N1I02 Questions with correct Answers
Health history vs physical exams - ✔✔health history: subjective, interactions, what patient says
about themselves
physical exam: objective, what nurse observes, vital signs, inspection, percussion, palpation,
auscultation
steps after collecting data - ✔✔1. compare data to normals
2. make list of signs and symptoms
3. group data thats similar
4. validate the data
what are vital signs for? - ✔✔Measure the effectiveness
of the circulatory, respiratory, neurological, and endocrine body functions
when are some times to take vital signs? - ✔✔- upon administration
- before during and after procedures or big medications
- when patient changes
- before patient is sent home
- if patient says they are in distress
Define inspection - ✔✔concentrated watching
palpation - ✔✔using sense of touch
auscultation - ✔✔listening to sounds produced by the body, with a stethoscope
when to use diaphragm vs bell on stethoscope - ✔✔diaphragm: high pitched sounds (breath,
bowel, normal heart)- hold this firmly
bell: low-pitched sounds (extra heart sounds or murmurs)- hold this lightly
normal temperature for adults - ✔✔36-38 degrees
avg oral/temporal/tympanic: 37 degree
avg rectal: 37.5 degree
avg axillary: 36.5
normal pulse for adults - ✔✔60-100 beats per min
normal resp rate for adults - ✔✔12-20 per min
normal blood pressure for adults - ✔✔systolic: 120-139 mm Hg
, diastolic: 80-89 mm Hg
pulse pressure: 30-50 mm Hg
oxygen sat normal for adults - ✔✔95-100 %
normal temp for child - ✔✔37 degrees
normal blood pressure for an infant - ✔✔systolic: 65-115
diastolic: 42-80
normal blood pressure for 7 year old - ✔✔systolic: 87-117
diastolic: 48-64
normal temp for older adult - ✔✔tends to be lower- 36 degrees
what conditions can affect blood pressure of an adult - ✔✔chronic kidney disease and diabetes
4 moments of hand hygiene - ✔✔1. Before initial patient/environment contact
2. Before aseptic procedure
3. After body fluid exposure risk
4. After patient and environment contact.
what is the body's thermostat - ✔✔hypothalamus (part of the endocrine system)
temp is under neural and vascular control
anterior hypothalamus responsibility in temperature - ✔✔The anterior hypothalamus nerve cells
may become OVERHEATED, and INDUCE HEAT LOSS through:
- Diaphoresis (sweating, heat loss through evaporation)
- Vasodilation of blood vessels
- Inhibition of heat production
posterior hypothalamus responsibility in temperature - ✔✔The posterior hypothalamus nerve
cells may sense HEAT LOSS and attempt to CONSERVE HEAT through:
- Shivering
- Vasoconstriction
pyrexia - ✔✔fever
hyperthermia values - ✔✔40 degrees and above
afebrile - ✔✔no fever
Health history vs physical exams - ✔✔health history: subjective, interactions, what patient says
about themselves
physical exam: objective, what nurse observes, vital signs, inspection, percussion, palpation,
auscultation
steps after collecting data - ✔✔1. compare data to normals
2. make list of signs and symptoms
3. group data thats similar
4. validate the data
what are vital signs for? - ✔✔Measure the effectiveness
of the circulatory, respiratory, neurological, and endocrine body functions
when are some times to take vital signs? - ✔✔- upon administration
- before during and after procedures or big medications
- when patient changes
- before patient is sent home
- if patient says they are in distress
Define inspection - ✔✔concentrated watching
palpation - ✔✔using sense of touch
auscultation - ✔✔listening to sounds produced by the body, with a stethoscope
when to use diaphragm vs bell on stethoscope - ✔✔diaphragm: high pitched sounds (breath,
bowel, normal heart)- hold this firmly
bell: low-pitched sounds (extra heart sounds or murmurs)- hold this lightly
normal temperature for adults - ✔✔36-38 degrees
avg oral/temporal/tympanic: 37 degree
avg rectal: 37.5 degree
avg axillary: 36.5
normal pulse for adults - ✔✔60-100 beats per min
normal resp rate for adults - ✔✔12-20 per min
normal blood pressure for adults - ✔✔systolic: 120-139 mm Hg
, diastolic: 80-89 mm Hg
pulse pressure: 30-50 mm Hg
oxygen sat normal for adults - ✔✔95-100 %
normal temp for child - ✔✔37 degrees
normal blood pressure for an infant - ✔✔systolic: 65-115
diastolic: 42-80
normal blood pressure for 7 year old - ✔✔systolic: 87-117
diastolic: 48-64
normal temp for older adult - ✔✔tends to be lower- 36 degrees
what conditions can affect blood pressure of an adult - ✔✔chronic kidney disease and diabetes
4 moments of hand hygiene - ✔✔1. Before initial patient/environment contact
2. Before aseptic procedure
3. After body fluid exposure risk
4. After patient and environment contact.
what is the body's thermostat - ✔✔hypothalamus (part of the endocrine system)
temp is under neural and vascular control
anterior hypothalamus responsibility in temperature - ✔✔The anterior hypothalamus nerve cells
may become OVERHEATED, and INDUCE HEAT LOSS through:
- Diaphoresis (sweating, heat loss through evaporation)
- Vasodilation of blood vessels
- Inhibition of heat production
posterior hypothalamus responsibility in temperature - ✔✔The posterior hypothalamus nerve
cells may sense HEAT LOSS and attempt to CONSERVE HEAT through:
- Shivering
- Vasoconstriction
pyrexia - ✔✔fever
hyperthermia values - ✔✔40 degrees and above
afebrile - ✔✔no fever
