D & D -- Vital signs Ch. 20

rectal temperature temporal artery

A __________ is most often used for infants. It is important to use the proper technique to avoid damaging the rectal tissue. However, most pediatricians prefer the infants' temperatures to be taken with a _____________ because it is more comfortable for the baby, less invasive, and eliminates the possible complication of a perforated rectum.

95 %

A normal pulse oximetry reading would be ___________ or higher.

stroke volume

A pulse reflects the patient's heartbeat Stronger heart has a stronger _______________.

100.4 F 100 F 99 F

A rectal, temporal, and aural (ear) temperature over __________ (38 C); an oral temperature over ___________ (37.8 C); and an axillary temperature over ___________ F (37.2 C) are all considered a fever.

homeostasis

Almost every patient who visits the healthcare facility will have some vital signs measured. These signs are the body's indicators of internal _______________ and the patient's general state of health.

systolic

As a blood pressure cuff is deflated, the first tapping sound is the ____________ pressure.

arteries systolic pressure diastolic pressure

Blood pressure reflects the pressure of the blood against the walls of the ______________. Blood pressure is recorded as a fraction; the ____________ reading is the numerator (top number), and the ___________ reading is the denominator (bottom number).

metabolism

Body temperature is defined as the balance between heat lost and heat produced by the body. It is measured in degrees Fahrenheit (F) or degrees Celsius (C). The process of chemical and physical change in the body that produces heat is called _____________. Body temperature is a result of this process.

medulla oblongata

Breathing rates are controlled by the respiratory center, which is located in the _____________ of the brain.

own words

CC = stands for chief complaint. Document the CC in the patient's _____________.

16

Carlos counts eight respirations for 30 seconds. The rate is ___________ respirations per minute.

respiration

Correct way to do a pulse is a full 60 seconds. A _____________ = 1 full breath in and 1 full breath out

a) Blood volume b) Peripheral resistance created by blood viscosity c) Vessel elasticity d) Condition of the heart muscle and arterial walls

Describe four physiologic factors that can affect an individual's blood pressure.

thumb side

Detecting pulse -- use the ______________ of the person's wrist.

Fowler's position Semi Fowler's position

Different body Positions = _____________ = 90 degree angle _____________ = 45 degree angle

Sim's LLD Knee chest

Different body positions = _____________ = left, down. (bottom leg straight and other leg bent) ______________ = butt in the air -- bent body with knee to chest

Supine Prone

Different body positions = ____________ = on back (horizontal recumbent) ____________ = face down laying down

Lithotomy Trendenberg

Different body positions = _____________ = feet in stirrups ______________ = feet above head, laying down

Essential hypertension is the most common type of hypertension. It is idiopathic but is associated with obesity, high blood level of sodium, elevated cholesterol, family history, and race. Secondary hypertension = is caused by another underlying pathologic condition.

Differentiate between essential and secondary hypertension.

To obtain a correct blood pressure reading, the cuff used must be the proper size. The systolic and diastolic blood pressures can be lowered by as much as 5 mm Hg if the cuff is one size larger than appropriate. And up to 6 mm Hg if the cuff is too small.

Discuss the importance of using a correct blood pressure cuff size when monitoring patient blood pressures.

Blood volume Peripheral resistance created by blood viscosity Vessel elasticity Condition of the heart muscle and arterial walls

Factors Affecting Blood Pressure Factors that determine blood pressure include =

-- Age --Stress and physical activity -- Gender -- External factors (smoking, drinking hot fluids, and chewing gum).

Factors that may affect body temperature include the following:

C = (F- 32) divided by 1.8 F= (C X 1.8) + 32

Fahrenheit to Celsius formula is = Celsius to Fahrenheit formula is =

Continuous fever Intermittent fever Remittent fever

Fevers are classified according to the 24-hour pattern they follow. The 3 most common patterns are as follows = _______________ _______________ _______________

Place the scale in a private area of the office

How can you help patients feel comfortable about having their weight measured in the office?

1 minute

How long should the pulse be counted for the most accurate results?

1 foot = 12 inches

How many inches is in 1 foot?

180 120

Hypertensive crisis of blood pressure = Systolic over _________ and/or diastolic over ________

the hypertension is associated with another disease

If a patient is diagnosed with secondary hypertension, this means that the =

1: 4

In a healthy adult at rest, the ratio of respirations to pulse beats is typically =

Palpation Percussion

Inspection = looking, wathing ______________ = provider is pushing on the belly to see how their organs feel. _______________ = tapping or striking an object

smoking, drinking hot fluids, and chewing gum

List and describe factors that may affect body temperature. -- Gender = Hormone secretions result in fluctuations of the core body temp in women throughout the menstrual cycle. -- External factors = ___________, __________, and __________ can change body temp.

-- morning afternoon -- rapidly

List and describe factors that may affect body temperature. -- Time of day-- Body temp is lowest in the ____________ and highest in the _________. -- Age = The body temp of infants and young children fluctuates more __________ in response to external environmental temperatures. -- Stress and physical activity = Both exercise and emotional stress can increase the metabolic rate, causing an elevation in temperature.

a) The time of day b) Age c) Stress and physical activity e) Gender f) External factors

List and describe four factors that may affect body temperature.

Many ambulatory settings use pulse oximeters to assess in disorders such as pneumonia, brochitis, emphysema, asthma

List conditions for which a pulse oximetry may be used to assess a patient's oxygenation status.

1) Rate 2) Rhythm 3) Depth

List the 3 characteristics of respirations. 1) _______________ 2) ______________ 3) ______________

113.6

Mr. Garcia weighs 250 pounds. You are expected to record this weight in kilograms. It is equal to _____________kg.

Digital thermometer Tympanic thermometer Temporal artery thermometer

Name the 3 different types of thermometers.

(Found on page 476 - 477) gloves reflex hammer tuning fork (for ear) otoscope with lid ophthalmoscope stethoscope gel tongue depresser eye flashlight tape measure

Name the 9 items on the tray. (12 items in total --- including Tray cover, gown, and ---- ? )

(______ C x 1.8) + 32

Name the formula for converting Celsius to Fahrenheit.

(______ F - 32) / 1.8 The / means divided by

Name the formula for converting Fahrenheit to Celsius.

__________ Kg x 2.2

Name the formula for turning Kg into lbs.

_______ lbs / 2.2 The / means divided by

Name the formula for turning Lbs into Kg.

Multiply the number of kilograms by 2.2

Name the formula to convert kilograms to pounds.

Divide the number of pounds by 2.2

Name the formula to convert pounds to kilograms.

120/ 80

Normal blood pressure of an adult = Less than _________/ _________ mm Hg

inhalation and exhalation external respiration

One full respiration includes both _____________ and ___________. The exchange of oxygen and carbon dioxide in the lungs is called ____________.

eye examination

PERRLA = acronym for _____________

auscultatory gap

Phase 2 As the cuff deflates, even more blood flows through the artery. The movement of the blood makes a swishing sound. If you did not follow proper procedure in inflating the cuff, you may not hear these sounds because of their soft quality. Occassionally blood pressure sounds completely disappear during this phase. Loss of the sounds followed by their reappearance later, is called the _______________.

Review of systems

ROS =

examine physical appearance, speech, skin (skin can give indication of nutrition and hydration)

Sequence of exams by the doctor includes --> ______________, _____________, _____________,

Blurred vision Vertigo Fatigue Flushing Angina Dyspnea Headache Nosebleeds

Signs and Symptoms of Hypertension =

febrile seizure

Some patients experience an acute onset of chills and shivering, followed by an increase in body temperature. A serious possible complication in young children with high fevers is a ______________. Medication to reduce the fever, antipyretic drugs, should be taken as instructed to prevent dangerous spikes in temperature.

100. 4 100 99

Temperatures considered febrile include the following: a) Aural (ear) temperatures higher than __________ F (38 C) b) Oral temperatures higher than ___________ F (37.8 C) c) Axillary temperatures higher than __________ F (37.2 C)

Anthropometric measurements

The MA must understand the signifiance of the vital signs and must measure and record them accurately. _________________ are not considered vital signs but are usually obtained at the same time as vital signs. These measurements include height, weight, body mass index (BMI), and other body measurements, such as fat composition.

all age groups.

The TA thermometer also records accurate temperature readings in ______________.

oral site

The ___________ site is not typically used with young children. This site requires the patient to hold the thermometer under the tongue and keep the mouth closed, a task that can be difficult for children under the age of 3.

peripheral resistance blood flow

The ____________ of blood vessels refers to the lumen (the diameter of the vessel) and the amount of blood flowing through it. The smaller the lumen, the greater the resistance to ___________.

hypothalamus diurnal variation

The core body temperature is maintained within a normal range by the ____________. The average body temperature varies from person to person and is different in each person at different times throughout the day. In a healthy adult, this ____________ ranges from 97.7 to 99.5 F. The average daily temperature is 98.6 F. Body temperature is lowest in the morning and highest in the late afternoon.

phase V. (phase 5)

The diastolic BP is heard during which Korot-koff phase?

Age Condition State of consciousness Thermometers available in the facility Healthcare facility procedures. (STUDY in depth pg. 433 -- Age, condition, state of consciousness and WHY)

There are a number of factors to consider when determining which site should be used. =

Loss of appetite (anorexia) Headache Thirst Flushed face Hot skin General malaise

Variation from the patient's average body temperature range may be the first warning of an illness or a change in the patient's current condition. Patients with fever usually have the following indicators =

rate rhythm volume These factors vary with the size and elasticity of the artery.

What three characteristics should the medical assistant note while measuring a pulse?

66 beats per minute

What would be considered a normal pulse for an average-sized 37 year old patient in good health?

tympanic axillary rectal temporal artery

When an oral temperature is obtained, you do not have to indicate the site when documetning the reading in the patient's health record. If you use an alternate site, you should document the following identifiers after recording the temperature: -- (T) for ______________ -- (A) for _____________ -- (R) for ____________ -- (TA) for temporal artery

pulse pressure.

When you subtract the diastolic pressure from the systolic pressure, you get the _____________.

knee chest

Which body position can you not walk away from?

Radial

Which pulse is palpated on the wrist?

Orthopnea

Which respiration characteristic frequently occurs in patients with congestive heart failure and COPD?

calibrated

___________ = Determined by or checked against a standard (as in readings).

malaise

____________ = A condition of general bodily weakness or discomfort, often marking the onset of a disease.

chronic obstructive pulmonary disease (COPD)

____________ = A progressive, irreversible lung condition that results in diminished lung capacity.

rhonchi

____________ = An abnormal rumbling sound heard on auscultation, caused by airways blocked by secretions of muscle contractions.

bounding

____________ = Describes a pulse that feels full because of the increased power of cardiac contraction or as a result of increased blood volume.

vertigo

____________ = Dizziness; an abnormal sensation of movement when there is none.

essential hypertension

____________ = Elevated blood pressure of unknown cause that develops for no apparent reason; sometimes called primary hypertension.

hyperpnea

____________ = Excessively deep breathing.

diurnal variation

____________ = Fluctuations that occur during each day.

otitis externa

____________ = Inflammation or infection of the external auditory canal; commonly called swimmer's ear.

idiopathic

____________ = Of unknown cause.

febrile

____________ = Pertaining to an elevated body temperature.

myocardium

____________ = The middle layer, and thickest layer, of the heart; composed of cardiac muscles.

Intermittent fever Continuous fever

____________ = a fever that comes and goes, alternating between elevated and normal levels. _____________ = which rises and falls only slightly during a 24-hour period. The temperature consistently remains above the patient's average normal temperature range and fluctuates less than 3 degrees.

Rate Rythm Depth

____________ = is the number of respirations per minute. ____________ = refers to the breathing pattern -- space between each breath _____________ = is the amount of air inhaled and exhaled.

pulse deficit

_____________ = A condition in which the radial pulse is less than the apical pulse; it may indicate a peripheral vascular abnormality.

orthopnea

_____________ = A condition of difficult breathing unless in an upright position.

pyrexia

_____________ = A febrile condition or fever.

orthostatic (postural) hypotension

_____________ = A temporary fall in blood pressure when a person rapidly changes from a recumbent position to a standing position.

hyperventilation

_____________ = Abnormally increased breathing.

sinus arrhythmia

_____________ = An irregular heartbeat that originates in the sinoatrial node (pacemaker).

hypotension

_____________ = Blood pressure that is below normal (systolic pressure below 90 mm Hg and diastolic pressure below 50 mm Hg).

Cheyne- Stokes respiration

_____________ = Deep, rapid breathing, followed by a period of apnea.

thready

_____________ = Describes a pulse that is thin and feeble.

syncope

_____________ = Fainting; a brief lapse in consciousness.

auscultated

_____________ = Listened to with a stethoscope.

peripheral

_____________ = Refers to an area outside of or away from an organ or structure.

pulse pressure

_____________ = The difference between the systolic and diastolic blood pressures (30 to 50 mm Hg is considered normal).

homeostasis

_____________ = The internal environment of the body that is compatible with life. A steady state that is created by all the body systems working together to provide a consistent and unvaryying internal environment.

occlude

_____________ = To close, shut, or stop up.

Remittent fever

_____________ = which fluctuates considerably (i.e. by more than 3 degrees) and never returns to the normal range.

Systole Diastole

_____________ is the contraction of the heart. _____________ reflects the relaxation of the heart.

fluctuate

______________ = To shift back and forth

Volume

______________ is the amount of blood in the arteries. An increased blood volume raises BP, and a decreased blood volume lowers BP. With extensive bleeding, or hemorrhage, the blood volume drops, and so does the BP.

intermittent pulse

_______________ = A pulse in which beats occasionally are skipped.

auscultation menstruation manipulation manipulation (again same term)

_______________ = listening to the heart, arteries, etc. ______________ = measuring _____________ = passively moving a joint ROM (range of motion) = has to do with ____________.

Digital thermometers cross- infection

_________________ = are battery operated. Disposable covers fit snugly over the probes and are easily and quickly removed by pushing in the colored end of the probe. The instrument sounds a beep when the process is complete (in 10 to 60 seconds), and the reading appears on a screen on the face of the instrument. Because the only part of the instrument that comes in contact with the patient is the probe, which is covered, the risk of ______________ is greatly reduced.