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Certification Exam

What are purpose of vital signs? they reflect the function of 3 body processes necessary for life Body temp respiration heart function
What do vital signs include? Temperature Pulse Respiration Blood Pressure
What is body body temperature? a balance between heat production and heat loss in conjunction with each other
Hypothalmus? maintains and regulates body temperature
What is body body temperature? a balance between heat production and heat loss in conjunction with each other
Hypothalmus? maintains and regulates body temperature
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
What does afebrile and febrile mean Afebrile-without a fever Febrile-with fever
Intermittent Fever fluctuating fever that returns to or below baseline then rises again
Remittent Fever fluctuating fever that remains elevated. it does not return to baseline temperature
Continuous Fever a fever that remains constant above the baseline
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
When taking a patients temperature which site would have a least accurate reading ? Axillary
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
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
MA should wait 30 minutes before taking the patients temperature if? the patients had been eating, drinking or smoking
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
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)
Tympanic temperatures should not be taken on the following patients. Patients who have an ear disorder patients with ear drainage
Normal pulse rate for an adult? Normal heart rate for infants 60-100 bpm
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)
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
tachycardia fast heart rate of more than 100bpm
bradycardia slow heart rate less than 60bpm
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
Normal adult respiration rate? 12-20 per minute
Apnea temporary or complete absence of breathing
tachypnea respiration rate of greater than 40 per minute.It is transient in newborns
bradypnea decreased number of respirations . this occurs during sleep and may be due to certain diseases
respiratory rhythm pattern of breathing. this can vary with age infants have regular breathing while adults have regular
Orthopnea inability to breath unless in upright position
Cheyne Stokes regular pattern of irregular breathing
What does depth of respiration refer to? amount of air that is inspired and expired during each respiration
Hypoventilation reduced amount of hair is entering the lungs, resulting in decreased oxygen and increased carbon dioxide in the blood
hypernea abnormal increase in the depth and rate of breathing
Hyperventilation increased amount of air entering the lungs
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
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
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)
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
Palpation use the sense of touch to determine the characteristics of an organ system
Percussion tapping or striking the body usually with fingers or small hammer to determine size and density of the underlying organ or tissue
Auscultation listening to sounds produced by internal organs such as heart, lungs and abdomen
MA's role in the physical examination Room preparation Patient preparation assisting the physician
What does a physician use to make a diagnosis pt. health history the physical examination laboratory test
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
Dorsal Recumbent positioning: flat on back with knees flexed, soles of the feet is flat on the bed
Fowlers Use: promote drainage or to ease breathing positioning:
Semi Fowlers Use positioning
Dorsal Lithotomy Use positioning
Prone Use positioning
Sims Use positioning
Knee Chest Use positioning
Trendelenburg Use positioning
Where is the heart located? thoracic cavity between the lungs and just behind the sternum (breast bone)
Atria upper left and right chambers of heart
Ventricles lower left and right chamber of the heart
septum wall of the heart that seperates the right and left side
endocardium inner most layer of the heart , this layer is where the conductive system is found
myocardium middle and contractile layer of the heart. made of striated muscle fibers interspersed with intercalated disks
epicardium outermost layer of the heart(also the inner layer of the pericardium)
pericardium sac in which the heart is contained. serous fluid found in the sac prevents friction as the heart beats
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)
left atrium recieves blood via left and right pulmonary veins that has been oxygenated by the lungs
left ventricle receives oxygenated blood from the left atrium and pumps it to the body through the aorta
right ventricle receives deoxygenated blood from the right atrium, which it pumps to the lungs for oxygen through the pulmonary artery
pulmonary arteries the only arteries in the body that carries deoxygenated blood
pulmonary veins the only veins in the body that carry oxygenated blood
what is the aorta? the largest artery in the body that carries oxygenated blood from the heart to the body
tricuspid valve located between the right atrium and right ventricle
mitral (bicuspid) valve located between left atrium and left ventricle
what are the purpose of the heart valve? prevent backflow of blood
aortic valve located between left ventricle and aorta
pulmonic valve located between right venticle and pulmonary trunk
What are murmurs ? caused by disease of the valves or other structural abnormalities
atrioventricular valves are named because of their location between the atria and ventricles
semilunar valves they have half moon shaped cusps
sympathetic nervous system affects both atria and ventricles by increasing heart rate, conduction and irritability
parasympathetic nervous system affects the atria only by decreasing the heart rate, conduction and irritability
what is the heart influenced by? autonomic nervous system
Sinoatrial node (SA node) the hearts natural pacemaker that fires at 60-100bpm. located in the right atrium
atroventricular node located just above the tricuspid in the right atrium
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.
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.
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
Characteristics of cardiac cells Excitability Automacity conductivity contractility
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
Excitability ability to respond to external stimulus: electrica, chemical, and mechanical. All cardiac cells share this property
Conductivity the ability of all cardiac cells to receieve an electrical stimulus and transmit the stimulus to the other cardiac cells
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
Depolorization when the heart contracts
Repolorization when the heart relaxes
Which lead is used for grounding or reference lead ? Right Leg (RL)
Name the bipolar standard leads Lead I: left arm (+) right arm (-) Lead II: left leg (+) right arm (-) Lead III: left leg (+) left arm (-)
Augmented unipolar leads aVR: right arm aVL: left arm aVF: left leg
Unipolar precordial leads V1: V2 V3 V4 V5: 5th intercostal space, anterior axillary line V6: 5th intercostal space, maxillary line
Created by: bdorce
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