Vital Signs (part 2)
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When does a pulse begin?
When the Left Ventricle Contracts
When does a pulse end?
When the Left Ventricle Relaxes
The peak of the wave, or the contraction of the heart is known as?
Systole (Contration of the Heart)
The trough or resting phase of the heart is known as?
Diastole (Relaxation of the Heart)
The Pusle Rate is regulated by what?
the Autonomic Nervous System (ANS)
What is the Normal Adult Pulse Rate?
- 60-100 bpm
- Average is b/t 70-80 bpm
Which Node is primarily responsible for the rate of the heart?
- The SA Node (Sino Atrial)
- The pacemaker of the heart
Which Node works with the SA node to pace the heart rate?
The AV Node (Atrio Ventricular)
What factors influence the Pulse?
- Age (Children are more rapid than Adults)
- Sex (Females have highre HR than males b/c of hormones)
- Exercise (Athletes have a slower HR)
- Food (a full stomach increases heart rate)
- Fever (increases HR)
- Blood Loss (increases HR)
- Position Changes
- Narcotics (decrease HR)
- Breathing Meds (increases HR)
Which pulse location is most acurate?
- The Apical Pulse
- 5th ICS, MCL (on left)
What makes the "Lub" heart sound (S1)?
Closure of the Tricuspid and Mitral (AV) Valves
What makes the "Dub" heart sound (S2)?
Closure of the Aortic and Pulmonic (Semilunar) Valves
What are the common Pulse points?
- Apical (apex of heart - 1 full minute)
- Posterior Tibial
Inadequate Circulation could present ______ & ______
Pallor and Cynosis
A Heart Rate Less than 60 bpm is _______
A Heart Rate Greater than 100 bpm is _______
How long should you take a pulse if it is irregular?
How do you rate the quality of a pulse?
- 0 = none
- 1 + weak
- 2 + normal
- 3 + bounding
What is the Stroke Volume?
The quantity of blood pumped out by each contraction of the left ventricle
What is the Cardiac Output?
The Stroke Volume times the pulse (heart) rate
What Factors can affect a Pulse Rate?
Exercise, Temperature, Emotions, Drugs, Hemorrhage, Postural Changes, Pulmonary Conditions
What is Respiration?
The exchange of oxygen (O2) and carbon dioxide (CO2) in the body
What are the 2 processes of Respiration?
Mechanical and Chemical
Explain the Mechanical process of Repiration.
- Pulmonary Ventilation; breathing
- Active movement of air in and out of the respiratory system
Explain the Chemical process in Respiration.
- Exchange of O2 and CO2
- Transport of O2 and CO2 throughout the body
- Exchange of gases between the capillaries and tissues
What regulates repiration in the brain?
The Medulla Oblongata and the Pons
What is the most potent stimulant in normal lungs?
CO2 (it causes you to breath in order to get rid of it)
What happens if you give a COPD patient too much O2?
The O2 will supress their respiratory drive (drive to breath)
What does Hypercapnia mean?
How do you treat it?
- High CO2Treat w/ Hypoxia (high oxygen)
What are the 2 Mechanics of Respiration?
What does it involve?
- Drawing air into the lungs
- Involves the ribs and diaphragm, creating negative pressure and allowing air to flow into the lungs
Relaxation of thoracic muscles and diaphragm, causing air to expel from the lungs
The diaphragm moves ______ in Inspiration and ______ in Expiration.
What is the normal Rate of Respirations?
12 - 16 breaths per minute
How should the rhythm and effort be in a normal respiration?
regular and unlabored
What should you make sure to look for in assessing repirations in a COPD patient?
- Accessory Muscles
- Flaring of Nostrils
- Pursed Lips
Cessation of breathing is ______
Abnormally slow breathing is _______
- (less than 12 breaths per min.)
Abnormally fast breathing is ______
- (more than 16-20 breaths per min.)
High pitched, musical, and usually expiratory breath sounds are ______
(Maybe) High pitched/popping, and usually inspiratory breath sounds are ______
A piercing, high-pitched sound heard primarily during inspiration and in respiratory distress is ______
Labored breathing that produces a snoring sound is _______
- Rapid and deep breathing resulting in excess loss of CO2 (hypocapnea)
- Client may complain of feeling light-headed and tingly
The rate and depth of respirations are decreased and CO2 is retained
What factors influence Respirations?
- Exercise (Increases)
- Pain (Increases)
- Stress (Increases)
- Smoking (Increases)
- Fever (Increases)
- Pulse Rate (Increases)
- Hemoglobin (if low - Increases)
- Disease (Both I/D)
- Medications (Both I/D)
What do Arterial Blood Gases (ABGs) do?
Directly measures the partial pressures of oxygen, carbon dioxide, and blood pH
What is Pulse Oximetry, and how do you measure it?
- Noninvasive method of monitoring respiratory status
- Uses an external device (on the finger) that measures oxygen saturation
What is a late sign of Respiratory distress that is alot of trouble?
Blowing off too much CO2 is ______ and retaining too much CO2 is _______.
Hyperventilation, and Hypoventilation
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