Blood pressure is the least useful vital sign in adults due to its variability and dependence on multiple factors.
Blood pressure is the vital sign that is least useful in adults. While changes in blood pressure can indicate certain medical conditions, it is a measure that can fluctuate based on various factors, sometimes making it less reliable than other vital signs like heart rate or body temperature.
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Answer:
Option B, capillary refill
Explanation:
Capillary refill is a test performed in the routine head-to-toe assessment of a patient in which the nail beds of the digits of their hands and feet are compressed (as well as the palmar and plantar surfaces, respectively), causing the underlying skin to slightly blanch before returning to its expected pinkish hue. The idea is that this quick physical examination can effectively provide insight into how well the patient's extremities are perfusing blood and oxygen without the use of equipment. The expectation is that the patient's hue will return within 3 seconds, indicating sufficient perfusion.
However, in comparison to the other choices of skin color, pupillary reaction, and blood pressure, capillary refill's validity can be fairly subjective to external factors, and does not provide as much information for the patient's condition. Capillary refill can be obstructed by the presence of polished or artificial nails. The room temperature and patient age could also affect the capillary refill. If the patient is dehydrated, this can affect capillary refill results as well.
Further, observing skin color and turgor can also provide the same information about perfusion. The skin is the biggest organ of the human anatomy, so if the patient is experiencing difficulty perfusing blood and oxygen or has significant blood loss, their skin will tell the tale; cyanotic, non-blanchable, or pale (pallor) can evidence some of the same, if not more, conditions relating to hypoperfusion.
Pupillary reaction can be used to suggest cranial nerve dysfunction, strokes, ingestion/consumption of substances, presence of certain lesions (e.g. tumors), and more. It is more important because such indications and potential rule-outs.
Finally, blood pressure is one of the most most important vital signs. Blood pressure can help determine life-saving diagnoses. If the patient has significant blood loss (e.g. hypovolemic shock), blood pressure compared to the patient's baseline or the expected range can aid in determining just how much blood and fluid resuscitation the patient will require. If the patient is experiencing anxiety and healthcare professionals want a way to quantify and document evidence of it, the blood pressure can communicate it. The blood pressure provides better insight as to what is happening with the heart than capillary refill; and a rudimentary complete kit with manual sphygmomanometer (blood pressure cuff and gauge) and stethoscope are fairly inexpensive for the quick and essential information they can provide.
For these reasons, the least useful vital sign is capillary refill, option B.
