Phase 1

vital signs, vascular diseases

constitutional signs and symptoms definition

symptoms that can affect many different systems of the body, requiring further evaluation

constitutional signs and symptoms examples

fever

weight loss/gain

fatigue/tiredness

dyspnea (trouble breathing)

malaise

nigh sweats/generalized hyperhidrosis

bone pain

change in appetite/anorexia

generalized chronic pain

concentration problems

palloar

pruritus (itching)

where is temperature regulated

hypothalamus

what is the gold standard of reading body temp

pulmonary artery

what type of temperature reading should be used on children from 2 months old to 16 years

tympanic membrane

what type of temperature reading should be used on adults

oral

what is the average accepted body temp

98.6

what is the accepted range of body temp

97.7-99.5

hyperthermia temperature

>104

hypothermia temperature

<95

what are these symptoms describing

faint/dizzy

rapid/weak pulse

excessive sweating

pale,clammy skin

muscle cramps

heat exhaustion

what are these symptoms describing

throbbing headache

rapid, strong pulse

no sweating

red/hot/dry skin

may pass out

heat stroke

difference between fever and heat exhaustion/stroke

fever = body is in control

exhaustion/stroke= external temperature is in control

what kind of treatment should you do for heat exhaustion

move to cool location

rest

hydrate (sodium)

what kind of treatment should you do for heat stroke

cold immersion

intravenous hydration

emergency room

define pulse

regular expansion of artery caused by ejection of blood from heart k

define rate of pulse

beats/min

define rhythm of pulse

regular/irregular

define amplitude of pulse

strong or weak

rate of pulse is determined by what

systole/left ventricular contraction

what is a normal rate of pulse

60-100 bpm

fast pulse rate =

tachycardia

slow pulse rate=

bradycardia

pulse rate increases during

inspiration

pulse rate decreases during

expiration

small/weak pulse might be caused by

heart failure, hypovolemia, aortic stenosis, vasoconstriction in local area

large/bounding pulse might be caused by

regurgitation, vasodilation, heart block, atherosclerosis

pulsus magnus =

strong and bounding amplitude

pulsus parvus

thready pulse amplitude

pulsus alternans

large amplitude pulse followed by low amplitude pulse in regular rhythm

pulsus paradoxus

systolic pressure drops greater than 10mmHg during inspiration

T/F: pulse amplitudes should be asymmetrical

false, should be symmetrical

describe thromboangitis obliterans

AKA

AKA buerger disease

blood vessels are inflammed, swell and can become blocked with blood clots

thromoangitis obliterans is often associated with what population

smokers

capillary refill time for

children

females

elderly

children: <2s

females: <3s

elderly: <4s

capillary refill might be diminshed with what states

dehydration

shock- acidosis

peripheral vascular disease

hypothermia

decreased CO (hypotension)

arterial occlusion

define turgor

skin elasticity

decreased turgor might be due to

dehydration

old age

normal respiratory rate

14-20 breaths/min

fast respiratory rate

>25 bpm

slow respiratory rate

<12 bpm

describe cheyne stokes respiratory rhythm

crescendo, decrescendo, apnea (stop)

cheyne stokes might indicate what issue

CNS pathology (stroke)

uremia (kidney failure)

heart failure

describe ataxic breathing

alternating apnea and deep breaths

ataxis breathing might indicated

meningitis

hypernea

deep breathing due to increased metabolic demand

hyperventilation

deep breathing not due to increased metabolic demand — more like anxiety

hypopnea

shallow breathing accompanied with tachypnea

blood oxygen saturation =

amount of oxygen bound to hemoglobin in blood

normal blood oxygen saturation

95% +

severe hypoxia = blood oxygen saturation of

80-85%

low blood oxygen saturation would be common in what type of patients

COPD

severe hypoxia 80-85% can be marked by

decreased brain function

hypoxia =

failure of normal tissue oxygenation

hypoxemia =

failure of normal blood oxygenation

systolic pressure=

force exerted when ventricles contract

diastolic pressure=

force exerted by peripheral vascular resistance

normal blood pressure

less than 120/80

when to diagnose hypertension (gold standard)

wear monitor continuously for about 24 hours

urgent hypertension crisis

>180/20 with no symptoms of end organ dysfuction

emergent hypertension crisis

>180/20 with symptoms of end organ dysfunction

hypotension reading

<90/60

10-15 mmHg difference in systole between arms increases risk of

peripheral artery disease

difference between systolic and diastolic pressure=

pulse pressure

what is a normal pulse pressure and what does pulse pressure indicate if abnormal

normal= 30-40 mmHG

indicator of aortic non-compliance

what are the sounds called you hear when taking blood pressure

Korotkoff sounds

bruit=

sound of turbulent blood flow

why do you need to take an estimated systolic pressure using the radial artery occlusion?

to avoid auscultatory gap

orthostatic hypotension you may see a drop in systolic pressure by _____ mmHg and a drop in diastolic pressure by ______

>20 mmHg

>10mmHg

presyncope=

lightheaded/feeling like you might faint

what is used as the gold standard for diagnosing PAD of lower extremity

ankle brachial index

most common condition causing heart disease

coronary artery disease

atherosclerosis= ______ + ________ = ________

fatty core + fibrous cap = plaque

types of plaques that can form with atherosclerosis

vulnerable/non stable (easily ruptured)

stable

atheroma

fully developed atherosclerotic plaque

acute myocardial infarction are commonly due to

thrombus formation in coronary artery

effects of atheroma

stable angina, PAD, aneurysm, stenosis, elevated blood pressure

effects of thrombus

heart attack, stroke, mesenteric ischemia

acute arterial obstruction

blood flow to leg stops suddenly, local problem

what is this describing?

gangrene

sudden pain in leg/foot

pale/blue skin

skin feeling cold to the touch

problems moving foot, leg, or toes

no pulse

acute arterial obstruction

what is peripheral artery disease

systemic circulatory disorder caused by atherosclerotic narrowing of peripheral arteries, leading to decreased blood flow

what is this describing?

leg pain/cramping when walking, resolves with rest

cool skin

diminished pulses

slow wound healing

tissue loss

peripheral artery disease

risk factors of peripheral artery disease

smoking

diabetes

hypertension

hyperlipidemia

advanced age

what is deep vein thrombosis

clot that forms in venous system typically in lower extremity

what is this describing

pain, warmth, swelling, and redness in lower extremity presenting unilaterally

deep vein thrombosis

what causes DVT

extended bed rest, immobility, pregnancy, smoking, diabetes

what can DVT lead to? why?

pulmonary embolism because thrombus dislodges and travels to the lungs

what is this describing

shortness of breath

rapid breathing

chest pain

rapid HR

lightheadedness

cough with hemoptysis (cough up blood)

pulmonary embolism

what is pulmonary embolism

a clot that travels to the lungs causing obstruction of the pulmonary arteries leading to impaired gas exchange, increased strain on right side of heart

what is chronic venous insufficiency

long term condition in which venous system of lower extremities can’t effectively return blood to the heart, usually due to valvular impotence, vneous obstruction or calf muscle pump dysfunction

what is this describing

leg swelling that worsens when standing

aching or heaviness

varicose veins

skin hyperpigmentation or liodermatosclerosis

venous stasis ulcers

chronic venous insufficiency

T/F: most arterial vascular diseases/problems will be pale/blue and cold

true

T/F: most venous vascular disease/issues with be warm, red, and swollen

true