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MTC Vital Signs
| Question | Answer |
|---|---|
| Temperature range | 97 - 99.5 degrees F |
| Pulse range | 60-100 beats per minute |
| Respirations range | 12-20 breths per minute |
| Blood Pressure range | 100/60 - 140/90 |
| Oxygen Saturation | 93% |
| When do you measure vital signs? | on admission, during assessment, before-during- and after a procedure, anytime you notice a behavioral change, before and after administering medication which directly affect the VS, if the patient complains of feeling different from previous encounter |
| What is temperature? | the balance between heat produced and heat lost |
| Where do you measure for core temperature? | rectal and typanic |
| Where is surface temperature measured? | axillary and forehead |
| Radiation | the diffusion or dissemination of heat by electromagnetic waves. Ex: the body gives off waves of heat from uncovered surface |
| Convection | the dissemination of heat by motion between areas of unequal density. Ex: an oscillating fan blows currents of cool air across the surface of a warm body |
| Evaporation | the conversion of a liquid to a vapor. Ex: body fluid in the form of perspiration and insensible loss is vaporized from the skin |
| Conduction | the transfer of heat to another object during direct contact. Ex: the body transfers heat to an ice pack, causing the ice to melt |
| Factors that affect body temperature | age, circadian rhythm, exercise, endocrine, and environment |
| Stages of Fever: Onset | increased heart rate, shivering, increased respiratory rate, pale-cold skin, cyanotic nail beds, goosebumps, no sweating |
| Stages of Fever: Plateau (stage 2) | no chills, warm skin, increased pulse and respiratory rate, increased thirst, some dehydration, dowsy, herpetic lesions may appear (fever blisters), weakness |
| Stages of Fever: The fever breaks | sweating, skin flushed - warm and dry, decreased shivering, dehydration |
| Patterns of Fever: Sustained | constantly elevated |
| Patterns of Fever: Intermittent | fever spikes with return to acceptable range at least one time in 24 hours |
| Patterns of Fever: Remittent | fever spikes and falls without a return to acceptable levels |
| Patterns of Fever: Relapsing | febrile episodes with periods of acceptable levels mixed together, Each usually lasting 24 hours. |
| Bradycardia | Pulse rate is below 60 beats per minute |
| Tachycardia | Pulse rate is above 100 beats per minute |
| Factors that influence pulse rate | age, exercise, emotions/pain, hemorrhage (loss of blood volume), environmental temperatures, fever, smoking, caffeine |
| Ventilation | exchange of gases |
| Diffusion | movement of oxygen into blood cells External - lungs to blood Internal - blood to cells |
| Perfusion | process by which oxygenated blood passes through body tissues |
| Eupnea | normal respirations |
| Bradypnea | decreased respiratory rate |
| Tachypnea | increased respiratory rate |
| Apnea | a period in which there is no breathing |
| Dyspnea | difficult or labored breathing |
| Factors that influence respirations | age, exercise, rest, anxiety/stress, fever, anemia, pain, medications, body position |
| Orthopnea | moving to an upright position to maximize ventilator efforts |
| What if O2 Sat is less than expected? | recheck with other equipment, observe the patient for cyanosis, tachycardia, restlessness. Assist the patient to a position that maximizes ventilator efort |
| Blood Pressure | the force on the walls of the artery created by the pulsing blood under pressure from the heart |
| Systolic | the highest pressure on the artery walls |
| Diostolic | the lowest pressure on the artery walls |
| Factors that influence blood pressure | age, exercise/rest, gender, race, stress/anxiety, medications, temperature, hemmorrhage, postural changes |
| Errors in Blood Pressure measurements: false highs | cuff too narrow, cuff too loose,too close to meals, smoking, exercise, deflating cuff too slowly, |
| Errors in Blood Pressure measurements: false lows | unnotices Auscultatory gap, careless technique, arm higher than heart, cuff too large |
| Basic guidelines for checking vital signs | when patient has had food or drink in the last 30 minutes, check ID, introduce yourself, and explain what you are doing |
| Vasodilation | vessels expand and give off heat |
| Vasoconstriction | vessels shrink and hold in heat |
| Heat Production | Metabolism. Skeletal muscle activity: exercise, shivering, and piloerection (goosebumps). Vasoconstriction. Hormones:Thyroxin (too little-cold) and Epinephrine (too much-hot). Infection/inflammation. Environmental extremes |
| Pyrexia | fever - heat loss mechanism unable to keep pace with excess heat production |
| Pulse deficit | difference in apical and radial rates. a difference means blood is not getting to the extremity - profussion |
| Assessing pulse quality (strength) | measurement of force with which blood is ejected against the arterial wall. 0, +1, +2, +3, +4 |
| Assessing profusion (circulation) | color, warmth, blanching or capillary refills, pulses |
| Respiration | mechanism the body uses to exchange gases between the atmophere, blood and cells. strongest stimulus is carbon dioxide. |
| Pulse pressure | the different between systolic and diastolic pressures |
| Cardiac output | heart rate x stroke volume |
| Peripheral resistance | elasticity of arteries and lumen size |
| Lower cardiac output | lower BP: weak heart muscle - heart attack low blood volume - bleeding |
| Higher cardiac output | Higher BP: fluid overload heart medications |
| Orthostatic hypotension | occurs when a patient with anormal BP develops symptoms and a low BP whe rising to an upright position |
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