OXYGEN SATURATION & BP

pulse oximeter

noninvasive that measures O2 saturation

pulse oximeter step 1

sensor attached to finger

pulse oximeter step 2

diode emits light

pulse oximeter step 3

detector measures amount of light absorbed by Hb02

healthy person with no lung disease or anemia (low oxygen-rich blood) SpO2

92-100%

alternative probes for O2 saturations

forehead, toe, earlobe

hypoxia

O2 below 92%

supplemental (given) oxygen that increase O2 comes from?

MD or your provider

what is blood pressure?

force of blood against arterial walls

which line is BP measured?

via “A” line

BP is measured indirectly with

sphygmomanometer

INTERNAL factors influencing BP (one)

cardiac output

INTERNAL factors influencing BP (two)

volume of blood

INTERNAL factors influencing BP (three)

resistance/elasticity of vessels

INTERNAL factors influencing BP (four)

viscosity

sphygmomanometer is?

blood pressure cuff

Korotkoff sounds can be heard when?

auscultating manual BP

check BP at what level?

bare arm at heart level

where do you place the BP cuff?

+/-2.5 cm above brachial artery

patient position during BP

feet flat on floor and sit 5 min prior (relax)

systolic (systole)

maximal force against arterial walls during ventricular contraction

diastolic (diastole)

minimal force against arterial walls during ventricular relaxation

pulse pressure

difference between systolic and diastolic

pulse pressure measures?

amount of blood pumped out during systole

pulse pressure calculation

(120/80) → 120-80= 40 (pulse pressure)

normal pulse pressure

30-40

stroke volume

volume of blood (mL) ejected from ventricle during contraction

mean arterial pressure (MAP)

constant pressure that forces blood into tissues

mean arterial pressure (MAP) measurement is determined by the?

average over a cardiac cycle

MAP is looked at when we consider

low BP or unstable conditions/BP

mean arterial pressure (MAP) can tell us about

brain or organ perfusion (if they’re getting enough blood)

MAP value for adequate tissue/organ perfusion

greater or equal to 60 mmHg

EXTERNAL: factors that affect blood pressure (one)

exercise

factors that affect blood pressure (two)

emotions

factors that affect blood pressure (three)

meds

factors that affect blood pressure (four)

age **FIX ON TEMP FLASHCARDS**

factors that affect blood pressure (five)

circadian rhythm

factors that affect blood pressure (six)

gender

factors that affect blood pressure (seven)

position (feet uncrossed)

factors that affect blood pressure (eight)

digestion

factors that affect blood pressure (nine)

OBESITY

after usage, what should we do with BP equipment?

routinely inspect

BP cuff level (sphygmomanometer) should be at

zero

flat side of stethoscope

diaphragm

top side of stethoscope

bell

cuff (bladder) length

80% arm circumference

cuff width

40% arm length

BP cuff size (one)

long/xL

BP cuff size (two)

cone shaped - obese

BP cuff size (three)

standard adult/large

BP cuff size (four)

pediatric/small

BP cuff size (five)

newborn (extremely small maybe 6 in or less)

can also check BP on..?

legs

BP on leg is more common within?

baby/kids

BP cuff too small can result

falsely high BP reading

BP cuff too larger can result

falsely low BP reading

BP step one

arm relaxed

BP step two

arm at heart level

lower BP position (arm below heart) results in

higher readings

BP step three

wait 1-3 min before repeating on same arm (or 5 min)

BP step four

not over clothes

resting time before BP

at least 5 min

position of cuff bladder

bladder over brachial artery

cuff distance from auscultation site

2-3 cm

peak inflation level

20-30 mmHg above radial pulse disappearance

cuff deflation rate

2-3 mmHg/sec

systolic sound

first sound heard (Korotkoff phase 1)

diastolic sound

when sounds disappear (Korotkoff phase 5)

high bp

140/90 OR above

pre-high bp

121-139/81-89

normal bp

120/80 OR less

essential/primary HTN (not specific cause/”just because…”)

stressors, pain, dietary, genetics, etc.

secondary HTN (caused by condition)

renal, adrenal, pituitary, tumor

high BP term & reading

hypertension (above 140/90)

low BP term & reading

hypotension (below 90-95/60)

low BP can be caused by what events?

bleeding, dehydration, anemia, medications, fall risk

orthostatic hypotension

BP drops when standing up or sitting down

orthostasis def

BP drops by at least 20/10 mmHg (when they rise)

during orthostatic hypotension , when BP goes down

pulse goes up

orthostatic hypotension are what measurements?

serial measurements of pulse and BP

orthostatic hypotension related factor (one)

suspect volume depletion

orthostatic hypotension (two)

history of syncope (fainting)

orthostatic hypotension (three)

risk for falls

how to check orthostatic hypotension?

lying, sitting, standing BP and pulse

how long do we wait between readings for orthostatic hypotension

wait 2-3 minutes (lying, sitting, standing)

orthostatic hypotension documentation items

time, positions, readings, Pt report of symptoms

what age do we begin BP in children?

3 yo

why do we take vital signs in a sequence for pediatrics?

for accuracy (kids freak out so their BP rises)

VS sequence in pediatrics step one

respirations (least invasive, or not gonna upset pediatrics)

VS sequence in pediatrics step two

pulse

VS sequence in pediatrics step three

temperature

VS sequence in pediatrics step four

O2

VS sequence in pediatrics step five

blood pressure

what makes vital signs concerning?

vital sign trend changes (up or down)

vital signs presents a new finding can be

more concerning

more concerning: acute VS change vs chronic VS change?

acute VS (chronic VS have trends)

we use the PAINAD scale for…?

dementia patients (advanced dementia)

PAINAD scale is subjective or objective?

objective (done by nurse)