PAS-516: Vital Signs - Pulse, Respiration, Temperature, Height/Weight, and Pain

Vocabulary flashcards covering vital signs including pulse, respiration, temperature, BMI/waist circumference measurements, and types of pain.

Normal Adult Heart Rate

A resting pulse rate of $60-90\,\text{bpm}$.

Radial Pulse

The most commonly used pulse point, located below the thumb on the lateral wrist.

Brachial Pulse

A pulse point used mostly for infants/newborns or when radial pulse is unavailable, located medially from the midpoint of the antecubital fossa.

Femoral Pulse

A pulse point used mostly for infants, located distal to the inguinal ligament and less than halfway from the pubis to the anterior superior iliac spine.

Cardiac Apex

The most accurate pulse site (Point of Maximal Impulse or PMI), located at the bottom tip of the heart over the ventricles and mostly used for infants.

Carotid Pulse

A commonly used pulse point located below the jaw, anterior to the sternocleidomastoid, and lateral to the trachea.

Popliteal Pulse

A pulse point located under the popliteal fossa, slightly lateral.

Dorsalis Pedis Pulse

A pulse point on the anterior aspect of the foot, lateral to the extensor hallucis tendon, which cannot be felt in $10\%$ of the population due to anatomical variation.

Posterior Tibialis Pulse

A pulse point located posterior to the medial malleolus (inner ankle bone).

Pulse Deficit

The difference between the apical (cardiac apex) and peripheral pulse rates, associated with atrial fibrillation, heart failure, or weak heart contractions.

• Anxiety

• Medication

• Pain

• Cardiac conditions

• Pulmonary conditions

• Thyroid disease

• Anemia

What are some factors that can influence pulse?

1. Rate

2. Rhythm

3. Depth

4. Effort

What are the four things being assessed in respirations?

Normal Adult Respiratory Rate

A breathing rate between $14-20\,\text{breaths per minute}$.

Sighing Respiration

A breathing pattern with frequent sighs, which may be associated with hyperventilation syndrome causing dyspnea and dizziness.

• Occasional sigh is normal

Bradypnea

Slow breathing defined as less than $14\,\text{breaths per minute}$, caused by physiologic factors, diabetic coma, drug-induced respiratory depression, or increased cranial pressure.

Tachypnea

Rapid, shallow breathing caused by restrictive lung disease, pleuritic chest pain, or an elevated diaphragm.

Obstructive Breathing

Prolonged expiration due to narrowing of airways and increased airflow resistance, caused by asthma, chronic bronchitis, COPD, foreign bodies, or a mass.

Hyperpnea / Hyperventilation

Rapid, deep breathing caused by exercise, anxiety, pulmonary disorders, hyperthyroidism, metabolic acidosis, or in comatose patients by brain infarction, hypoxia, or hypoglycemia.

Kussmaul's Respirations

Labored, deeper breathing with a fruity breath odor from exhaled acetone, caused by metabolic acidosis (DKA).

Cheyne-Stokes Breathing

A breathing pattern with periods of deep breathing alternating with periods of apnea; normal in sleeping children and elderly, or caused by heart failure, uremia, drug-induced respiratory depression, or brain damage.

Ataxic Breathing

Unpredictable breathing irregularity featuring shallow or deep breaths with periods of apnea, caused by respiratory depression or brain damage.

37 degrees Celsius

98.6 degrees Fahrenheit

What is a normal body temperature in both celsius and fahrenheit?

(℃ x 1.8) + 32 = ℉

What is the conversion of degrees Celsius to Fahrenheit?

(℉ -32) / 1.8 = ℃

What is the conversion of degrees Fahrenheit to Celsius?

Hyperpyrexia

An extreme elevation in body temperature above $41.1\,^{\circ}\text{C}$ ($106\,^{\circ}\text{F}$) that does not correlate with the severity of the illness.

Hypothermia

A body temperature below $35\,^{\circ}\text{C}$ ($95\,^{\circ}\text{F}$), associated with decreased movement, interference with vasoconstriction, hypothyroidism, or hypoglycemia.

Pulmonary Artery Temperature Assessment

The gold standard and most accurate method for measuring body temperature, though highly invasive due to internal catheterization.

Purpose of temperature

Provide important info about presence of illness and provides a broad range of differential diagnoses associated with a fever.

Body Mass Index (BMI)

A measure of body fat based on height and weight evaluated in adult men and women, but not used for children.

Underweight

What is the classification of a BMI <18.5

Normal weight

What is the classification of a BMI 18.5-24.9?

Pre-obese/Overweight

What is the classification of a BMI 25.0-29.9?

Obese Class 1

What is the classification of a BMI 30.0-34.9?

Obese Class 2

What is the classification of a BMI 35.0-39.9?

Obese Class 3

What is the classification of a BMI 40.0 or higher?

Elevated Waist Circumference

A measurement greater than $40\,\text{inches}$ ($102\,\text{cm}$) in males or greater than $35\,\text{inches}$ ($88\,\text{cm}$) in females, evaluated for individuals with a BMI between $25-35$.

Abdominal Obesity

Also known as central adiposity, visceral, android, or male-type obesity; increases the risk for heart disease, diabetes, hypertension, dyslipidemia, and nonalcoholic fatty liver disease.

Because it is a subjective value; vitals are objective

Why is pain not a true vital sign?

Nociceptive (Somatic) Pain

Pain resulting from tissue damage to the skin, musculoskeletal system, or viscera, such as bruising or fractures.

Neuropathic Pain

Pain caused by a direct affect to the somatosensory system, such as Herpes Zoster (Shingles).

Psychogenic Pain

Pain influenced by psychiatric conditions, personality/coping styles, or cultural influences.

Idiopathic Pain

Pain with no identifiable etiology.

The 4 A's of Pain Outcomes

The four criteria considered when monitoring patient outcomes during pain treatment: Analgesia, Activities of daily living, Adverse effects, and Aberrant drug-related behaviors.