ch 6 stds pt care

Adolescent BP range

85–130 systolic, 45–85 diastolic

Adult flow rate for nasal cannula

1–4 LPM

Average axillary temperature

97.6–98°F

Axillary temperature abbreviation

A

Bacteria risk with oxygen equipment

Equipment can harbor bacteria because they thrive in oxygenated environments

Body temperatures not compatible with survival

105.8–111.2°F or below 93.2°F

BP deflated too quickly causes

False low reading

BP deflated too slowly causes

False high reading

Brachial pulse location

Antecubital fossa above elbow

Bradycardia

A slow heart rate of less than 60 beats per minute

Blood pressure definition

Amount of blood flow ejected from LV during systole and resistance encountered

Blood pressure instrument

Sphygmomanometer

Causes of increased BP

Exercise, emotions, large meals

Child flow rate for nasal cannula

¼–½ LPM

Children (5–13) normal temperature

97.8–98.6°F

Chronic obstructive pulmonary disease (COPD)

Disease of the lungs in which inspiratory and expiratory lung capacity is diminished

Contactless temperature scanner function

Indicates normal vs abnormal (no exact reading)

COPD oxygen danger

High oxygen can suppress respiratory drive

Cyanosis

A condition in which the blood does not supply enough oxygen, causing bluish lips/fingertips

Dehydration

Excessive loss of fluids causing headaches, constipation, and other symptoms

Definition of diastolic pressure

Lowest pressure during ventricular relaxation

Definition of hypoxemia

Low levels of oxygen in the blood

Definition of systolic pressure

Highest pressure during LV contraction

Difference between nonrebreather and partial rebreather

Partial rebreather has no valve, allowing some rebreathing of exhaled air

Diastolic

The blood pressure reading during ventricular relaxation (lowest number)

Documentation requirement for temperature

Must note the location (O, T, TM, A, R)

Dorsalis pedis pulse location

Top of foot

Dyspnea

Difficult breathing resulting from insufficient airflow to the lungs

Equipment needed for BP measurement

Sphygmomanometer and stethoscope

Factors affecting respirations

Illness, medications, exercise, age

Femoral pulse location

Groin

Fever symptoms

Increased pulse/respirations, hot dry skin, chills, discomfort, appetite loss

First step in respiration assessment

Observe chest movement

Hypertension

High blood pressure that may cause long-term artery wall damage

Hypertensive crisis

BP over 180/120 mmHg

Hypertensive stage 1

130–139/80–89 mmHg

Hypertensive stage 2

140/90 mmHg or higher

Hypercapnia

Carbon dioxide being retained in the arterial blood

Hypotension

Low blood pressure that may cause dizziness or fatigue

Hypothalamus

Region of the diencephalon that regulates body temperature

Hypoxemia

Low levels of oxygen in the blood

Infant normal pulse rate

120 bpm

Infant normal temperature

99–99.7°F

Korotkoff sounds

Extraneous tapping, knocking, or swishing sounds during BP measurement

Left arm use for BP

Provides a more accurate reading due to direct line to the heart

Mechanical ventilator purpose

Provides assisted or controlled breathing

Minimum flow rate for face mask

5 LPM to flush CO₂

Mouth (oral) temperature abbreviation

O

Most accurate pulse in infants

Apical pulse

Most accurate temperature site

Rectal

Most accessible pulse in adults

Radial

Most common oxygen delivery device

Nasal cannula

Most common temperature site today

Temporal

Normal adult oxygen saturation

95–100%

Normal adult pulse

60–90 bpm

Normal adult temperature

97.8–99°F

Normal child pulse

90–100 bpm

Normal respirations for adults

10–20 breaths/min

Normal vital signs include?

BP, temperature, pulse, respirations, pulse oximetry

Nasal cannula oxygen concentration

21%–60%

Nasal catheter purpose

Low- to moderate-flow oxygen delivery method

Oxygen as a medication

Must be prescribed by a physician

Oxygen danger during imaging

Risk of sparks or fire with pure oxygen present

Oxygen saturation indicating hypoxemia

less than 92%

Oxygen toxicity mild effect

Reversible tracheobronchitis

Oxygen toxicity severe effect

Irreversible lung damage

Oxygen delivery: aerosol mask

60–80% oxygen mixed with water particles

Oxygen delivery: face mask

30–50% oxygen; used short term

Oxygen delivery: nonrebreathing mask

Can provide up to 100% oxygen

Oxygen delivery: partial rebreathing mask

Delivers 60–90% oxygen

Oxygen delivery: Venturi mask

Provides precise oxygen concentration (24–60%)

Oxygen delivery hazard in COPD

High oxygen may suppress respiratory drive

Orthostatic hypotension

BP drops quickly upon standing; also called postural hypotension

Pain, movement, emotion effect on respirations

Increase respiratory rate

Popliteal pulse location

Behind the knee

Posterior tibial pulse location

Inner ankle

Pulse definition

Arterial pulsation created by blood pumping from the heart

Pulse oximetry purpose

Measures oxygen saturation and heart rate

Pulse pressure definition

Difference between systolic and diastolic BP

Pulse rate response to BP

Becomes rapid when BP is low

Pulse sites in legs

Femoral, popliteal, posterior tibial, dorsalis pedis

Radial pulse location

Thumb side of wrist

Rectal temperature abbreviation

R

Respiration assessment includes?

Rate, depth, quality, pattern

Respirations affected by awareness?

Yes—patient may alter breathing if aware

Sign of hypoxemia visible on skin

Cyanosis (blue lips/fingertips)

Sites for temperature measurement

Oral, tympanic, rectal, axillary, temporal

Sphygmomanometer

Blood pressure cuff

Sphygmomanometer types

Mercury and aneroid

SpO₂ placement locations

Finger, earlobe, toe

Systolic

The BP reading during ventricular contraction (highest number)

Temporal temperature abbreviation

TM

Tympanic

Bell-like; relating to the tympanum (ear)

Tympanic temperature abbreviation

T

Tachycardia

A fast heart rate of more than 100 beats per minute

Venturi mask purpose

Deliver precise oxygen concentration

Vital signs

Assessment of BP, pulse, respirations, temperature, pulse oximetry

Volatile

Easily vaporized or evaporated; unstable or explosive

Warning: When NOT to take BP

Arm with fistula, IV, paralysis, edema, or same side as breast surgery

What can prolonged fever cause?

Central nervous system damage