131 terms

Principles Exam 2

Normal Temperature Range:
96.8 - 100.4 Fahrenheit
36 - 38 Celsius
Normal Pulse Range:
60 - 100 Beats Per Minute
Normal Blood Pressure:
Normal Respiratory Rate:
12 - 20 breaths per minute
Normal Oxygen Saturation Range:
95 % or greater
Body Temperature:
Heat produced minus Heat Loss
Core Temperature can be measured by:
Rectum, Tympanic Membrane, Temporal Artery, Esophagus, Pulmonary Artery, Urinary Bladder
Surface Temperature can be measured by:
Skin, Oral, Axillary
Anterior Hypothalmus
Posterior Hypothalmus
Controls body temperature
Regulates Heat Loss
Regulates Heat Production
Widening of blood vessels that inhibits heat production
Reduces blood flow by narrowing of blood vessels
Heat production occurs through:
Basal Metabolic Rate
Voluntary movement (exercise/activity)
Nonshivering thermogensis (in neonates)
Heat loss occurs through:
Radiation-transfer w/out contact (vasodilation)
Conduction-transfer w/direct contact (hot or cold object)
Convection- transfer w/air movement (fan)
Evaporation-transfer from liquit to gas (sweat)
Controlled by hypothalamus; located between cerebral hemispheres
Skin temperature regulation:
Subcutaneous tissue & fat insulates, keeping heat inside body
Factors affecting body temperature:
newborns- loose up to 30 % heat through head
child-until puberty temp regulation unstable
Elderly-tends to be lower
Hormonal Level-
Woman experience greater fluctuations
Variations during menstrual cycle & menopause
Hot flashes:
Are caused by inability to control vasodilation and vasoconstriction
Exercise increases temperature by:
Stimulating muscle activity, requiring increased blood supply and increased carbohydrate & fat breakdown
Circadian rhythm:
Changes body temperature
Temperature maxes out by 6 pm
Temperature is lowest between 1 -4 am
Can be changed by people working night shift-takes 3 wks
Fever (temperatures above 100.4 / 38 c)
Causes of Pyrexia (fever):
Hypothalamus unable to keep "set point"
Ambient temperature/humidity
FUO-fever of unknown origin
Fever has the ability to:
Increase Oxygen demands
Increase metabolism
Stress cardiac & respiratory systems
(is an important defense mechanism)
Sustained Fever:
Temp over 100.4 w/ NO fluctuation
Intermittent Fever:
Fluctuation between febrile & afebrile
One afebrile reading in 24 hr period
Remittent Fever:
Fluctuation of temperature but always febrile
No return to afebrile at any time
Relapsing Fever:
Periods of febrile and afebrile temperatures; periods often longer than 24 hrs each
How mild temperatures help immune system:
WBC production is increased, iron concentration is reduced, suppressing growth of bacteria
Temperature over 104 (may go as high as 113)
Malignant Hyperthermia:
Rapid rise in core body temperature that happens when anesthesia is administered;
Caused by hereditary
Heat stroke:
Heat depresses hypothalmic function;
If patient becomes unconscious w/non-reactive pupils, permanent neurological will occur if cooling measures aren't started immediately.
Causes of Heat Stroke:
Prolonged exposure to sun or high environmental temperatures; most common in high humidity
Signs of Heat Stroke:
Giddiness, Muscle Cramps, Confusion, hot-dry skin, delirium, dry mucous membranes, excessive thirst, increased Heart Rate, Nausea, Decreased Blood pressure
Heat Exhaustion:
Loss of water and electrolytes by profuse diaphoresis (profuse sweating) from heat exposure
Symptoms of heat exhaustion:
Rapid thready (weak) pulse
Postural hypotension (low bp)
Dry mucous membranes, poor skin turgor, thirst,
confusion, Rapid weight loss, slow vein filling,
Flat neck veins, lethargy & Oliguria (decreased urine output >30L/hr)
Heat Emergency managment:
Cooler environment, remove excess clothing,
cool wet towels on skin, fan, IV fluids,
Hypothermia blankets, cool slowly
Prolonged exposure to cold
Body temperature from 86 - 96.8 F
Uncontrolled shivering at 95 F
Symptoms of hypothermia at 94 degrees:
Decreased HR, Resp rate, BP, cyanotic skin,
Progressive-cardiac dysrhythmias, unconsciousness, decreased response to painful stimuli
Ice crystals from inside cell, causing permanent damage
Susceptable areas to frostbite:
Tip of the nose
Appearance of Frostbite:
White, waxy, firm to touch
Loss of sensation in area
Cold Emergency Management:
Gradual warming, protect injured area, warmed fluids
prevent further heat loss-remove wet cloths, layer clothing, body to body heat
Celsius to Fahrenheit conversion factor:
°C x 9/5 + 32 = °F
Fahrenheit to celsius conversion factor:
(°F - 32) x 5/9 = °C
Axilla temperatures:
Safe for newborns and unconscious
The indicator of circulatory status
What causes the pulse:
Electrical impulses originate in the SA Node and travel to heart muscle to stimulate contraction
Ventricular contraction:
60-70 mL of blood enter aorta
Stroke Volume:
Volume of blood pumped from one ventricle of the heart with each beat
Cardiac Output:
The amount of blood pumped by heart per minute
Pulse rate x stroke volume
Average 5000 mLs per minute
Difficulty breathing
Infant range pulse:
120 to 160 bpm
Apical pulse:
Provides most accurate assessment of heart function
Infant/child pulse locations:
Brachial or apical
Pulse strength:
Bounding 4 +
Strong 3+
Weak 2+
Thready 1+
Absent 0
Heart sounds are:
High pitched (use diaphragm)
Bowel, lung & heart sounds are:
High pitched
Heart & vascular sounds:
are low pitched (use bell)
Pulse over 100 BPM
Pulse under 60 BPM (except in infants)
Factors that effect pulse:
Exercise, temperature, emotions, drugs, hemorhage, postural changes, pulmonary conditions
Pulse deficit:
Difference between apical & radial pulse (ineffective contraction)
Irregular rate:
Arrhythmia or dysrhythmia
Movement of gases in and out of lung
O2 & CO 2 exchange between alveoli & RBC's
Distribution of RBC's to and from pulmonary capillaries
Tidal Volume:
Air inhaled (500 mL)
Factors affecting respiration:
Exercise, pain, anxiety, smoking, body position, medications, neurological injury, hemoglobin
Blood Pressure:
Force exerted on walls of artery measured in mm/Hg
Peak of maximum pressure when ejection occurs
Minimal pressure exerted against arterial walls at all times
Percentage of RBC's in blood
Decreased blood flow to vital organs
Dilation of arteries
Decreased Urine output
Thickening of walls
Loss of elasticity
False Low Pressures:
Cuff to wide
False High Pressures:
Cuff to narrow, cuff to loose,
Auscultatory Gap:
The interval of pressure where Korotkoff sounds indicating true systolic pressure fade away and reappear at a lower pressure point during the manual measurement of blood pressure
Every day of non-movement:
Results in 3% of daily loss of muscle strength
Body Balance:
Achieved by low center of gravity & wide base of support
A force that occures in a direction opposite to the movement
Normal contraction & flexion
Walking, swimming, dance,etc.
Tighten muscles without movement of parts
Support framework
Mineral storage
Blood cell formation
Fibrous joints:
Closed and fixed
Synovial joints:
Move freely
Cartilaginous joints:
Little movement, elastic, separate surfaces
Synostotic joints:
No movement; bone to bone
Bind joints
Connect bones and cartilage
Joint flexibility and support
Connect muscles to bones
Supportive tissue
Shock absorber between articulating bones
Muscle group- lever system of bones causing movement
Muscle group-
Muscles excert pull on bones in opposite direction;
Gravity continually pulls on parts of body
Muscle group-
Working muscles (biceps, brachialis)
Two active movers-one antagonistic
Muscle group-
Stabilizes joints & allow standing & sitting
Muscle group-
Work against each other
Movement at the joint
Active mover contracts with antagonistic relexes
Nervous System:
Regulates movement and posture
Major voluntary motor area:
Located in cerebral cortex
called Precentral Gyrus or Motor Strip
Left motor strip fibers initate voluntary movement on right side of body; right side initates left...
Awareness of the position of the body and its parts
Nerve endings in muscles, tendons, joints
Cerebellum (controls voluntary movement)
Inner Ear
Disorders of bones, joints and muscles:
Osteoporosis, arthritis, degenerative changes
Stratum Corneum:
Outermost layer of epidermis
Maintains hydration
Top layer of skin
Functions to restore skin
Inner layer of skin
Strength & elasticity
collagen, blood vessels & nerves
Largest organ of body:
15 % of body weight
Pressure Ulcers:
Also called a decubitus ulcer
Localized Injury
Bony Prominence
Step by step development of a disease and the chain of events leading to that disease due to a series of changes in the structure and/or function of a cell/tissue/organ being caused by a microbial, chemical or physical agent.
Risk Factors for pressure ulcer development:
Impaired sensory perception, imparied mobility, friction, moisture, shear, alterations in LOC
4 common spots for pressure ulcers:
Elbows, sacrum, hip and heels
Areas w/little fat over bony prominences are common sites
Stage 1:
Persistent red, blue, or purple area of skin; no open areas
Stage 2:
Partial thickness skin loss; looks like an abrasion or blister
Stage 3:
Full thickness skin loss
Damage and/or necrosis of subcutaneous tissue
Deep crater
Stage 4:
Full thickness skin loss w/extensive destruction, necrosis or damage to muscle, bone and other structures
Granulation tissue:
New tissue, young, fragile cells
Stringy material attached to wound bed
Necrotic tissue which must be removed before healing can occur.
Abnormal accumulation of fluid under skin
Any fluid that filters from the circulatory system into lesions or areas of inflammation.
Primary Intention:
Wound is approximated, clean edges, mainimal risk for infection and scarring
Secondary Intention:
Tissue loss, gaping, irregular wound, epithelium heals over scar; wound is left open until it becomes filled by a scar.
Tertiary intention:
Delayed closure, wide scar; heals from base of wound
Concomitant medical conditions:
Concurrent medical condtions; existing at same time
The use of two or more drugs together, usually to treat a single condition or disease
A restriction in the supply of blood to a body part (ex: tissue) that is due to obstruction of the inflow of arterial blood
Causes damage to the Dermis by stretching and angulation of tissue capillaries
Causes damage to the Epidermis from mechanical force when skin is dragged across a coarse surface
Clear, watery plasma
Thick, yellow, green, tan or brown
Pale, red, watery: Mixture of clear and red fluid
Bright red, indicating active bleeding
Localized collection of blood underneath tissue
Partial or total separation of wound layers
Protrusion of visceral organs through wound openin.