NSG 3100 Exam 2 Review 2021/2022

NSG 3100 Exam 2 Review 2021/2022 Chapter 19 Vital Signs-Objectives for Unit #3 1. Understand there are 5 vital signs that are done when assessing your patient and that oxygen saturations should be included also. (p. 275) o Vital signs are used to monitor the functioning of body systems o Assessment of vital signs allows the nurse to detect changes in the health status of the patient, identify early warning signs of life-threatening health conditions, and evaluate the effectiveness of interventions o Vital signs consist of body temperature (T), pulse (P), respirations (r), and blood pressure (BP). > T= refers to the measurable heat of the human body > P= detectable rhythmic expansion of an artery that occurs with the pumping action of the beating heart; thus, the pulse rate is measured as a number of heart beats per minute (BPM), with pulse intensity and pattern often specified as well. > R= the act of breathing, so respirations are assessed for frequency, or breaths per minute (BPM); abnormal quality and pattern of breathing also should be noted > BP= the measurable pressure of blood within the systemic arteries > Pulse oximetry= measures the amount of oxygen available to tissues, typically are included with reported vital signs. The pulse oximeter reading is the percentage of hemoglobin that combines with oxygen (SpO2). 2. Know the different pulse sites and how to assess these sites. (p. 283-285) o Temporal: Where temporal artery passes over temporal bone of head; above and lateral to the eye; used when radial pulse is not accessible o Carotid: At the side of the neck where the carotid artery runs between the trachea and the sternocleidomastoid muscle; used in cases of cardiac arrest and for determining circulation to the brain o Apical or point of Maximal impulse (PMI): Apical, at the apex of the heart, and PMI, at the fifth intercostal pace, midclavicular line; used for infants and children up to 3 years of age, placed in the supine position, to determine discrepancies with radial pulse, and used in adults with conjunction with some diseases and medications and during a head to toe assessment