1. Monday, June 9, 2014

2.  Let’s review the 4 vital signs!  Heart rate  Respiratory rate  Blood pressure  Temperature

3.  What does heart rate tell you?  Tells you part of the patient’s story – how your body is being supplied by oxygenated blood  Where can you measure heart rate?  11 sites, 8 discussed last class  How do you describe (document) heart rate?  Site, rate, rhythm, depth

4.  Describe the process of breathing  Inhalation and expiration: exchange of gases in the body  What does respiratory rate tell you?  Tells you how much oxygen you may need, and how much carbon dioxide to expel  How does respiratory rate relate to heart rate?  Hold your breath  Your body needs oxygen, but needs to also get rid of gas wastes: CO2

5.  What is blood pressure?  A ratio of the pressure in your arteries when your heart contracts & relaxes  Systolic vs diastolic  What is hypotension vs hypertension?  Hypo – below normal, ie. shock  Hyper – above normal, ie. cardiovascular disease  What does blood pressure tell you?  Tells you whether oxygenated blood is getting delivered properly

6.  What does temperature tell you?  The body self-regulates its temperature to ensure cellular reactions work best  What is hypothermia vs hyperthermia?  Temperature below or above normal can seriously affect body function  What is the difference between core and peripheral temperature?  Core: taken by ear (T) & rectum (PR)  Peripheral: taken by armpit (Ax), mouth (PO)

7.  Manual blood pressure  1) Make sure patient has not been doing any strenuous activity for about 5 minutes.  2) Take cuff and secure it around patient’s arm, placing the tubing centre to the patients brachial artery site  3) Locate the radial pulse, and inflate the cuff until you cannot feel the pulse anymore (obliteration), making note of the mmHg

8.  Manual blood pressure continued  4) Now place your stethoscope on this site and listen for a pulse. Inflate cuff above the obliteration point by 30-40mmHg.  5) Slowly deflate cuff at 2-3mmHg per second, and make note when you begin to hear the pulse again. That’s your systolic!  6) Continue to deflate and make note when you no longer hear the pulse. That’s your diastolic!

9. Heart Rate Respiratory Rate Temperature Blood pressure Critical thinking 100 600 200 700 300 800 400 500

10.  What is the normal heart range for an adult?  60-100 Back to the Board

11.  What is the normal heart rate range for an infant?  110-180 BPM Back to the Board

12.  What is tachycardia?  Increased heart rate over the normal range Back to the Board

13.  There are 11 sites to palpate pulse. 8 were in the last presentation: name 3 of these sites.  Apical  Radial  Femoral  Popliteal  Brachial  Carotid  Dorsalis pedis  Temporal Back to the Board

14.  What are the 4 components of documenting of heart rate?  1) Site  2) Rate  3) Rhythm  4) Depth Back to the Board

15.  How is respiratory rate measured?  Respirations per minute Back to the Board

16.  What is the normal range for a child?  20-25 respirations per minute Back to the Board

17.  Name 2 of the 3 components of documenting respiratory rate.  1) Rate  2) Rhythm  3) Depth Back to the Board

18.  What is the process in which your diaphragm flattens and chest expands allowing exchange of oxygen in your lungs?  Inhalation Back to the Board

19.  Name 2 things that can affect your ability to breath: Bonus points if you can explain how.  Airway is obstructed  Lung tissue is poor (ie. inflammation, thickened)  Lung cannot inflate properly (ie. collapsed, pressure against lung space) Back to the Board

20.  What is the normal range for temperature?  35.0-37.5*C Back to the Board

21.  What site is denoted by the letter “O”?  Oral temperature site Back to the Board

22.  Name the 4 sites to take temperature.  Oral  Rectal  Axillary  Tympanic Back to the Board

23. WWhat is the difference between core and peripheral temperatures? CCore refers to temperatures closest to internal organs PPeripheral refers to temperatures away from internal organs Back to the Board

24.  Which type of temperature sites is the most accurate? Bonus points if you can explain why.  Core temperature sites such as tympanic & rectal  Because they are a better at measuring the temperature of your internal organs and less influenced by fluctuations of your environment Back to the Board

25.  What is the normal blood pressure of an adult?  120/80 Back to the Board

26.  What is the unit of measure for blood pressure?  mmHg or “millimetres of mercury” Back to the Board

27.  What is the difference between systolic & diastolic pressures?  Systolic is a measures of the pressure in the arteries when the heart contracts  Diastolic is a measure of the pressure when the arteries relax Back to the Board

28.  What is the normal blood pressure of an infant?  90/55 Back to the Board

29.  Give 3 symptoms of hypotension.  Dizziness, light-headedness, syncope (fainting), cold/clammy skin, fatigue, shallow breathing, blurred vision, lack of concentration, nausea Back to the Board

30.  BEFORE taking vital signs, what are some observations you can make that may affect how you interpret your findings? Back to the Board

31.  A 20 year old man comes into the ER with a stab wound to the stomach. His vitals are T- 37.2*C (PO), BP-88/60, HR-121, RR-24. Explain the relationship between his blood pressure and his heart rate. Back to the Board

32.  A 77 year old lady becomes increasingly confused so her family takes her to see the doctor. Her vitals are T-37.7*C (PO), BP- 109/68, HR-108 and RR-18. The nurse takes a rectal temperature and it’s T-38.2*C (PR). What does this finding mean? Back to the Board