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Vital Signs is also known as the ___
cardinal signs
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What are the four critical areas
- body temperature
- pulse
- respiration
- blood pressure
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it is used with comparison for later findings
baseline data
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it is the balance between the heat produced by the body and the heat lost from the body
body temperature
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thermal units of a clinical thermometer
degrees
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is is primarily produced by metabolism
body heat
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it is the heat regulating center
hypothalamus
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types of body temperature
- core temperature
- surface temperature
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it is the thermal temperature of the deep tissues in the body
core temperature
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normal core temperature is between ___ inside the body
36.7 C - 37 C
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it is the temperature of the skin, subcutaneous tissue amd fat
surface temperature
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it rises and falls in response to the environment
surface temperature
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factors affecting body's heat production
- basal metabolic rate
- muscle activity
- thyroxine output
- epinephrine, norepinephrine and sympathetic simulation
- increase temperature of body cells
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process involved in heat loss
- radiation
- convection
- conduction
- evaporation
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it is the transfer of heat from the surface of an object to the surface of another without contact between them
radiation
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the transfer of heat from one surface to another requiring temperature difference between two surfaces
conduction
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the dissipation of heat by air currents
convection
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the continuous vaporization of moisture from the skin, oral mucus or respiratory tract
evaporation
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factors affecting temperature
- age
- time of the day/diurnal variation
- exercise
- hormones
- presence of infection
- ingestion of hot or cold liquids
- stress
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elder people are at risk of hypothermia due to ___
- sedentary activity
- decrease subcutaneous fat
- inadequate diet
- decrease thermoregulatory controls
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highest temperature of the day is at what time?
8pm to 12mn
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lowest temperature of the day is at what time?
4am to 6am
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alterations in the body temperature
- pyrexia
- hyperpyrexia
- hypothermia
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body temperature above normal range
pyrexia (febrile)
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very high fever, 41 C and above
hyperpyrexia
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subnormal core body temperature
hypothermia
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this may be caused by excessive heat loss, inadequate heat production or impaired hypothalamic function
hypothermia
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types of fever
- intermittent fever
- remittent fever
- relapsing fever
- constant fever
- fever spike
- decline fever
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the temperature fluctuates between periods of fever and periods of normal or subnormal temperature
intermittent fever
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the temperature fluctuates within a wide range over the 24 hour period but remains above normal range
remittent fever
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the temperature is elevated for a few days, alternated with 1 to 2 days of normal temperature
relapsing fever
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body temperature is constantly high
constant fever
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a temperature that rises for fever level rapidly following a normal temperature and then returns to normal within few hours
fever spike
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it is the sudden decline of fever, this indicates impairment of function of the hypothalamus
crisis or flush or defervescent stage
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this is the gradual decline of fever. this indicates that the body is able to maintain homoeostasis. This is the desired decline of fever
lysis
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clinical signs of fever
- onset fever
- course of fever
- defervesence
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sites of taking body temperature
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most accessible and convenient method
oral
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least desirable site for determining body temperature
axilla
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it is not close to the major blood vessels and is more likely to be affected by the environmental temperature
axilla
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it is the safest and most non-invasive method of temperature taking
axilla
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types of thermometer
- chemical disposable thermometer
- electronic thermometer
- temperature sensitive strip
- infrared thermometer
- tympanic membrane thermometer
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it comes in individual cases and is discarded after use
chemical disposable thermometer
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it can provide reading in only 2-60 seconds depending on the model
eletcronic thermometer
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it is ideally suited for children because the sheath is unbreakable and the time necessary for accurate measurements is relatively short
electronic thermometer
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it is usually applied on the forehead or abdomen and responds to heat by changing color
temperature sensitive strip
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it senses body heat in the form of infrared energy given of by the body paart
infrared thermometer
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it records temperature through a sensor or probe that is placed in the ear canal to detect infrared radiation from the eardrum
tympanic membrane thermometer
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calibrated in degrees centigrade or fareheit
stem
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contains liquid mercury
bulb
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it expands when heated and rises in the stem
mercury
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purpose of taking/measuring body temperature
- to determine if temperature is within normal limit
- to provide baseline data for further evaluation
- to determine alterations in disease conditions
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from fahrenheit to centigrade
C= ( F - 32 ) x 5/9
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from centigrade to fahrenheit
F= ( C x 9/5 ) + 32
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it is a wave of blood created by contradiction of the left ventricle of the heart
pulse rate
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the pulse rate is regulated by the ___
autonomic nervous system
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it measure how fast or slow the heart is beating
pulse rate
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factors affecting the pulse rate
- age
- gender
- exercise
- fever
- medications
- hemorrhage
- stress
- position changes
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younger person has higher pulse rate
age
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after puberty, females have higher pulse than males
gender
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increase metabolic rate, thereby increasing the pulse rate
exercise
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digitalis, beta-blockers decrease pulse rate, epinephrine, atrophine, sulfate increase pulse rate
medications
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increase pulse rate compensatory mechanism for blood loss
hemorrhage
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sympathetic nervous stimulation increases the activity of the heart
stress
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in sitting or standing position, there is decreased venous return to the heart, decrease bp, therefore increasing pulse rate
position changes
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pulse sites
- temporal
- carotid
- apical
- brachial
- radial
- femoral
- popliteal
- posterior tibial
- dorsalis pedis
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the site is superior and lateral to the eye
temporal
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used when radial pulse is not accesible
temporal
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at the side of the neck below the lobe of the ear where the artery runs between the trachea and the sterncleidomastoid muscle
carotid
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for elderly patients who may have impaired circulation
carotid
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used for infants, during cardiac arrest, to determine circulation of the brain
carotid
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apical pulse is also referred to as the ___
apical impulse
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it is located at the apex of the heart
apical
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an imaginary line dropping straight down from the center of the clavicle
mid clavicular line
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used for infants and children up to 3 y/o
apical
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used to determine discrepancies with radial pulse
apical
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used in conjuntions with some medications
apical
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at the inner aspect of the biceps muscle of the arm or medially in the antecubital space
brachial
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elbow space
antecubital space
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used to measure blood pressure
brachial
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used during infant's cardiac arrest
brachial
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where the radial artery runs along the radial bone, on the thumb side of the inner aspect of the wrist
radial
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readily accessible and routinely used
radial
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where the femoral artery passes along side the inguinal ligament approximately midway between the anterior iliac spine and the symphysis pubis in the groin area
femoral
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used in cases in cardiac arrest
used for infants and children
used to determine circulation to a leg
femoral
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where the popliteal artery passes behind the knee
popliteal
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used to determine circulation to the lower leg
used to determine leg blood pressure
popliteal
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on the medial surface of the ankle, where the posterior tibial artery passes behind the medial malleolus
posterior tibial
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used to determine circulation of the foot and ankle area
posterior tibial
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where the dorsalis pedis artery passes over the the bones of the foot
dorsalis pedis
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used to determine circulation to the foot and toe area
dorsalis pedis
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refers to the number of beats per minute
rate
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the pattern of beats and the intervals between the beats
pulse rhythm
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the irregularity in rhythm
dysrhythmia
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is the force of blood with each beat
pulse volume
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is a measure of the elasticity of the arteries
pulse tension
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common abnormalities related to pulse rate
- tachycardia
- bradycardia
- arrythmia
- running pulse
- feeble, weak or thready
- water hammering pulse or corrigan's pulse
- dicrotic pulse
- pulse deficit
- intermittent pulse
- weak or absent pulse
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a rate > 100 beats per minute or more for an adult
tachycaridia
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a rate usually below 50 beats per minute
bradycardia
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decreased regular pulse rate
arrythmia
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described as a pulse rate that is too fast to be counted
running pulse
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term used for a pulse whose volume is small and can be readily obliterated
feeble, week or thready
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is a pulse with a very forceful beat, with the artery falling away very quickly
water hammering pulse or Corrigan's pulse
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means one heart beat for two arterial pulsations, giving the sensation of a double beat
dicrotic pulse
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is the difference between the apical and readial counts taken simultaneously
pulse deficit
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refers to a pulse that occasionally skip a beat
intermittent pulse
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fading away or palpable pulse
weak or absent pulse
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purpose of taking pulse rate
- to obtain baseline measurement of the patients heart rhythm and volume
- to monitor changes in the patient's cardiovascular status
- to evaluate the reponse of the heart to various therapeutic modalities
- to evaluate blood flow to an extremity
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