Vital Signs study material
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| Vital Signs / Cardinal Signs | BP (blood pressure); T (temperature); P (pulse); R (respiration)
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| BP | The measurement of arterial pressure during cardiac cycle
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| Systolic | The first or top reading of a blood pressure measurement representing the maximal arterial pressure during ventricular contraction
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| Diastolic | The bottom number or reading of a blood pressure that represents the least amount of pressure as blood during the relaxation phase of the heart
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| Korotkoff Sounds | The 5 phases or variation of sounds of the blood pressure measurement
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| Korotkoff Phase 1 | The first sound heard as the cuff deflates. This is recorded as the systolic blood pressure
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| Korotkoff Phase II | The second sound as cuff deflates as blood makes swishing sound.
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| Korotkoff Phase III | A distinct sharp tapping sound as blood moves through the artery.
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| Korotkoff Phase IV | A soft tapping sound which becomes muffles and begins to grow fainter.
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| Korotkoff Phase V | The disapperance of sound - generally recorded as the diastolic reading
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| Auscultatory gap | The disappearance of the sounds of blood pressure in Phase II of Korotkoff sounds. Occurs in hypertension and certain types of heart disease.
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| A blood pressure sound that may occasionally continue all the way to zero - usually occurs with children, after exercise, with fever, pregnancy or anemia. | Korotkoff Phase IV
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| Palpatory method of taking blood pressure | SYSTOLIC blood pressure determination obtained by the palpation (feeling) of the radial or brachial pulse rather than by auscultory (listening) methods.
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| Anthropometric measurements | Height and weight - should always be documented indicating as with or without shoes (most accurate without).
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| 60 inches = ______________ feet | 5 ft
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| 64 inches = _______________feet | 5'4"
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| 72 inches = ______________feet | 6 ft
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| To convert from pound to kilograms | Divide by 2.2
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| To convert from kilograms to pounds | Multiply by 2.2
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| 150 lbs = ______________ | 68.18 kg
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| 52 kg = ________________lb | 114.4 lbs
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| A blood pressure cuff that is too large for your patient will give you a falsely______________reading | Low
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| A blood pressure cuff that is too small for your patient will give you a falsely _____________reading. | Elevated
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| As a general rule of thumb you should pump up the blood pressure cuff to ______mm/Hg unless you do a palpatory tecnique first to determine approximate systolic reading. | 160 mm/Hg
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| You should hear no sound for _________30 mm/Hg prior to the start of the systolic reading to be sure you have not started within an ascultatory gap | 30 mm/Hg
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| For patients that have had ___________surgical procedure, blood pressure may be obtained from the lower extremity and never from upper extremity | Mastectomy - can cause lymphedema
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| If using a thigh cuff to obtain BP from lower extremity the pulse point used to auscultate the sounds is the _________ | Popliteal for thigh; dorsalis pedis for calf.
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| Best position to obtain Blood Pressure | Patient sitting comfortably, legs uncrossed, arm at heart level resting on support with palm up and elbow relatively straight.
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| The correct way to locate placement of the stethoscope over the brachial artery for blood pressure | Palpate the antecubital area locating the brachial pulse (Have patient flex arm slightly while bent or push up into your hand. Feel for biceps brachii tendon then just to the medial the bicipital aponeurosis – artery is just below.)
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| Name the equipment used to obtain a blood pressure | Sphygmomanometer and stethoscope
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| What part of the stethoscope should be cleaned between patients and medical assistant use. | Ear pieces and diaphragm
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| The air should be deflated from the BP cuff.______________________ | Smoothly at about a rate of 2-3 mm/heartbeat
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| A wait time of ____________should be given if a BP needs to be repeated | 30-60 seconds
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| Blood pressure may be different in the different arms - true or false? | True - that is why it is important to get readings from both arms initially.
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| Restrictive tight clothing may affect the BP reading - true or false? | True
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| Orthostatic BP readings are obtained by_________________ | Allow patient to rest lying down for 5 minutes. Take BP with patient in recumbent position; have patient sit up and immediately repeat BP; have patient stand up and immediately repeat BP (some physicians may want only supine and standing).
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| Orthostatic BP readings help define what problem? | Orthostatic hypotension - positional drop in BP (systolic 20 pts/ diastolic 10 pts)
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| Primary Hypertension | Elevated blood pressure wit no outside cause
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| Secondary Hypertension | Elevated blood pressure caused by disease/disorder of other body system eg. kidney disease
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| Blood Pressure values: Normal High Low | Normal: Less than or equal to 120/80 to 90/60
High: > 140/90 (121/81 to this point is prehypertensive)
Low: < 90/60
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| Potential pulse points to evaluate pulse by palpation | Temporal artery; carotid artery; brachial artery; radial artery; femoral artery; popliteal artery; dorsalis pedis artery (Radial is most common for routine pulse evaluation)
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| The THREE areas the are evaluated each time the pulse is taken: | Rate; Rhythm; Strength or Volume
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| Pulse is alway documented in a _____time frame? | Beats per minute (so if evaluated for 30 seconds, number felt is doubled)
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| The location where a pulse can be evaluated by auscultation? | Apical pulse (stethoscope placed between 5th and 6th rib at intercostal space at apex of heart which is approx below left nipple) This method requires listening for ONE FULL MINUTE.
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| Normal resting pulse rate for an adult | 60-80 bpm
80-100 bpm considered elevated
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| Tachycardia | > 100 pbm
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| Bradycardia | < 60 bpm
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| Infant and children heart rate | Newborn 12-160
1-2 years 80-140
3-6 years 75-120
7-11 years 75-110
Adolescence to adulthood 60-100
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| Respiration is recorded over what period of time | Documented in per minute, evaluated usually at 30 seconds (double reading to document)
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| Normal Respiratory Rates | Newborn 30-50
1-3 years 20-30
4-6 years 18-26
7-11 years 16-22
Adolescence to Adulthood 12-20
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| Things to evaluate with respiration..... | Rate (per minute inspiration and expiration cycle); Rhythm (pattern); Depth (deep/shallow)
Also if you can hear wheezing etc document.
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| Temperature can be measured by what methods? | Temporal artery; oral; tympanic; axillary; rectal
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| Normal temperature | Oral: 98.6 F - 37 C
Axillary: 97.6 F - 36.4 C
Tympanic: 98.6 F - 37 C
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| Converting Fahrenheit to Celsius | C = (F-32) x 5/9
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| Converting Celsius to Fahrenheit | F = (C x 9/5) + 32
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| Pyrexia means | fever
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| To obtain a tympanic temperature the pinna of the ear should be.... | Patients over age 3 pull up and back.
Patients under age 3 pull down and back.
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| For oral temperatures, you should ask the patient _______________ | If they have had anything by mouth (hot or cold items) in the past 15-30 minutes or if they have smoked a cigarette (if a smoker), or exercised.
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| Pulse pressure is defined as ______ | The difference between the systolic and diastolic blood pressure reading. eg. BP 120/80 (120-80=40 so Pulse pressure = 40) 30-50 mm is considered normal (Various cardiovascular problems and age causing less elasticity of the vessels can alter this)
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| Pulse pressure determination as quality control measure. | BP 120/80; Calculate PP 120-80=40; Divide Systolic number by 3 (120 /3=40) so both numbers are within 10 points helps to validate correct technique. Does not always work out, but can be used to determine if recheck of BP is advised eg. auscultatory gap.
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