Assessing Vital Signs and Heart Sounds Lab

pulse

the left ventricle

systole

the highest pressure point

diastole

the lowest pressure point

125

newborn: average BPM

85

12 yr male: average BPM

90

12 yr female: average BPM

70

18 yr male: average BPM

75

18 yr female: average BPM

50-60

athlete: average BPM

75

adult: average BPM

75

aging: average BPM

70-190

normal limits of newborn

65-105

normal limits of 12 yr male

70-110

normal limits of 12 yr female

50-90

normal limits of 18 yr male

55-95

normal limits of 18 yr female

50-100

normal limits of an athlete

60-80

normal limits of an adult

60-100

normal limits of an aging

increases, decreases

dehydration INCREASES/DECREASES heart rate and INCREASES/DECREASES blood volume

increases

anxiety INCREASES/DECREASES heart rate

beta blockers

medication in which normally expect linear relationship between exercise and BPM, but these patients have a bunted HR response to exercise

0

force of pulse scale; absent

1+

force of pulse scale; diminished, weak, thready

1+

force of pulse scale; decreased stroke volume

2+

force of pulse scale; normal

3+

force of pulse scale; moderately increased

3+

force of pulse scale; slightly increased SV and EF, exercise, stress, anxiety

4+

force of pulse scale; markedly increased, bounding

4+

force of pulse scale; increased SV and EF

35-55

normal resting RR (breaths/min): birth-3 mo.

20-30

normal resting RR (breaths/min): 1-3 yr

20-26

normal resting RR (breaths/min): 3-6 yr

15-25

normal resting RR (breaths/min): 6-10 yr

12-30

normal resting RR (breaths/min): 10-16 yr

12-20

normal resting RR (breaths/min): 18 yr

10-12

normal resting RR (breaths/min): typical healthy adult

blood pressure

measurement of the force of blood pushing against the side of the arterial wall

diaphragm

part of a stethoscope; used for high-pitched sounds; lung, normal heart

bell

part of a stethoscope; used for low-pitched sounds; abnormal heart, S3, S4

80%

Arm cuff size - bladder LENGTH should be ____% of arm circumference

40%

Arm cuff size - bladder WIDTHshould be ____% of arm circumference

Korotkoff sounds

series of sounds heard through the stethoscope; S1 and S2

systolic BP

first Korotkoff sounds heard as release pressure

1

Korotkoff sound: silence to snapping (faint tapping); 120 mmHg

2

Korotkoff sound: snapping to murmur (swishing); 107 mmHg

3

Korotkoff sound: murmur to thumping (distinct tapping); 90 mmHg

2, 3

Between what two Korotkoff sounds is there a gap?

4

Korotkoff sound: thumping to muffling; 85 mmHg

5

Korotkoff sound: muffling to silence; 80 mmHg

2

At what Korotkoff sound can a potential auscult be heard?

auscultatory gap

The cuff is inflated 20-30 mmHg beyond the cuff inflation value in order to avoid the _______ ____ when Korotkoff's sounds temporarily disappear during auscultation and falsely low readings.

<120/<80

optimal resting BP (systolic/diastolic)

120-139/80-89

prehypertension BP (systolic/diastolic)

140-159/90-99

hypertension stage 1 BP (systolic/diastolic)

>160/>100

hypertension stage 2 BP (systolic/diastolic)

increase

With aging, systolic and diastolic BP tends to INCREASE/DECREASE 2 degrees in less compliant arteries.

>200/>110

ACSM exercise contraindication for resting BP (systolic/diastolic)

>250/>115

ACSM exercise contraindication for exercise BP in low risk adults (systolic/diastolic)

decrease (by 10)

ACSM exercise contraindication for exercise BP in cardiac patients: INCREASE/DECREASE in systolic BP

<10

What is considered a normal increase or decrease in diastolic BP for young and trained athletes with exercise?

increases

Diastolic BP in older, aging individuals with exercise: diastolic should not vary, abnormal INCREASES/DECREASES observed with CAD, CABG, HTN and compensated CHF

20, 10, increase

Orthostatic hypotension = supine to stand or sit to stand: decrease >___ mm SBP or decrease > ___ mm SBP and DBP with concomitant pulse INCREASE/DECREASE of >15 BPM (within 3 minutes)

lub

Is the lub or dub louder?

S1

occurs at onset of ventricular systole (closure of AV valves)

S2

occurs at onset of ventricular diastole (closure of semilunar valves)

S3

occurs immediately following S2 in early ventricular diastole (CHF, normal in healthy young adults)

S4

immediately precedes S1, occurs in late ventricular diastole (hypertensive and coronary heart disease, MI, CABG)

murmur

indicates blood regurgitation through the valves - mitral regurgitation, aortic stenosis

pericardial friction rub

heart rubs against inflamed pericardium or lung pleura; pericarditis