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Why Take Vitals
- assess alterations after intervention
- assess things going on in the body not otherwise seen
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Body Temp Equation
Heat Produced-Heat Lost=Body Temp
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BMR
- Basal Metabolic Rate
- heat produced by body at rest
- affected by thyroid, testosterone, exercise amt, and stress
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Non-Shivering Thermogenesis
- infants, neonates
- cant shiver
- brown fat metabolized to produce heat
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Muscle Activity increases BMR/Heat Production by ____
50x
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Methods of Heat Loss
- Radiation
- Conduction
- Convection
- Evaporation
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Radiation
heat transfered w/o direct contact
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Conduction
- Heat transfered w/ direct contact
- ex ice pack
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Convection
- Transfered away by air movement
- ex fan
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Evaporation
- transfer of heat energy when water turns to gas
- we loose 600-900 mL per day from skin, lungs etc
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Diaphoresis
- visible sweating
- forehead and upper thorax
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Behavioral Control
- actions we do to control our temp.
- ex add/remove clothing
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Circadian Rhythm Affects on Vitals
- Temp, bp, hr cont to rise until around 4pm, then back down
- lowest around 2-4am
- night shift opposite, based on sleep schedule
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Stages of Fever
Chill, plateau, febrile
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Symptoms of Plateau Fever
- Skin = warm, dry
- Temp rising
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Symptoms of Febrile Fever
diaphoretic, warm, flush
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Malignant Hyperthermia
- family history
- w/ anesthia get high fever, seize and die
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Heat Stroke
- water all gone
- skin warm and dry
- giddy/confused, hallucinations
- nausea, muscle cramps
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Hypothermia
- below 95 memory loss, depression, poor judgement, uncontrolled shivering
- hr up and bp down until below 94 hr bp and resp all fall
- cyanotic unreponsive, cardiac disrythmia
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Moderate Hypothermia
30-33 C
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Severe Hypothermia
below 30 C
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Places to take Temp
- Tympanic Membrane
- Rectal
- Oral
- Axilla
- Skin
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Pulse
- palpable bounding of the blood flow in the peripheral artery
- Rate left ventricle pumps blood to body
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Places to take Pulse
Temporal, Brachial, Ulnar, Femoral, Popliteal, Posterior Tibial, Dorsalis Pedis, Apical
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Apical
5th Intercostal Midclavicular line
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Femoral Pulse
iliac Crest and pubic symphsis
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dysrythmia
- any alteration in the rhythm
- ex brady, tachycardia
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systolic
peak of maximum pressure when ejection occurs
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Blood Pressure
FORCE exerted on walls of artery by pulsing blood
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Diastolic
remaining blood in arteries when heart relaxes
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Prehypertension
120-139/80-89
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Stage I Hypertension
140-159/90-99
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Stage II Hypertension
160/100 or higher
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Ventilation
movement of air in and out of lungs
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Diffusion
movement of O2 and CO2 btwn alveoli and red blood cells
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Perfusion
Distribution of RBCs to and from Pulmonary capillaries
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Hyperventilation
- putting out too much CO2
- can be lack of O2 also
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Hypoventilation
- CO2 build up, need O2
- slow breathing
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Cheyne-Stokes respiration
- deep breaths followed by apnea
- dying
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Kussmauls respirations
- diabetes
- confusion, fruity alcohol breath, drunk-like
- deep, rapid breathing
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Biot's Respirations
- damage to medulla - pressure on brain
- shallow respirations w/ apnea periods
- no deep breaths or sighs, panting
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