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Terms in this set (78)
Indication of health status; effectiveness of
Vital Signs
circulatory, respiratory, neural, & endocrine function
Temperature, Pulse, Respirations, Blood Pressure.
What are vital signs?
Oxygen Saturation, Pain (the 6th vitals sign)
When should you Initial assessment, post-op, anytime with nursing
measure vital signs? judgment (no order is needed for VS)
Where do you document In the patient's chart, on a flowsheet
vital signs?
What are normal vital Before reporting abnormals, ask about history,
signs? When should you normal heart rate, blood pressure and ask about
report abnormals? medications that could be affecting the vitals
Always make sure to The right size equipment (blood pressure cuff)
have the correct (what)
for vitals signs
Assessing & interpreting The nurses
vital signs is who's
responsibility?
The nurse should have True
knowledge of the
patient's usual (normal)
vital sign ranges, True or
False
What factors can affect a Stress, exercise, position, smoking, lighting,
persons vital signs? temperature, etc.
, If a patient is on blood Yes, give the BP medication unless BP is detrimental
pressure medication and to the patient (high heart rate, the patient could be
there BP is at 119/68 dizzy). The pt. BP could rise from activities later on in
should the nurse give the the day.
medication?
If the patient's blood Heart rate is going to increase to get more blood
pressure is low, what is pumped to the heart
the heart rate going to
do?
Always approach the Standard protocol (name, DOB, and allergies)
patient using what?
The frequency to obtain Orders, assessment, and nursing judgement
vital signs is based off of
what?
What should you teach What is normal, their normal, hypertension, diet
patient about their vitals?
A diet for hypertension Low sodium, exercise
is?
When should the patient At the same time of the day, after the same
take their blood pressure task/activity ( may be ordered to do randomly under
for monitoring? circumstances)
Does one high blood No, it has to be continuously high
pressure reading mean
that the patient has
hypertension?
Body temperature= heat produced- heat loss
Temperature Surface temperature varies, but core temperature
kept within narrow range for optimal cell function
The normal temperature 96.8- 100.4 F
range in an adult
Pyrexia means what Fever
What temperature is >39 C or 102.2 F, usually not harmful
considered a fever?