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Vital signs

Bradycardia Less than 60 bpm Why? Long term pain, medications, hypothermia, resting, sleeping, heart block.
Hypertensive crisis Diastolic blood pressure is dramatically elevated. Diastolic (bottom #) BP above 120-130 Needs to be treated quickly to prevent damage to the heart, brain, kidneys, and eyes.
Telemetry Lead Placement White to the Right (right upper chest) Clouds over Grass (Green bottom right) Smoke over Fire (Red below left breast. Black upper) Chocolate close to hear
Shock Something happens, as a result theres is an insufficient amount of blood being pumped to the heart to carry oxygen to the tissues. *BP \/, Pulse /\, Respirations /\ *clammy, cool *pale *may become unresponsive
Septicemia Pathogens are present in the blood stream. *infection throughout the body * can result in death *temps above 101 *usually respond to treatment with IV antibiotics
Narrowing Pulse Pressure Normal pulse pressures are 40-50 Numbers narrowing can indicate a serious problem with the hearts ability to pump blood. *EXTREMELY important to notice and report to charge nurse.
Normal Pulse Pressure Normal 40-50
Telemetry Battery powered transmitter that continuously monitors patients heart rate and rhythm. 3-5 leads ambulatory continuous monitorying
Auscultatory Gap Temporary disappearance of sound occurs between the 1st and 2nd korotkoff sounds *often heard in pts with hypertension (HTN)
Korotkoff Sounds Pulsating sounds when reading blood pressure
Orthostatic Hypotension When BP drops from standing up too fast from standing up too fast.
Hypertension Sustained elevated pressure above 140/90. *based on 2 separate readings on 2 separate days.
Normal Adult BP 100-140/ 60-90
Normal Child BP 100-110/65
Normal Infant BP 78/42
Diastolic relax, Pressure in the artery between beats. *relax and refill
Systolic squeeze, 1st Normal sound heard. Ventricles contracting and forcing blood.
Blood Pressure Arterial Pressure Pressure exerted by circulating volume of blood on arterial walls, veins, and chambers of heart. Millimeters of mercury (mmHg)
Left Ventricle Pushing out of heart to the body.
Right Ventricle Pushing into heart from body.
Core Temp Temp of the deep tissue of the body. *remains relatively consistent.
Inspiration INhaling. Breathing IN oxygen to the lungs.
Thready Pulse Difficult to feel and disappears easily, when only slight pressure is applied.
Weak Pulse Pulse is not felt when light pressure is applied to wrist
Bounding Pulse More volume than usual. Stronger than normal. *easily felt with light palpation *(3+) *feels full and spring like, even under moderate pressure,
Dyspnea Difficult/ painful respirations Difficulty breathing
Apnea Lack of spontaneous respirations or not breathing
Hyperventilation rate of ventilations exceeds normal requirements for exchange of respiratory gases usually amounts to an increase in rate and depth of respirations
Hypoventilation Rate of ventilation entering lungs is insufficient for metabolic needs usually amounts to a decrease in rate and depth of respirations
Altered Tissue Perfusion Blood Supply pale color coldness of extremity
Amplitude Volume of blood pushing against the artery wall with each beat. *How strong is it?
Dysrhythmia Any disturbance or abnormality in a normal rhythmic pattern.
Factors that affect pulse rate? *patients age *gender *emotional state *size *temp *heart condition *amount of physical activity *medications
Tachycardia Faster than 100 BPM *Fever, some medications, acute pain, feaer/anxiety, shock, exercise, hemorrhage
What to check for in the pulse? Rate - Beats per min Rhythm - regular or irregular Strength - weak, thready, or bounding
Hypothermia Low body temp Below 93.2
Constant Fever Remains elevated consistently and fluctuate very little.
Intermittent Fever Rise and fall, spikes and returns to normal.
Remitten Fever Rises and falls but wont go away until patient is well.
Auscultate Listen for sounds within the body to evaluate the condition of heart, lung, pleura, and other organs or detect fetal heart tones.
Surface Temperature Temp of skin
Tachypnea Rapid resp. rate above 20 RPM. *can be caused by exercise
Bradypnea slow repiratory rate less than 12 RPM
Equation to find Celcius C = (F-32) x 5/9
Equation to find Fahrenheit F = (9/5 x C) + 32
What causes high temperature inaccuracies? *smoking *drinking/eating hot stuff *infant or child *taken only in evenings? *exercise *hot environment *stress *INFECTION?
What causes low temperature inaccuracies? *cold food/drink *elderly *taken in AM *environment *chronic disease
Pyrexia *Febrile *Hyperthermia above normal body temp. /\ 105 can damage normal body cells
Pulse Pressure difference between systolic and diastolic
Pulse Deficit difference found between the apical and radial rates *must be checked by two people at the same time.
hypothalamus regulates body temp.
Adult Pulse 60-100 *average 80
Tympanic Temperature Taken in the ear drum. No infants under 6 months
apical pulse represents the actual beating of the heart
Created by: kfweaver