PTA 101: Module 2

Pulse oximetry is measured in...?

% of saturation

What are some abnormal respiration responses?

- slow/no increase with activity - continues to increase with activity plateau - slow/no decrease as activity intensity declines

What are some BP "red flags"?

- systolic greater than 250 mmHg - diastolic greater than 115 mmHg - systolic drop greater than 10 mmHg from baseline - failure of the systolic pressure to increase with increasing workload

What is the normal heart rate for newborns?

100-130 beats/min.

What are the normal respiratory values in adults?

12-18 breaths/min.

What are the values for prehypertension?

120-139/80-89 mmHg

What are normal BP values for the elderly?

120-140/80-90 mmHg

How do you calculate maximum heart rate?

220 - persons age

What are the normal respiratory values in infants?

30-50 breaths/min.

What is the normal heart rate for adults?

60-100 beats/min.

What is the normal heart rate for children?

80-120 beats/min.

What are normal BP values for an infant?

85-90/35-65 mmHg

What are the normal values of pulse oximetry?

95% - 100%

What is the normal values for an oral temperature?

96.8*F - 99.3*F (37*C)

What are the values for bradycardia?

< 60 beats/min.

What are the values for hypoxemia?

< 90%

What are the respiratory values for bradypnea?

<10 breaths/min.

What are normal BP values for an adult?

<120 / <80 mmHg

What are the values for tachycardia?

> 100 beats/min.

What are the values for a pyrexic temperature?

> 100*F

What are the values for a hyperpyrexic temperature?

> 106*F (emergency)

What are the respiratory values for tachypnea?

>20 breaths/min.

When should you assess vitals?

BEFORE, DURING, and AFTER treatment *or anytime a change in status is inconsistent w/ activity

What is the unit of measure for temperature?

Fahrenheit & Celsius

Vital signs documentation...

Taken prior to exercise with patient seated: BP in left UE ______ mmHg. Right radial pulse = ______ beats/min. Respiration rate = ______ breaths/min.

What factors generally increase temperature?

afternoon, young age, infection, activity, stress/emotion, ovulation/pregnancy, environmental temperature

Pulse decreases with:

age, hypertension, and in well conditioned people

A sign is...?

an observable finding related to a persons condition

Temporal artery - pulse site?

anterior and adjacent to the superior ear

Femoral artery - pulse site?

at femoral triangle slightly anterior and lateral to inguinal crease

What is heart rate (pulse) measured in?

beats/min. (beats per minute)

Diaphragm vs. Bell? (small side) best suited for low frequency sounds like BP

bell

What is respiration rate measured in?

breaths/min. (breaths per minute)

Respiratory rate is measured in...?

breaths/minute

A decrease in blood volume cause BP to...?

decrease

Why do we check vital signs?

establishes baseline, goal setting/plan of care, patient response/effectiveness of treatment

Relaxation of thoracic musclles

expiration

What is syncope?

fainting

Why should you avoid supine position when assessing respirations?

gravity's effect on the diaphragm

Respiration is ________ in the young & elderly.

higher

A symptom is...?

how a person experiences a condition; difficult to measure accurately

Brachial artery - pulse site?

in antecubital fossa, medical to biceps, may be on medial aspect of mid shaft of humerus

A decrease in arterial size causes BP to...?

increase

A decrease in vessel elasticity causes BP to...?

increase

Define: temperature...

indication of the intensity/degree of heat within the body

Define: pulse...

indirect measure of the contraction of the left ventricle of the heart; measures rate at which the heart is beating

What is blood pressure?

indirect measurement of pressure inside an artery caused by blood flow through the artery

Pulse increases with:

infection, stress/anxiety, hypotension

Carotid artery - pulse site?

inferior to angle of mandible and anterior to SCM muscle

Activation of thoracic muscles

inspiration

How does a patient act when lethargic?

lack of energy, interest, and enthusiasm

Blood pressure is typically taken in the...?

left arm, unless made known

Commonly referred to as a vital sign red flag, what is orthostatic hypotension?

low BP upon standing from a seated or supine position

What effect does dehydration have on BP?

lowers blood pressure

How do you calculate target heart rate during exercise?

maximum HR x desired intensity (%)

Posterior tibial artery - pulse site?

medial aspect of foot, inferior to medial malleus

Popliteal artery - pulse site?

midline of posterior knee crease, between HS tendons

What is blood pressure measured in?

millimeters of mercury (mm Hg)

What is defined as, the patients perception of how hard they feel like their body is working?

perceived exertion

What is systolic value?

pressure during left ventricle contraction pushing blood into aorta

Sign vs. Symptom? objective

sign

What are Korotkoff's sounds?

sounds you hear when taking someone's blood pressure systolic pressure = first faint tapping sound diastolic pressure = sounds disappear

What tools are used to measure blood pressure?

stethoscope and sphygmomanometer

Sign vs. Symptom? subjective

symptom

While it's commonly called the fifth vital sign, pain management is actually a...?

symptom (subjective but quantifiable)

What are the values for hypotension?

systolic < 100

What are the values for hypertension?

systolic > 130, and/or diastolic > 90 mmHg

Blood pressure is documented as...?

systolic/diastolic mmHg

What happens to blood pressure with age?

systolic: increases diastolic: decreases

If a patient is experiencing dizziness it is known as...?

vertigo

Significant changes from normal or baseline values when assessing BP, RR, & HR are also deemed..?

vital sign red flags

Radial artery - pulse site?

volar side of wrist, medial side of radial styloid process

Perceived exertion is often referred to as...?

"Borg's Scale"

Give example(s) of BP medications...

- beta blockers - diuretics -ACE inhibitors - calcium channel blockers

Special patient populations?

- elderly - pediatric - debilitated / deconditioned - PMH of cardiovascular problems - recent trauma (CVA, SCI, HTN, PVD, etc.)

What are some adverse responses to activity?

- mental confusion - fatigue - exhaustion - lethargy - slow reactions - slow response to commands/stimuli - nausea - syncope - vertigo - diaphoresis - pupillary changes - sluggish - apathetic

What are vital signs influenced by?

- physical activity - environmental temperature - age - emotional status - physiological status (illness, disease, medications, trauma)

Diaphragm vs. Bell? (big side) typically used for high frequency sounds (lung sounds)

diaphragm

Dorsal pedal artery - pulse site?

dorsum of the foot, follow tendons of EHL and EDL

Difficulty breathing is termed as?

dyspnea

What factors generally decrease temperature?

early morning, old age, cool environment

Other factors affecting respiration include...?

emotional status, disease, thoracic cavity changes, air quality & altitude

Other factors affecting BP include...

emotional status, medications, cardiac output

What are the FOUR main vital signs?

heart rate, respiration, blood pressure, and temperature

Respiration is defined as...?

one inhalation and one exhalation

What is often considered the "fifth vital sign"?

pain assessment

What is diastolic value?

pressure during ventricular rest period of heart and refilling

What is diaphoresis?

profuse sweating

What are the additional measurements of vital signs?

pulse oximetry, pain scales, perceived exertion ratings

What is key in pain assessment?

questioning

What happens to respiration during activity?

rate & depth increase

Define: pulse oximetry...

Measures the oxygen saturation of the blood using infrared light

What happens to BP with physical activity?

- BP increases with muscle contraction - systolic should gradually increase with exercise > plateau's as exercise intensity plateau's > gradually decreases with exercise decrease - diastolic should remain essentially the same

What are some reasons you may have to take blood pressure in another area (other than left arm)?

- IV placed - shunt for dialysis - low or high muscle tone (after stroke) - lymphedema (or after axillary nodes removed following CA)

What factors in BP assessment can affect the results?

- arm position - value in left UE > right UE - muscle contraction (relax)

What are some normal pulse responses?

- rapid increase with activity - pulse plateaus as activity intensity plateaus - post-exercise, returns to resting rate within 3-5 minutes

What are some abnormal pulse responses?

- slow or no increase with exercise - increase or decrease with exercise as intensity plateaus - slow or no decrease as intensity declines - rhythm becomes irregular during or after exercise