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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.

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