Vital signs

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  • BP
    • Supine
    • Orthostatic (after standing for 2-3 minutes)
    • Assess and compare with previous BP
    • Pulsus paradoxus
      • A sign of cardiac tamponade
      • May be caused by uremic pericarditis
      • The examiner inflates the sphygmomanometer cuff fully, listens for Korotkoff sounds as the cuff is slowly deflated, and then notes the pressure at which Korotkoff sounds are initially audible only during expiration. As the cuff is further deflated, the examiner notes the pressure at which Korotkoff sounds become audible during expiration and inspiration. The difference between these 2 pressures is the pulsus paradoxus. In cardiac tamponade, the pulsus paradoxus measures greater than 10 mm Hg.
      • Does This Patient With a Pericardial Effusion Have Cardiac Tamponade?
  • TPR
    • Temperature (oral, ear, axillary, anal)
    • Pulse rate (60-100/minute)
    • Respiratory rate (12-20/minute)
      • Dyspnea
        • A subjective symptom
        • Use of accessory muscles?
        • Supraclavicular or intercostal retraction?
      • Tachypnea (>20/minute)
      • Kussmaul respiration (air hunger, hyperventilation)
      • ~Cheyne-Stokes respiration
    • Paradoxial respiration