Chapter 21 Vital Signs
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acruz20012 on February 25, 2012
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45 terms
Terms | Definitions |
|---|---|
 Temperature (pg. 338) | The hypothalamus, located between the cerebral hemispheres, acts as a thermostat and controls body temperature by a feedback mechanism. |
| Blood Pressure | Medulla oblongata controls blood pressure |
| Respirations (pg. 340) | Breathing is involuntary and is controlled by the respiratory center located in the pons and medulla of the brainstem (medulla oblongata) |
| Febrile | A stage of fever in which the body temperature rises to the new set point established by the hypothalamus and remains there until there is a resolution of the cause of fever. |
| Afebrile | Without a fever |
| Hypothermia | Subnormal body temperature |
| Hyperthermia | Above-normal body temperature; malignant hyperthermia; a syndrome affecting patients undergoing general anesthesia, marked by a rapid rise in body temperature, signs of increased muscle metabolism, and rigidity. |
| Cardiac output | The pulse rate multiplied by the stroke volume |
| Stroke volume | The volume of blood pushed into the aorta per heartbeat. |
| Pyrexia | Fever; when a body temperature rises above 100.2F (38.0 celsius) |
| Cyanosis | Bluish discoloration or skin color changes, particularly around the mouth and in the nail beds, due to lack of oxygen |
| Hypoxia | State of insufficient oxygen in the blood |
| Diastole | The phase or part of the cardiac cycle when the ventricles relax and fill with blood |
| Systole | The phase or part of the cardiac cycle when blood is pumped from the ventricles and fills the pulmonary and systemic arteries. |
| Bradycardia | A slow pulse that is less than 60 beats per minute. |
| Tachycardia | A heart rate greater than 100 beats per minute. |
| Tachypnea | Increased or rapid breathing |
| Eupena | A normal, relaxed breathing pattern |
| Hypoxia | State of insufficieent oxygen in the blood. |
| Hypertension | Blood pressure elevated above the normal range |
| Apnea | Abscence of breathing |
| What are the vital sign changes that could result from the following: (pg.360) Blood loss/shock Head injury: Patient in pain: | Blood loss (reduced blood volume): BP decreases if the circulatory system contains an inaequate volume of blood, as from low cardiac output, hemorrhage, or shock Head injury: Injuries to the head and increased intracranial pressure result in increased BP. Patient in pain(stress and emotions): Anxiety, pain, tension, worry, and stress raise BP by stimulating the sympathetic nervous system, which causes vasoconstriction and resulting in increased heart rate. |
| What is the procedure for measuring the following values? pulse pressure (pg 359) core body temperature (pg. 343) body temp with a mercury glass thermometer(pg. 344) apical pulse (pg.353) respirations (pg. 356) temperature measurement for a patient with seizure activity(pg. 343) | pulse pressure: The difference between the systolic and the diastolic pressure. Example: 150/98 - 150-98=52 pulse pressure: 52 core body temperature: is the temperature of the deep tissues of the body. body temp with a mercury glass thermometer: Make sure pt. has not eaten, drunk fluids, or smoked within the previous 15 minutes. A glass thermometer must remain in the sublingual pocket for 3 to 5 minutes. apical pulse: Locate the apex of the heart by palpating for the fifth intercostal space at the midclavicular line respirations: count for 30 sec multiplied by 2. Respiration includes both inspiration and expiration. temperature measurement for a patient with seizure activity: Rectal Temp |
| How many liters a minute of blood is there for a normal cardiac output? (pg. 339) | Average cardiac output in the adult is about 5L of blood per minute |
| What are Cheyne Stokes breathing? | A pattern of dyspnea followed by a short period of apnea. Respirations are faster and deeper, then slower, and are followed by a period of no breathing. |
| Describe orthostatic hypotension | Drop in BP occurring with change from supine to standing or from sitting to standing position. |
| What are the normal values of TPR and B/P (pg. 341, 355, 357, 359) | Temp: 97.5-99.5 Pulse: 60-100 Resp: 12-20 B/P: Systolic <120; Diastolic <80 |
| What is Korotkoff sounds? (pg. 363) | Sounds that relate to the effect of arterial wall vibrations during auscultation of BP |
| What is auscultory gap? (pg. 364) | period where no sound is heard during BP |
| How do you prevent heat loss in the newborn infant? | cover head |
| Identify names and locaations for peripheral pulses (pg. 339) | Temporal, Carotid, Apical, Brachial, Radial, Femoral, Popliteal, Posterial tibial, Dorsalis pedis |
| Identify phases of the systolic B/P | The ventricles contract (left ventrical), carrying blood into the aorta, and blood flows into the relaxed atria, First number recorded in BP |
| How is B/P regulated by body mechanisms? | the medulla oblongata signals the parasympathetic nervous system to cause a decrease in heart rate. The parasympathetic nerves also cause blood vessels to dilate, or open, which decreases resistance, leading to lower blood pressure. The sympathetic nervous system also causes some blood vessels to constrict, which increases the resistance of the vessels. Together, these responses increase the amount of blood pumped by the heart each minute, which increases the blood pressure |
| Identify body temperature changes during the female menstrual cycle (pg. 343) | Body temp drops slightly just before female ovulation and then may rise 1 degree above normal during ovulation. Temp drops again on the onset of the next menstrual period. During pregnancy, temp may stay at a high-normal because of an increase in the patient's metabolic rate. |
| What are the changes of aging that effect the older adults ability to regulate temperature? (pg. 343, 344) | Elderly patients tend to have lower base body temperature, with the base temperature often being 96 degrees. If an elevation of 2 degrees occurs, fever is present. They lose body heat easily. |
| When is body temperature at it's highest? Lowest | Highest: 105.8 (hyperthermia) Lowest: below 94 (hypothermia) |
| Give examples of body heat loss by the following: (pg. 338) Conduction Convection Radiation Evaporation | Conduction: When warm skin touches a cool object, heat is lost to the object by conduction. Ice bags applied to the skin increase conductive heat loss. Convection: Air movement causes heat to be transferred from the skin to the air molecules by convection. Fast moving air from an electric fan cools by convection. Radiation: When objects in the surroundings are warmer than the body, heat is radiated to the body and absorbed. Evaporation: Sweat glands. When water evaporates from skin, heat is transferred to the air. |
| Which temperature route best monitors for hypothermia? | rectal |
| Pulse paradoxus | an abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration |
| Pulse deficit | Deficit between the apical and radial pulse |
| Pulse alternans | is a physical finding with arterial pulse waveform showing alternating strong and weak beats |
| Movement of air in and out of the lungs is termed | Respiration |
| Identify phases of the Kororkoff sounds (pg. 363) | Phase 1: systolic pressure indicated by faint, clear tapping sounds that gradually grow louder Auscultatory gap: No sound Phase II: Swishing-murmur or swishing sounds that increase as the cuff is deflated Phase III: Knocking- louder knocking sound that occurs with each heartbeat Phase V: Silence- disappearance of sound (marks diastolic pressure) |
| What are the nursing actions for an elevated temperature | -cool wash cloth -put fan on -take covers off -drink fluids |
| Identify how vasoconstriction and vasodilation of blood vessels effect the TPR and B/P (pg. 360) | Vasoconstriction: Sympathetic nervous system stimulation causes blood vessels to decrease in lumen diameter, thus raising BP. This may happen in cold temperatures Vasodilation: Parasympathetic nervous system stimulation causes blood vessels to increase in lumen diameter, thus lowering BP. This may happen in response to warm temperatures, fever, and relaxation. |
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