Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
CH15
Measuring height, weight and vital signs
| Question | Answer |
|---|---|
| the brachial pulse is located in the neck t/f | f; elbows |
| the ________ pulse is found near the outside of the forehead | temporal |
| the heart emits the _________ pulse | apical |
| the ________ pulse is found in the neck | carotid |
| the femoral pulse is located in the groin t/f | t |
| the knee is where you find the ______ pulse | popliteal |
| the feet is where you find the posterior pulse t/f | f; pedal pulse found in feet, posterior pulse found in ankle |
| ave adult pulse is 120- 150 bpm t/f | f; 60-100, |
| SpO2 | peripheral capillary oxygen saturation. percentage of blood saturated hemoglobin dissolved in blood |
| a stethoscope is used to listen to sounds produced by organs. t/f | t |
| systolic pressure is the amount of force required to contract the lungs t/f | f; amount of force required to pump blood out of heart and into arterial circulation |
| what is a pulse oximeter? | device measures both pulse and O2 levels in blood |
| the pressure in the arteries when heart is at rest is ________ | diastole |
| blood pressure is the amount of force exerted by blood on artery walls t/f | t |
| vital signs inc ____, ______, _____ and _____ | temp, pulse, resp, blood pressure |
| normal systolic pressure is 100- 140 mmHg t/f | t |
| normal diastolic pressure is between 50-100 mmHg t/f | f; 60-90 mmHg |
| systolic/ diastolic pressure below 90/ 60 mmHg must be reported t/ | t |
| 140/90 mmHg in canada is considered _______ | high |
| normal BP is _______/______mmHg | 120/80 |
| diabetics usually have a BP of 130/80 t/f | t |
| blood pressure | the amount of force exerted by the blood against the walls of the arteries |
| body temp | amount of heat in the body, a balance between amount of heat produced and amount lost |
| the heart rate is less than _____ BPM during bradycardia | 60 |
| dysrhythmia | irregular rhythm of the pulse; beats may be unevenly spaced or skipped |
| hyper tension | persistent BP measurements above normal systolic or diastolic pressure; 140/90 mm Hg |
| hypotension | a condition in which systolic BP is below 90 or diastolic below 60 |
| pulse | beat of the heart felt at an artery as a wave of blood passes through the artery |
| pulse rate | number of heartbeats or pulses felt in 1 min |
| systolic pressure | amt of force required to pump blood out of the heart and into the arterial circulation |
| tachycardia | rapid heart rate; a rate over 100 BPM in adults |
| vital signs have four main body functions and may include __________ sometimes as a fifth | oxygen saturation levels (SpO2) |
| taking SpO2 will require special training by your employer t/f | t |
| vital signs reflect the function of three body processes essential to life 1)__________, 2)_________________, 3__________________ | 1)regulation of body temp 2) breathing 3) heart function |
| measuring vital signs as well as weight and height, provide important info for the care planning process t/f | t |
| ___________ and _________ are measured when a client is admitted to a facility; always daily, t/f | f; daily, weekly or monthly sometimes |
| if there is a concern about fluid retention a client is often weighed _____________ | daily |
| if there a concern about weight gain or loss the client is often weighed _____________ | daily |
| weigh the client at ______________ for daily, weekly or monthly measurements and use _____________ scale | same time , same |
| the best time to weigh client is ___________ breakfast | after |
| clothes add weight to the scale therefore only ____________ or pj's should be worn | gown |
| shoes and slippers can add to both height and weight when taking measurements t/f | t; therefore they should be removed |
| have the client void after being weighed t/f | f; before |
| if a urine sample is needed during a weighing, collect it at the _____________ time | same |
| the most common weigh scale used in facilities is the weight scale in ______________ | bath tub lift scale |
| balance beam, chair, lift and wheel chair scales are all types of scales that can collect weighing data t/f | t |
| balance beam scales are used for clients that can ____________ | stand |
| a lift scale is used mainly if a client is tired t/f | f; mainly if a client is unable to stand |
| you must ensure you weigh your client with the ______ clothing, _______ time of day, and ________ scale | same, same, same |
| make sure LED scales read ____ before weighing the client | zero |
| to convert metric units, divide pounds by 2.2 to get weight in kilograms t/f | t; eg 10lb= 4.5kg, 160lb=72.7kg |
| a persons vital signs can be affected by meds, pain, illness, activity, exercise, sleep, food, fluids, smoking and emotions t/f | t |
| a persons vital signs are always constant with little fluctuation t/f | f; vary within certain limits and are affected by many stimulus |
| vital signs are measured to detect changes in abnormal body functions t/f | f; normal body functions |
| vital signs can indicate a response to treatment and signal life threatening events t/f | t |
| vital signs are part of the evaluation step in the care planning process t/f | f; assessment |
| vital signs are measured after a physical examinations t/f | f; during |
| vital signs are measured when a client is admitted into a facility t/f | t |
| vital signs are measured only once a day for hospital clients and clients in subacute care units t/f | f; several times a day |
| vital signs are measured pre and post op t/f | t |
| vital signs are measured before/ after complex surgeries or diagnostic tests t/f | t |
| vital signs are measured after all care measures t/f | f; only some |
| vital signs are measured after a fall or other injury | t |
| vital signs are measured when meds may effect ability to walk t/f | f; when meds could affect R or circulatory system |
| vital signs are measured whenever a client c/o pain, dizziness, light headedness, SOB, tachycardia, or not feeling well t/f | t |
| vital signs are measured when the PSW can get to them t/f | f; as often as dictated by clients condition |
| vita signs are measured as ordered by a PSW t/f | f; as ordered by the dr |
| vital signs are measured as stated on the CP t/f | t; often daily or weekly |
| vital signs are measured as instructed after the client is given meds to relieve a fever t/f | t |
| vital signs can reveal even _____ changes in a clients condition | minor |
| _______________ is essential when you measure , record and report vital signs | accuracy |
| if you are unsure of your accuracy, do not ask your supervisor for help, take them again t/f | f; promptly ask your supervisor to take them again |
| unless asked otherwise take vital signs when the client is at ________, _______ down or sitting | rest, lying |
| always compare your vital signs reading with clients _________ reading | baseline |
| immediately report any vital signs ______ or ________ normal range | above, below |
| immediately report any vital signs that have changed from previous measurements t/f | t |
| the clients name, date, time vitals were taken and the vital sign measurements must be accurately an clearly recorded t/f | t |
| PSW can compare current and previous vital measurements t/f | f; nurse or dr does this |
| age, weather, exercise, pregnancy, menstrual cycles, emotions and stress can have an impact on body temp t/f | t |
| body temp is normally higher in the morning and lower in afternoon and evening t/f | f; lower in morning and higher in afternoon/ evening |
| temp __________ or ______________ a normal range can signal illness or health problems | above, below |
| to convert F to C subtract _____ from F reading and divide by _____ | 32, 1.8 |
| to convert from C to F multiply the C reading by _____ and add _____ | 1.8,32 |
| mouth temp is also called ____________ | oral temp |
| underarm temp is also called_____________ | axillary temp |
| ear temp is also called _______________ | tympanic temp |
| rectum temp is also called______________ | rectal temp |
| although rectal temps are rarely used a PSW can perform this as it is required t/f | f; this is a controlled act, only authorized health care providers can perform this procedure. once trained and with proper supervision a PSW can be delegated this task by a nurse |
| each body site has a ________________ range of temperature, so check your CP and with your supervisor as to where you are taking the temp | normal |
| the normal range for oral temp is ______________ | 36-37.5 C/ 96.8-99.5F (ave temp 37C/ 98.6F) |
| the normal range for tympanic temp is ____________ | 35.8-38C/ 96.4-100.4F (ave temp 37.4C/99.3F) |
| the normal rage for axillary temp is ________________ | 34.7-37.3C/ 94.5-99.1F (ave temp 36.5C/ 97.7F) |
| the normal range for rectal temp is ______________ | 35.5-38C/ 95.9-100.4F (ave temp 37.5C/ 99.5F) |
| ________________ adults have a lower body temp compared to __________ people | older, younger |
| report symptoms of cold or illness regardless of normal temp t/f | t |
| oral temp can be taken on an unconscious client, you must use a dental opening to do so t/f | f; do not use oral method of taking temp on an unconscious person |
| if a client has had surgery on or injury to ________, ________, ________ or ________ do not take oral temp | face, neck, nose, mouth |
| a client with a nasogastric tube or hemiplegia should not have oral temp used t/f | t |
| a delirious, restless, confused or ______________ client should not have an oral temp taken | disorientated |
| a client with convulsive disorder can have oral temp taken if they are not in a state of convulsing t/f | f; do not take oral temp |
| is a client breathes through their moth or has mouth ___________ do not take oral temp | sores |
| oxygen therapy doe not effect taking oral temp t/f | f; do not take oral temp on clients receiving oxygen therapy |
| before taking an oral temp make sure the client has not eaten hot/ cold food, drank hot/ cold liquids, smoked or chewed gum for 30 mins prior t/f | f; 20 mins prior |
| if you can not take oral temp, the __________________ temp is usually next choice | tympanic |
| tympanic temp is best option for _____________ and clients with ___________ | children, dementia |
| if there is drainage coming from the ear, first clean the ear and be gentle when using the tympanic thermometer t/f | f; do not take tympanic temp if drainage is coming from the ear or client complains of pain in ear |
| when taking tympanic temp pull outward and back gently on the ear to align the canal t/f | f; pull DOWN and FORWARD gently |
| axillary temp is less reliable than oral or tympanic temp, so it is only used if other sites are unavailable t/f | t; although its less invasive nature makes it ideal for newborns, unconscious or uncooperative clients |
| the axilla must be dry before using for temp t/f | t |
| thermometers spread microbes so plastic coverings and cleaning/ drying between clients must occur t/f | t |
| surgical asepsis and standards of nursing practice must be followed when using thermometers t/f | f; medical asepsis and standards of nursing practice |
| pacifier thermometers are special thermometers used on ___________ and ________________ | infants and toddlers |
| infants pulse is _____________ BPM | 120-160 |
| toddlers pulse is ____________ BPM | 90-140 |
| preschoolers pulse is __________BPM | 80-110 |
| school aged kids pulse is ___________ BPM | 75-100 |
| adolescent pulse is _____________BPM | 60-100 |
| adults pulse is _____________BPM | 60-100 |
| some factors that may effect P inc elevated body temp, exercise, pain, position, caffeine, emotions and meds t/f | t |
| the rhythm of the pulse should be _________________ | regular |
| the force of pulse relates to its ____________ | strength |
| a forceful pulse is easily felt and could be descried as __________, __________ or _____________ | strong, full, bounding |
| a hard to feel pulse could be described as ___________,_____________or ______________ | weak, thready, feeble |
| blood pressure equipment can count beats, shows pulse rate, rhythm rate, force emitted and BP t/f | f; do not give info about rhythm or force, those are felt through touch |
| the ____________ pulse is one of the routine vital signs you will have to take | radial |
| a healthy adult has ______ to ______ RPM | 12-20 |
| T, P and R are all effected by similar factors t/f | t |
| respirations are counted right after P is t/f | t; try to make it look like you are still taking the clients pulse and distract them so their breathing is not affected |
| R is counted by watching how often the chest rises and falls and _______ secs | 30 |
| rise and fall of the chest is counted as two respirations t/f | f; counted as one. multiply the number by two for the number of respirations in one min |
| if ___________ pattern is noted, count respirations for one min | abnormal |
| newborn normal resp rate is ______________RPM | 30-60 |
| infant normal resp rate is ______________ RPM | 25-50 |
| toddler normal resp rate is _______________ RPM | 25-32 |
| child/ preadolescent normal resp rate is____________ RPM | 20-30 |
| adolescent normal resp rate is ______________ RPM | 16-19 |
| adult normal resp rate is ___________ RPM | 12-20 |
| count an ___________ resp rate for one full min | infants |
| record rate of R, uniformity/ depth of R, R rhythm, pain/ difficulty breathing, R noises and any abnormal R patterns t/f | t |
| BP is controlled by force of __________ contractions, __________ of blood pumped with each heartbeat and how ___________ the blood flows through the blood vessels | heart, amount, easily |
| diastole | period of heart muscle relaxation |
| systole | period of heart contracting |
| blood pressure is measured in millimeters (mm) of ___________ (Hg) | mercury |
| electronic manometer | auto displays BP measurement, P rate is usually displayed also |
| sphygmomanometer | instrument used to measure BP |
| the inflated cuff of monometer is positioned over the ______ artery | brachial |
| the BP is measured as you inflate the manometer cuff t/f | f; as its deflated |
| the ________________ is used to listen to the sounds in the brachial artery as the cuff of a manometer is deflated | stethoscope |
| you do not need to use a stethoscope to listen to the brachial artery if a electronic sphygmomanometer is used t/f | t |
| measuring BP could be a controlled act where you work o check your employer policy and provincial legislation t/f | t |
| do not take BP on an arm is injured or with an IV infusion, cast or a __________ access site | dialysis |
| if your client has had breast surgery do not take the BP on that side t/f | t |
| allow clients to rest _____ to _____ mins before taking BP | 10 to 20 |
| only take BP on a client standing is a ____ has ordered it | dr |
| for client comfort a sleeve can remain on when taking BP to ensure your client stays warm t/f | f; direct contact with skin is needed |
| the _______ sound is the systolic pressure when listening at the brachial artery during BP measurements | first |
| the point at which the sound disappears is the _________ pressure when listening at the brachial pulse during BP measurements | diastolic |
| if unsure of your BP accuracy wait ___ to _____ seconds before repeating | 30 to 60 |
| the apical pulse is felt over the heart and is special because its taken with a ______________ | stethoscope |
| an arrow on the BP cuff marks the cuff placement in relations to the _____________ artery | brachial |
| check incontinence products ____________ weighing takes place, as wet incontinence products add weight | before |
Created by:
Wil.Wilson
Popular Health & Social Care sets