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Nurs 204 Exam 2 | Questions & Answers (100 %Score) Latest Updated 2024/2025 Comprehensive Questions A+ Graded Answers | 100% Pass

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Nurs 204 Exam 2 | Questions & Answers (100 %Score) Latest Updated 2024/2025 Comprehensive Questions A+ Graded Answers | 100% Pass

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Nurs 204 Exam 2 | Questions & Answers (100 %Score) Latest Updated 2024/2025
Comprehensive Questions A+ Graded Answers | 100% Pass


Measuring Vital Signs - Temperature -T

Pulse - P Respiration - R

Blood Pressure - BP

Vital Signs - TPR and BP



Purpose of Vital Sign (2) - a. Detect any chances in normal body function

b. Determine response to treatment



Vital Signs measuring (5) - Measurement- taken at rest

Temperature - measure body heat

Pulse - measure heart rate and rhythm

Respiration - how often patient inhales and exhales

Blood Pressure - measures pressure against the walls of the arteries



When Vital Signs are taken - Every shift change - minimum every 8 hours



When taking signs, what's important to know about patient? (4) - a. Normal levels

b. Medications that they are currently on/taking

c. Borderline



Heat production (3) - 1) Muscles

2) Glands

3) Oxidation of food



Heat loss (3) - 1) Respiration

2) Perspiration

,3) Excretion



Between heat production and heat loss is____ ____? - Body temperature



How to increase temperature (5) - 1) Shivering

2) Epinephrine

3) Increased metabolism

4) Vasoconstriction

5) Shunts blood from the body surface



How to decrease temperature (2) - 1) Vasodilation diverts blood to the body surface where heat can be
transferred to surrounding environment

2) Sweating



Factors affecting body temperature (13) - a. Circadian rhythms

1) Time of the day

*Lowest when sleeping - internal clock -

b. Age / gender

c. Environment

d. Illness

e. Medications

f. Infection

g. Emotions

h. Hydration

i. Clothing

j. Environment temperature / air movement

k. Hormone levels (women)

l. Effects of fever

m. Methods to reduce fever

,*Taking temperature

Sites to take temp. (5) - 1) Oral - most common (blue)

2) Rectal - most accurate - registers one degree Fahrenheit higher than oral; closest to core temperature
(blue)

3) Axillary - least accurate - registers one degree Fahrenheit lower than oral

4) Tympanic - probe inserted into the ear canal

5) Forehead



*Taking temperature

Normal body temperature

1) Oral

2) Rectal

3) Axillary - 1) Oral: 97.6-99.6 F or 36.5-37.5 C

2) Rectal: 98.6-100.6 F or 37.0-38.1 C

3) Axillary: 96.6-98.6 F or 36.0-37.0 C



Taking temperature

Instruments used to measure T

(5) - a) Non-mercury glass

- Oral and rectal -

b) Chemically treated paper - disposable

c) Plastic - disposable

d) Electronic - probe covered with disposable shield

- In hospital -

e) Tympanic - electronic probe used in ear



Temperature - Safety Precautions (3) - 1) Hold rectal and axillary thermometers in place

2) Check glass thermometer for chips

, 3) Delay taking oral temperature for 10-15 minutes is patient has been smoking, eating, drinking
hot/cold liquids, or chewing gum



Pulse Physiology (2) - a. Pulse is the pressure of blood pushing against the wall of an artery against the
wall of an artery as the heart beats and rests.

b. Pulse easier to locate in arteries close to skin than can be pressed against bone



Factors affecting the pulse (11) - a. Age

b. Gender (female slightly higher)

c. Blood loss

d. Position: lying to sitting to standing

e. Drugs

f. Illness

g. Emotions

h. Emotions

i. Exercise

**Athletes (always taking about professional) have lower pulse rates - their hearts are trained to pump
less blood

j. Temperature

k. Physical training



Normal pulse rates child & adult - Adult: 60-100

Child: 120-160



Increased and decreased pulse

& Pulse deficit - a. Tachycardia - fast



b. Bradycardia - slower

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