Vital Signs
Which four measurements are traditionally considered the classic vital signs?
Temperature, pulse, blood pressure, and respiratory rate.
What is the normal oral temperature range for most people?
97°F to 99.5°F.
What is the normal resting pulse-rate range for most adults?
60 to 100 beats per minute.
What term describes an abnormally rapid respiratory rate?
Tachypnea
Which normal breath sound is soft, low-pitched, and normally heard over most peripheral lung fields?
Vesicular breath sounds
What is tactile fremitus?
Vibrations felt through the chest wall while a patient speaks
Temperature: A patient’s temperature rises from 37°C to 39°C. Based on the approximate metabolic effect of fever, what happens to oxygen consumption and carbon dioxide production?
They increase; each 1°C increase raises oxygen consumption and carbon dioxide production by approximately 10%, so a 2°C rise would be expected to increase them by about 20%.
When evaluating a patient’s vital signs, what is generally more important than one isolated measurement?
Trends in the vital signs over time.
What term describes an elevation in body temperature above normal caused by disease?
Fever
What term describes a pulse rate that is above the normal adult range?
Tachycardia.
What term describes an abnormally slow respiratory rate?
Bradypnea
Which high-pitched, musical breath sound is often heard more prominently during expiration?
Wheezing (but can also be heard upon inspiration and expiration)
What should the patient say while you compare tactile fremitus over matching areas of the chest?
“Ninety-nine” or another repeated phrase used consistently
Breath Sounds: A patient has a high-pitched, musical sound that is louder during expiration. What is the sound, and what does it indicate is happening in the airway?
Wheezing; it generally suggests airway narrowing or bronchospasm
For a hospitalized patient who is not in the ICU, how often are vital signs commonly recorded?
Every 4 to 6 hours.
When body temperature rises by 1°C, by approximately what percentage do oxygen consumption and carbon dioxide production increase?
Approximately 10%.
What three characteristics should be assessed when evaluating a patient’s pulse?
Rate, rhythm, and strength.
Which breathing pattern is associated with diabetic keto-acidosis?
Kussmaul breathing
Which low-pitched, coarse, snoring sound may lessen or clear after a patient coughs?
Rhonchi
Why should the RT compare corresponding areas on the right and left sides of the chest during palpation and percussion?
To identify asymmetry, which may suggest an abnormality affecting one side of the thorax or lung
What brief, fine popping sound may be heard late in inspiration when small peripheral airways suddenly open?
Fine Crackles
Why is assessing a patient’s level of consciousness important during a physical assessment?
BEST: It helps assess cerebral perfusion and oxygenation.
ACCEPTABLE: It establishes the patient’s neurologic baseline and helps detect changes in condition
Which three body sites are typical locations for measuring temperature?
Oral, rectal, and axillary.
Which artery is the best location for checking a pulse in a patient with very low blood pressure?
The femoral artery.
Which three conditions can contribute to bradypnea: hypothermia, narcotic overdose, head injury, or infection?
Hypothermia, narcotic overdose, and head injury
Which two heart sounds make up the normal “lub-dub” heard during cardiac auscultation?
S1 and S2
What does thoracic percussion help the RT assess?
The density or air content of tissue beneath the chest wall; it can assess structures about 5–7 cm below the chest wall
How does a pulse oximeter estimate SpO₂, and why does it need a pulsating arterial blood-flow signal?
It uses red and infrared light and the arterial pulse signal to estimate oxygen saturation.
You enter a room and immediately recognize that a patient is in respiratory distress. What should you do first?
Quickly evaluate the problem and intervene or get help as needed.
What is the main advantage of tympanic thermometry compared with more traditional methods?
It is fast, clean, and noninvasive.
In a patient with lung disease, what oxygenation problem commonly contributes to tachycardia?
Hypoxemia
How can you accurately count the respiratory rate of an alert patient without causing the patient to change their breathing pattern?
Pretend to count the pulse while observing chest or abdominal movement; count for 30 seconds and multiply by 2.
Which high-pitched sound suggests upper-airway narrowing and is often most prominent during inspiration?
Stridor
What type of percussion sound would you expect over an area with increased density, such as fluid or consolidated tissue?
Dullness
Which physical-assessment technique allows the RT to identify visible chest shape, chest-wall movement, accessory-muscle use, retractions, and skin color?
Inspection