Vital Signs (part 3)

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Vital Signs (part 3)
2010-10-10 20:21:32
Foundations Nursing JSU

Oxygen Therapy, Pain, and Blood Pressure
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  1. What is a Nasal Cannula?
    A way of giving oxygen therapy that is pretty accurate
  2. How is oxygen ordered for a Nasal Cannula?
    In liters/minute, which can be converted to % of inspired O2 (FiO2)
  3. What percentage of oxygen is in a normal room's air?
    21 %
  4. What are the amounts (in L) and the % of oxygen that can be ordered for a Nasal Cannula?
    • 1-2 L = 24-28 %
    • 3-4 L = 32-36 %
    • 5-6 L = 40-44 %
  5. Can you use a simple face mask for a COPD patient?
    No - b/c of retension
  6. Explain a Venturi Mask.
    • Can deliver higher concentrations of O2
    • Much more reliable
    • Has color coded adaptor with FiO2 printed on it & instructions for flow meter
  7. A Venturi Mask looks almost like a simple face mask...
    What should you look for to know it is a V-Mask?
    • colored adaptors
    • (yellow, white, green, blue, pink, and orange)
  8. What is the 5th vital sign?
  9. The ____ ________ requires pain assessments for all patients.
    Joint Commission
  10. The Non-Rebreathing Face Mask :
    • Has reservoir
    • Delivers highest (up to 90%) w/o intubating the patient
    • READ the directions!! Fill the reservoir bag 1st
  11. Which type of mask delivers the highest O2 (up to 90%) w/o intubating the patient?
    The Non-Rebreathing Face Mask
  12. Which Mask has a reservoir?
    The Non-Rebreathing Face Mask
  13. The pressure of the blood as it is forced against arterial walls during cardiac contraction is known as ________
    Blood Pressure
  14. The contraction phase of blood pressure is known as _______
    Systole (S1)
  15. The relaxation/resting phase of blood pressure is known as _______
    Diastole (S2)
  16. The Stroke Volume is:
    The amount of blood forced out by the left ventricle upon each contraction
  17. The Cardiac Output is:
    The total quanitity upon each contraction pumped per minute
  18. Pulse Pressure is:
    • The difference b/t systolic and diastolic pressures
    • The indicator of volume output of the Left Ventricle
  19. The Pulse Pressure should generally be _____ of the systolic pressure.
    no greater than 1/3
  20. Blood pressure of 120/80 has a pulse pressure (PP) of ____
  21. What does a Narrow pulse pressure indicate?
    the potential of CV Collapse
  22. Increased Cardiac Output = _______ BP
  23. Decreased Cardiac Output = _______ BP
  24. Peripheral Resistence =
    • Blood Viscosity (thickness)
    • Vascular Compliance
  25. Blood Volume =
    • Hemorrhage (if BV decreases)
    • Renal Failure (if BV increases)
  26. Cardiac Output =
    • The amount of blood pumoed each minute
    • Heart Rate x Stroke Volume
  27. The amount pumped with each contraction = ________ & per minute = ________
    Stroke Volume & Cardiac Output
  28. What is the Equation for Cardiac Output?
    CO = HR x SV
  29. What unit is Blood Pressure measured in?
    mm/Hg - millimeters of mercury
  30. The difference b/t systolic and diastolic pressure is known as the _____ ______
    pulse pressure
  31. What is the most common way of measuring BP?
    Indirect or Noninvasive - gets an accurate estimate or arterial BP obtained by external measuring devices
  32. Explain the Direct Method of measuring BP:
    • Done only in in-client setting
    • Catheter is threaded into an artery under sterile conditions
    • Attached to tubing that is connected to an electronic monitoring system
    • Pressure is constantly displayed as a waveform on the monitor screen
  33. What equipment do you need to obtain an Indirect BP measurement?
    • Sphygmomanometer - consists of a vinyl or cloth cuff, a pressure bulb with a regulating valve, and a manometer
    • Stethoscope - used to auscultate the systolic and diastolic pressure
  34. What are the steps to use a BP Cuff?
    • Select appropriate arm (No AV Shunt/Mastectomy)
    • Place stethoscope over an artery
    • Inflate the cuff; the artery is occluded as the pressure of the cuff exceeds the pressure in the artery
    • Deflate the cuff; blood begins to flow rapidly through the partially open artery, producing turbulent flow you will hear through the stethoscope
  35. When are the 5 Korotkoff sounds heard?
    • 1st occurs during systole/tapping/systolic BP
    • 2nd soft/swishing
    • 3rd Midway/sharp/tapping
    • 4th softer than 3rd
    • 5th Silence corresponds to diastolic BP
  36. A BP Cuff bladder should encircle ___ of arm
    • 80%
    • Too small cuff = false high
    • Too large cuff = false low
    • Cuff with arm at side
    • Keep arm at heart level if recumbent
  37. Normal Systolic/Diastolic pressure is:
    <120 / <80
  38. Pre-hypertension Systolic/Diastolic pressure is:
    120-139 / 80-89
  39. Stage 1 Hypertension Systolic/Diastolic pressure is:
    140-159 / 90-99
  40. Stage 2 Hypertension Systolic/Diastolic pressure is:
    >160 / >100
  41. Hypertension is:
    • The “silent killer ”: often no symptoms
    • Often idiopathic. (unknown etiology)
  42. Contributing factors of hypertension are:
    family hx, obesity, smoking, heavy ETOH use, high NA intake, sedentary lifestyle
  43. Prehypertension is:
    BP reading of 120-130 systolic or 80-89 diastolic

    obtained with two readings, taken 6 minutes apart, with the client sitting (JNC 7, 2003)
  44. BP persistently higher than normal

    Diagnosed when BP is >140 mm Hg systolic or>90 mm Hg diastolic on two or more separate occasions
  45. Primary or Essential Hypertension:
    • Diagnosed when there is no known cause for the increase
    • Accounts for at least 90% of all cases of hypertension
  46. Systolic blood pressure <100 mm Hg; some clients normally have low BP; ask if client is light-headed or dizzy
  47. What is a sudden drop in BP on moving from a lying to a sitting or standing position?
    Orthostatic or postural hypotension
  48. What factors influence Blood Pressure?
    • •Age (Both I/D)
    • •Stress (Increase)
    • •Race (Increase in A.A.)
    • •Diurnal Variations
    • •Pain (Both I/D)
    • •Body Position (Both I/D)
    • •Diseases (Both I/D)
    • •Lifestyle (Both I/D)
    • •Medications (Both I/D)
    • •Obesity (Increase)
    • •Family History (Both I/D)
    • •Sex (Both I/D)
    • •Exercise (Both I/D)
  49. BP _______ when standing and _______ when sitting
    increases, decreases
  50. BP _____ with pain and _____ with excesive pain
    increases, decreases
  51. BP is higher in a _____ than in a ______
    Male, Female

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