxide in the blood
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| hypernea | abnormal increase in the depth and rate of breathing
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| Hyperventilation | increased amount of air entering the lungs
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| What is blood pressure? | measures the amount of force exerted by the blood on the perioheral arterial wall. it consist of the highest (systole) and lowest (diastole) amount of pressure exerted during the cardiac cycle
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| What can cause false BP reading | wrong size BP cuff
arm is not positioned at heart level
cuff is not completely deflated before use
cuff deflated too fast
improper cuff placement
cuff is re-inflated during procedure
defective equipment
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| Anthropometric measurements | height, weight, bmi waist to hip ratio, percentage of body fat (adults)
head circumference , length, height, weight, weight for length (infants, children, and adolescents)
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| Inspection | use of observation to detect significant physical features or objective data such as
general apperance
state of nutrition
body habitus
symmetry
posture and gait (manner of walking)
Speech
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| Palpation | use the sense of touch to determine the characteristics of an organ system
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| Percussion | tapping or striking the body usually with fingers or small hammer to determine size and density of the underlying organ or tissue
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| Auscultation | listening to sounds produced by internal organs such as heart, lungs and abdomen
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| MA's role in the physical examination | Room preparation
Patient preparation
assisting the physician
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| What does a physician use to make a diagnosis | pt. health history
the physical examination
laboratory test
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| Horizontal Recumbent (supine) | Use: for most physical examinations
positioning: flat on back with legs extended. arms are placed above the head, along side the body or folded on the chest
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| Dorsal Recumbent |
positioning: flat on back with knees flexed, soles of the feet is flat on the bed
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| Fowlers | Use: promote drainage or to ease breathing
positioning:
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| Semi Fowlers | Use
positioning
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| Dorsal Lithotomy | Use
positioning
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| Prone | Use
positioning
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| Sims | Use
positioning
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| Knee Chest | Use
positioning
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| Trendelenburg | Use
positioning
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| Where is the heart located? | thoracic cavity between the lungs and just behind the sternum (breast bone)
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| Atria | upper left and right chambers of heart
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| Ventricles | lower left and right chamber of the heart
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| septum | wall of the heart that seperates the right and left side
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| endocardium | inner most layer of the heart , this layer is where the conductive system is found
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| myocardium | middle and contractile layer of the heart. made of striated muscle fibers interspersed with intercalated disks
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| epicardium | outermost layer of the heart(also the inner layer of the pericardium)
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| pericardium | sac in which the heart is contained. serous fluid found in the sac prevents friction as the heart beats
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| right atrium | receives deoxygenated blood returning from the body via super vena cava ( carries blood from the upper body) and the inferior vena cava (carries blood from lower part of the body)
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| left atrium | recieves blood via left and right pulmonary veins
that has been oxygenated by the lungs
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| left ventricle | receives oxygenated blood from the left atrium and pumps it to the body through the aorta
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| right ventricle | receives deoxygenated blood from the right atrium, which it pumps to the lungs for oxygen through the pulmonary artery
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| pulmonary arteries | the only arteries in the body that carries deoxygenated blood
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| pulmonary veins | the only veins in the body that carry oxygenated blood
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| what is the aorta? | the largest artery in the body that carries oxygenated blood from the heart to the body
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| tricuspid valve | located between the right atrium and right ventricle
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| mitral (bicuspid) valve | located between left atrium and left ventricle
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| what are the purpose of the heart valve? | prevent backflow of blood
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| aortic valve | located between left ventricle and aorta
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| pulmonic valve | located between right venticle and pulmonary trunk
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| What are murmurs ? | caused by disease of the valves or other structural abnormalities
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| atrioventricular valves | are named because of their location between the atria and ventricles
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| semilunar valves | they have half moon shaped cusps
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| sympathetic nervous system | affects both atria and ventricles by increasing heart rate, conduction and irritability
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| parasympathetic nervous system | affects the atria only by decreasing the heart rate, conduction and irritability
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| what is the heart influenced by? | autonomic nervous system
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| Sinoatrial node (SA node) | the hearts natural pacemaker that fires at 60-100bpm. located in the right atrium
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| atroventricular node | located just above the tricuspid in the right atrium
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| What is the AV nodal delay? | The atrioventricular node delays impulses by approximately 0.12s. This delay in the cardiac pulse is extremely important: It ensures that the atria have ejected their blood into the ventricles first before the ventricles contract.
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| bundle of his | collection of heart muscle cells specialized for electrical conduction that transmits the electrical impulses from the AV node (located between the atria and the ventricles) to the point of the apex of the bundle branches.
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| purkinji fibers | During the ventricular contraction portion of the cardiac cycle, the Purkinje fibers carry the contraction impulse from both the left and right bundle branch to the myocardium of the ventric
les. The purkinji fibers have the ability to act as the pacemak
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| Characteristics of cardiac cells | Excitability
Automacity
conductivity
contractility
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| Automaticity | the ability of the cardiac pacemaker cells to spontaneously initiate their own electrical impulse sites that have these impulses include SA node AV junction, purkinji fibers
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| Excitability | ability to respond to external stimulus: electrica, chemical, and mechanical. All cardiac cells share this property
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| Conductivity | the ability of all cardiac cells to receieve an electrical stimulus and transmit the stimulus to the other cardiac cells
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| Contractility | the ability of the cardiac cells to shorten and cause cardiac muscle contraction in response to an electrical stimulus. can be enhanced with certain meds like dopamine,epinephrine and digitalis
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| Depolorization | when the heart contracts
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| Repolorization | when the heart relaxes
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| Which lead is used for grounding or reference lead ? | Right Leg (RL)
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| Name the bipolar standard leads | Lead I: left arm (+) right arm (-)
Lead II: left leg (+) right arm (-)
Lead III: left leg (+) left arm (-)
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| Augmented unipolar leads | aVR: right arm
aVL: left arm
aVF: left leg
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| Unipolar precordial leads | V1:
V2
V3
V4
V5: 5th intercostal space, anterior axillary line
V6: 5th intercostal space, maxillary line
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