What are the vital signs we assess? Temperature Pulse Respirations Blood Pressure Pain O2
What is a normal temperature? 37 C or 98.6 F
What is a normal pulse? 60-100 bpm
What is a normal respiration rate? 12-20 breaths per minute
What is normal blood pressure? 120/80 mmHg
How do we ask patient...
NU 231 Exam 1 Study Questions and
Correct Answers
What are the vital signs we assess? ✅Temperature
Pulse
Respirations
Blood Pressure
Pain
O2
What is a normal temperature? ✅37 C or 98.6 F
What is a normal pulse? ✅60-100 bpm
What is a normal respiration rate? ✅12-20 breaths per minute
What is normal blood pressure? ✅120/80 mmHg
How do we ask patients to rate pain? ✅on a 0-10 pain scale
children often use face scale
neonates: Neonatal Infant Pain Scale (NIPS) or Neonatal Pain, Agitation and Sedation
Scale (N-PASS)
Nursing action for abnormal vitals ✅- Always retake them first
- Report any abnormal findings
- Follow principles of delegation
- Validate abnormal findings and further assess
When do we assess vital signs? ✅-Upon admission to any healthcare facility.
-Based on policy and procedures.
- Any time there is a loss in consciousness
-Any time there is a change in the patient's condition.
-Before and after surgical or invasive diagnostic procedures.
-Before and after activity that may increase risk, such as ambulation after surgery.
-Before and after administering medications that affect cardiovascular or respiratory
functioning.
What are the sources of heat production? ✅- The primary source is metabolism.
- Hormones, muscle movements and exercise can all increase metabolism.
- Epinephrine and norepinephrine are released when additional heat is required and
alter metabolism
, - Thyroid hormone and shivering increases heat production
- Energy production decreases and heat production increases
What are the sources of heat loss? ✅- Skin (primary source)
- Evaporation of sweat
- Warming and humidifying inspired air
- Eliminating urine and feces
- Transfer of body heat to environment
How is body heat transferred to the environment? ✅Radiation
Convection
Evaporation
Conduction
What affects body temperature? ✅- Circadian rhythm: body temp. is lower in morning
and higher between 4 and 8pm
- Age & Gender: Older adults have less subcutaneous tissue, this leads to loss of
thermoregulatory function. New borns are more susceptible to heat loss. Women
experience more temp. fluctuations than men
- Physical Activity: Muscle movement increases temp.
- State of Health: Certain disease processes can result in a change of body temp.
- Environmental Temp.: Hypothermia and Hyperthermia
How is pulse regulated? ✅By the autonomic nervous system through the SA node of
the heart
Define pulse rate ✅The number of contractions over a peripheral artery in 1 minute
Parasympathetic stimulation vs. sympathetic simulation (HR) ✅Parasympathetic
Stimulation = decrease in HR
Sympathetic Stimulation = increase in HR
List 3 ways to assess pulse ✅1. Palpate the peripheral arteries
2. Auscultate the apical pulse with a stethoscope
3. Use a portable Doppler ultrasound
List the common pulse sites ✅Temporal
Carotid (often used during cardiac arrest)
Brachial (commonly done on infants)
Radial (normal for adults)
Voordelen van het kopen van samenvattingen bij Stuvia op een rij:
Verzekerd van kwaliteit door reviews
Stuvia-klanten hebben meer dan 700.000 samenvattingen beoordeeld. Zo weet je zeker dat je de beste documenten koopt!
Snel en makkelijk kopen
Je betaalt supersnel en eenmalig met iDeal, creditcard of Stuvia-tegoed voor de samenvatting. Zonder lidmaatschap.
Focus op de essentie
Samenvattingen worden geschreven voor en door anderen. Daarom zijn de samenvattingen altijd betrouwbaar en actueel. Zo kom je snel tot de kern!
Veelgestelde vragen
Wat krijg ik als ik dit document koop?
Je krijgt een PDF, die direct beschikbaar is na je aankoop. Het gekochte document is altijd, overal en oneindig toegankelijk via je profiel.
Tevredenheidsgarantie: hoe werkt dat?
Onze tevredenheidsgarantie zorgt ervoor dat je altijd een studiedocument vindt dat goed bij je past. Je vult een formulier in en onze klantenservice regelt de rest.
Van wie koop ik deze samenvatting?
Stuvia is een marktplaats, je koop dit document dus niet van ons, maar van verkoper twishfrancis. Stuvia faciliteert de betaling aan de verkoper.
Zit ik meteen vast aan een abonnement?
Nee, je koopt alleen deze samenvatting voor €8,89. Je zit daarna nergens aan vast.
