Health Assessment

Module 2 – Vital Signs and Pain Assessment Key Terms

Vital Signs
apnea Temporary cessation of breathing.
bradycardia HR < 60. (adult).
bradypnea Abnormally slow breathing
Cheyne-Stokes Irregular pattern of breathing, characterized by shallow breaths followed by
deep breaths that fall off rapidly, followed by apnea, then repeats. Sometimes
seen with CHF.
diastolic pressure The elastic recoil, or resting, pressure that the blood exerts constantly between
each contraction.
diurnal rhythm A daily cycle of peak and trough: the BP climbs to a high in the late afternoon
or early evening and then declines to an early morning low.
eupnea Normal respiration.
hyperthermia Fever. Caused by pyrogens secreted by toxic bacteria during infection or from
tissue breakdown such as that following myocardial infarction, trauma,
surgery, or malignancy.
hypothermia Usually due to accidental prolonged exposure to cold.
mean arterial pressure The pressure forcing blood into the tissues, averaged over the cardiac cycle.
orthostatic A drop in systolic pressure of more than 20 mm Hg, or pulse increase of 20
hypotension bpm or more occurs with a quick change to a standing position. Due to abrupt
peripheral vasodilatation without a compensatory increase in cardiac output.
Also occurs with prolonged bed rest, older age, hypovolemia, and some drugs.
pulse The pressure wave felt on the arterial walls as the heart beats and pumps blood
into the aorta. Gives the rate and rhythm of the heartbeat.
pulse pressure The difference between the systolic and diastolic and reflects the stroke
volume.
rate Referring to the pulse: normal = 60-100bpm. More rapid in children and more
moderate during adult and older years. Varies with gender, females faster after
puberty.
rhythm Referring to the pulse: normally has an even tempo.
sphygmomanometer Instrument used to measure blood pressure.
sinus arrhythmia The heart rate varies with the respiratory cycle, speeding up at the peak of
inspiration and slowing to normal with expiration.
symmetry The same on both sides.
systolic pressure The maximum pressure felt on the artery during left ventricular contraction.
tachycardia HR > 100 (adult). Fever, sepsis, myocardial infarction.
tachypnea Abnormally fast breathing.
tympanic membrane Measures the core temperature by sensing the infrared emissions of the
thermometer tympanic membrane.
 Pain Assessment
acute pain Short term and self limiting, follows a predictable trajectory, and goes away
after the injury heals.
chronic pain Persistent. Pain continues for 6 months or longer. Does not stop when the
injury heals.
cutaneous pain Comes from the skin surface and subcutaneous tissues. Injury is superficial,
with a sharp burning sensation.
deep somatic pain Comes from blood vessels, joints, tendons, muscles, and bone. Injury may
result from pressure, trauma, or ischemia.
modulation Fourth phase of nosiception: pain message is inhibited. (analgesic effect).
neuropathic pain A type of pain that does not adhere to the typical and predictable phases
inherent in nociceptive pain – abnormal processing of the pain message.
Difficult to assess and treat. Pain can be perceived long after a wound has
healed.
nociception Describes how noxious stimuli are typically perceived as pain.
1. Transduction
2. Transmission
3. Perception
4. Modulation
Nociceptors: Specialized nerves that detect painful sensations from the
periphery and transmit them to the central nervous system. Located in the skin,
connective tissue, muscle, and thoracic, abdominal and pelvic viscera.
pain assessment tools More useful for chronic conditions or particularly problematic acute pain
problems.
1. Initial Pain Assessment – patient answers 8 questions concerning
location, durations, quality, intensity, and aggravating/relieving
factors.
2. The Brief Pain Inventory – asks the patient to rate the pain within the
last 24 hours using graduated scales (0-10) with respect to its impact
on areas such as mood, walking ability, and sleep.
3. McGill Questionnaire – patient ranks a list of descriptors in terms of
their intensity and to give an overall intensity rating to his or her pain.
perception Third phase of nosicieption. The conscious awareness of a painful sensation.
referred pain Pain that is felt at a particular site but originates from another location.
reflexive sympathetic A chronic progressive nerve condition characterized by burning pain, swelling,
dystrophy (RSD) stiffness, and discoloration of the affected extremity. Affects men and women
aged 40-60. Occurs weeks to months after a nerve injury. Neuropathic “wind
up” or “short circuit”
transduction First phase of nosiception. Occurs when a noxious stimulus in the form of
traumatic or chemical injury, burn, incision, or tumor takes place in the
periphery.
transmission Second phase of nosiception. The pain impulse moves from the level of the
spinal cord to the brain.
visceral pain Originates in the organs.