Vital Signs 1
What are four main vital signs that should recorded in acute care settings?
Pulse or Heart Rate, Blood Pressure, Respiratory Rate, and Pulse Oximetry
What is the standard weight-bearing precaution for a patient with a total hip replacement (posterior approach)?
No hip flexion past 90 degrees, no internal rotation, and no adduction
Tachycardia is heart rate >100bpm
What is the normative range for heart rate at rest?
60-100 beats per minute
A patient's blood glucose level is 65 mg/dL; what does this indicate?
A blood glucose level of 65 mg/dL is at the low end of normal (pre-hypoglycemia). It can cause weakness, confusion, and fatigue
Pulse Oximetry is the measurement of what?
How is the measurement documented?
Pulse oximetry measures blood oxygen saturation and is documented as SpO2.
A patient with a C6 spinal cord injury is beginning a dressing session. What is the primary precaution to consider regarding their blood pressure regulation?
Be aware of orthostatic hypotension. Gradually transition the patient to an upright position and monitor for dizziness or nausea.
What is dyspnea?
Shortness of breath
During a sit-to-stand transfer, your patient's heart rate jumps from 75 bpm to 125 bpm. What should you do?
Stop the activity, have the patient sit, check for dizziness or shortness of breath, and monitor recovery. If symptoms persist, notify the medical team.
What is the relevance of a high white blood cell count (WBC), such as 15,000 cells/mm³
An elevated WBC count suggests infection or inflammation, which may result in fever, fatigue, and decreased activity tolerance.
What is the normative range for peripheral body temperature?
97°-99°F
A post-stroke patient has unilateral neglect and a hemiparetic arm. What precaution should be followed to prevent injury?
Ensure proper arm support to prevent subluxation and teach positioning to avoid neglect.
What does MAP stand for and what does it measure?
MAP=Mean Arterial Pressure: measures the average pressure of blood in the arteries during a cardiac cycle-it indicates perfusion to vital organs.
What are the blood pressure values for hypotension?
SBP <90mmHg
DBP <mmHg
or MAP <65mmHg
A patient has a blood glucose level of 250 mg/dL before therapy. Why is this a concern?
Hyperglycemia. It can cause fatigue, dehydration, and impaired wound healing.
When should vital signs be assessed?
At rest to determine readiness for rehab sessions, during interventions to assess the response to activity or recovery during and after activity cessation.
Further assessment should occur with clinical judgment (symptoms of dizziness, dyspnea, etc).
A patient with a new sternal precaution should avoid which common functional movement when rising from bed?
Using their arms to push up (no pushing, pulling, or lifting more than 5-10 lbs). Instead, use the "log roll" technique.
What is peripheral neuropathy?
Damage to the peripheral nerves, causing numbness, tingling, or weakness, often in the hands and feet
A patient’s blood pressure drops from 120/80 to 90/60 mmHg after standing. What is your next step?
Have the patient sit back down, elevate their legs, provide hydration if appropriate, and reassess before resuming activity.
Your patient has an SpO₂ level of 88% while at rest. What should you do before continuing therapy?
Pause therapy, encourage pursed-lip breathing, and allow rest breaks. Check if the patient uses supplemental oxygen
What are five factors that affect vital signs?
Age, time of day, gender, environment, exercise, food/liquids, smoking, stress, comorbidities/disease, position, pain, agitation/delirium, hormones, and lab values.
A patient with a thoracic-lumbar spinal fusion is learning how to perform toileting tasks independently. What movement should they avoid, and what strategy should the OT recommend?
Avoid bending, lifting, and twisting (BLT). Use a reacher or tongs for hygiene, and recommend a raised toilet seat to maintain neutral spine alignment.
Define perseveration.
Repetitions of a word, phrase, or gesture after they are no longer appropriate.
What are the systolic blood pressure indications to end activity?
Decrease in SBP > 20mmHg from initial BP assessed, SBP >250mmHg or DBP >120 mmHg.
A patient’s hemoglobin (Hgb) is 19 g/dL. What does this indicate, and what precautions should OT take?
Elevated hemoglobin suggests dehydration or a risk of clot formation. OT should monitor for signs of dizziness, headaches, or high blood pressure and avoid excessive exertion.