HOMEWORK HELP Please help!?!

Sour Lemon · Jul 2, 2018

What are your thoughts about each question?

RandomNurse2b1 · Jul 2, 2018

Well... I'm new to learning vital signs so, I have thoughts but, I'm not sure if they are correct.

Sour Lemon · Jul 2, 2018

Well... I'm new to learning vital signs so, I have thoughts but, I'm not sure if they are correct.

Do share.

RandomNurse2b1 · Jul 2, 2018

Okay!

1) The patient's temperature is probably high due to her clothing or temperature outdoors or inside the building.

2) The athlete has a slower than normal pulse rate from routinely exercising.

3) blood pressure, respiration, and pulse.

Sour Lemon · Jul 2, 2018

Okay!
1) The patient's temperature is probably high due to her clothing or temperature outdoors or inside the building.
2) The athlete has a slower than normal pulse rate from routinely exercising.
3) blood pressure, respiration, and pulse.

That sounds reasonable, to me. The elevated temperature lady might also have had warm food or drink recently. Damn Starbucks.

KrCmommy522, BSN, RN · Jul 2, 2018

That sounds reasonable, to me. The elevated temperature lady might also have had warm food or drink recently. Damn Starbucks.

When I first learned vitals this was something they really stressed at my school. They couldn't say it enough to check to see if someone had just drank/eaten something warm or cold and to be sure to wait 15 min if they had so it didn't affect the temp.

RandomNurse2b1 · Jul 2, 2018

Oh yes! I remember reading in my textbook that you have to ask the patient if they eat, drink or smoke in the last 30 minutes before taking their temperature now it makes sense to me .

KrCmommy522, BSN, RN · Jul 2, 2018

Oh yes! I remember reading in my textbook that you have to ask the patient if they eat, drink or smoke in the last 30 minutes before taking their temperature now it makes sense to me .

Yep! I think that's what you're instructor is probably looking for. But, of course, it could also be clothing or temp outside or in the building. So, you can also include that. But, my best guess would be that what the instructor is really looking for is you saying something about the pt eating/drinking something warm, chewing gum, or smoking within the last 30 min could cause pts oral temp to increase. Cold drinks/food obviously REDUCE oral temp, hot drinks/food obviously INCREASE oral temp, I believe chewing gum and smoking INCREASE oral temp? Someone correct me if I'm wrong.

But, I know I will NEVER forget about checking if pt has eaten anything, drank anything, smoked, or chewed gum before VS and if so, waiting - my school DRILLED it into our heads! Lol! But, you can always get axillary temp!

Oh, no smoking or drinking coffee 30 mins before taking BP - that was also drilled into our heads!

RandomNurse2b1 · Jul 2, 2018

Did you read my answers to my other questions? what are your thoughts on those?

Mavrick, BSN, RN · Jul 2, 2018

I'm completing an assignment for one of my nursing classes. (Introduction to healthcare). I'm stuck on these three questions, I answered the rest of them. Could anyone help me and explain why? So, I can learn.
1. Your patient comes in for a routine physical examination with no complaints. You notice that her temperature is 100.6 F. What could be the reason for the elevated temperature?
2. Why does a well-conditioned athlete have a slower than normal pulse rate?
3. Your patient sits down in the chair to have her vital signs taken. She appears to be out of breath. She states that it has started to rain, and she had to run across the parking lot.
Which of her vital signs readings would you expect to be abnormal?

What I hate about this question is the ambiguity of "normal". What is normal for a person who has just sprinted across a parking lot? HR of 110? RR of 30?

Patients are always asking me if their HR or B/P or temperature is "normal" and I always have to ask "Do you know what is normal for you?" I can give you a number but depending on the situation it may not be at all normal for you to have a B/P of 92/55. Then again that might be perfectly normal for you.

KrCmommy522, BSN, RN · Jul 3, 2018

Did you read my answers to my other questions? what are your thoughts on those?

Yes, I did read those. Sorry, I should have said that in my first post. I agree with Sour Lemon that the answers are good.

Question 2: You are correct. Your heart is just like any other muscle, so it gets stronger with exercise. So, if you participate in regular cardiovascular exercise, your heart gets stronger, becomes more efficient, and, as a result, beats slower. It doesn't have to beat as fast as someone else's heart who isn't as fit.

Question 3: You are correct, except, temp can also increase after exercise. This is asking what you would EXPECT to be abnormal! Running puts extra demand on the cardiovascular system, which means your muscles need more oxygen than if you were at rest, so you breathe more quickly - which means increased respiratory rate would be EXPECTED. As a result of your muscles needing more oxygen, your heart starts to pump harder and faster to get blood to deliver oxygen to your muscles - which means a faster HR would be EXPECTED, and also means a higher systolic BP would be EXPECTED. Exercise, like running, increases the systolic BP because the systolic BP measures BP when the heart is beating. Diastolic BP, on the other hand, measures pressure in the blood vessels BETWEEN heart beats. You also EXPECT the temperature to increase after exercise because the muscles create heat energy, which raises body temp.

Here's some extra random information about this, probably more than you need but it will probably help you anyways! :)

The biggest changes from exercise (like running) occurs in the cardiovascular system. Within a few seconds of starting to exercise, there is increased demands on the body. These demands have to be compensated by alterations in the cardiovascular system. If you were exercising for a longer time (not just running in a parking lot), the body would need to work harder to prolong the exercise. The changes that occur in the cardiovascular system during exercise are all related - they let the body meet those increased demands from the increased workload on the body. Many of the different parts of the cardiovascular system work together to achieve this. These include HR, stroke volume, cardiac output, blood flow, BP, and distribution of blood flow.

A resting HR in a normal, healthy person is 60 - 100 bpm. However, "normal" differs with each person based on how healthy each person is. If someone lives a sedentary lifestyle, there resting HR may be closer to 100, while an athlete may have a really low HR (as low as 40 even) because their hearts are trained to pump blood efficiently - there hearts are very efficient in ejecting blood with each beat. So, if someone had a HR of 42 for example, if they were an athlete, you wouldn't think twice. However, if they lived a sedentary lifestyle, you would need to be concerned!! So, as you see, what is "normal" for one, is not "normal" for all. So, in response to exercise (like running), the body responds, and the HR rises. The speed of the HR increases based on the increased workload.

Like HR, stroke volume also increases during exercise. Stroke volume is the amount of blood that is ejected from the heart with each beat. If someone is not a trained athlete, their stroke volume will not increase quite as high as a trained athlete. As I said before, a trained athlete's heart is very efficient in ejecting blood with each beat, so during exercise they will have a higher stroke volume than someone who is not a trained athlete.

Cardiac output is the amount of blood pumped by the heart per minute (CO = HR x SV). At rest, CO is about 4 - 5 L/min. During exercise, an untrained athlete's CO will not increase as much as a trained athlete's.

During exercise, the distribution of blood flow changes. There is increased blood flow to skin to help increase heat loss to maintain the body's temp, increased blood flow to muscles, decreased blood flow to visceral organs so more blood volume is in active circulation, decreased renal blood flow, decreased filtration, increased blood volume, etc. During rest, a large amount of blood volume is in the venous system. When someone starts exercising, a lot of blood is ejected from the venous system into the active circulation as a result of vasoconstriction in the venous system.

Now, BP is CO x peripheral resistance. Total peripheral resistance is the resistance to blood flow in the vascular system. Total peripheral resistance INCREASES with vasoconstriction and DECREASES with vasodilation. As I said before, with exercise, there is a lot of vasoconstriction in the vessels. However, peripheral resistance actually DECREASES during exercise because of the massive vasodilation that occurs in the vessels that are supplying the skeletal muscles that are working hard during exercise. One would think that because of massive vasodilation, BP would decrease. But, even though there is an overall decrease in peripheral resistance, the increase in CO is enough to cause BP to increase. Increased BP is important during exercise to meet the increased demand on the musculoskeletal system. Similar to HR, systolic BP rises steadily with exercise. Little change occurs in diastolic BP. When exercise is stopped, systolic BP should go back to normal pretty easily.

Exercising causes the muscles to warm up. Your body regulates body temp by perspiration and respiration. Your muscles need a steady flow of energy in order to continue working. When your muscles make energy, heat is created. Your body works hard to regulate this temp change and keep it within a safe range. When exercising, muscles quickly deplete the energy that is stored up. In order to make more energy, muscles combine oxygen with ATP. A byproduct of this process is heat energy is created. This extra heat increases the body temp, so the body needs to eliminate heat as quickly as possible. The body's temp sensors alert the hypothalamus that body temp is increasing, and the body takes action to begin lowering it to keep it at a safe temp.

Hope this helps you!!