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Vital signs

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  • 1. What 3 body processes do vital signs reflect?
  • 2. When: PE admission per pt. conditions surgery dx. tests falls/injuries certain medications- BP meds, heart meds complaints as ordered- q4 hours, etcTake: sitting or layingRecord : on graphic sheets A very important indicator of health of body
  • 3.  Measurement of amt of heat in body Balance b/t heat lost & created Created when body changes food to energy Lost from the body to the environment by: ◦ Contact ◦ Perspiration ◦ Breathing
  • 4. ◦ Time of day◦ Age◦ Weather◦ Exercise◦ Emotions◦ Stress◦ Illness◦ Pregnancy◦ Menstrual cycle
  • 5.  Glass- break easy, clean Electronic-disposable covers Digital Chemically treated paper Tympanic
  • 6.  You need to take a temperature on a 85 year-old male with dementia. He is very confused and sometimes resists care. Which is the best site to take his temperature?
  • 7.  Taken: * PO-mouth * Axillary * Rectal * Tympanic * Forehead
  • 8.  PO: do not take if:  Rectal: ◦ < 6 years old  used if PO not optional ◦ Unconscious  DO not use if: ◦ OR to neck/mouth ◦ Diarrhea ◦ Rectal disorders ◦ On O2 ◦ Rectal OR ◦ Confused ◦ Confusion ◦ Paralyzed on 1 side ◦ Head trauma ◦ *If smoke, eat or drink ◦ * Must hold in place wait 15-20 minutes
  • 9.  Axillary:  Glass thermometers: ◦ Not as realible ◦ Easy to use on children  If broken follow ◦ Can’t be diaphoretic guidelines- can cause (sweaty) problems if they have mercury in it
  • 10. Route Normal range Time (take for)Rectal 98.6 - 100.6 2 minutesPO 97.6 - 99.6 2-3 minutesTympanic 98.6 Until beepsAxillary 96.6 – 98.6 5-10 minutes
  • 11. a. 100.3 Rb. 100.1 tympanicc. 97 Ax.d. 100.5 PO
  • 12.  Answer- 100.5 po
  • 13. a. Read thermometer after 30 secondsb. Use plastic covers to reduce the spread of germsc. Sterilize after each used. Place just the tip of the tympanic thermometer in the ear
  • 14.  Answer: B
  • 15.  Take your own oral temp.- read thermometer Take your partners- temperature with the tympanic and forehead thermometer
  • 16. Number of heart beats/minuteNormal range- 60-100/minuteCheck rate, rhythm and strength/force
  • 17.  Radial- Brachial- Carotid- Dorsalis pedis-
  • 18.  Body temperature Exercise Emotions Heat Position Pain Drugs
  • 19.  A. coma B. fever C. sleep D. depressant drugs
  • 20.  Answer: B. fever
  • 21.  Feel for: Rhythm-regular, irregular Force- weak, strong Use 2 fingers not thumb
  • 22.  Abnormal force:  Abnormal rhythm: ◦ Bounding/ strong ◦ Skipping beats -Weak/thready/feeble ◦ Not evenly spaced apart Abnormal rate: -bradycardia < 60/minute Tachycardia> 100
  • 23.  Inhaling & exhaling  Counting # breaths/minute respirationsNormal Rate: ◦ 12-20/minute –Adult  1 inhale & exhale= 1 ◦ Quiet, effortless respiration
  • 24.  Rate:  Character: Bradypnea- < 10  Labored Tachypnea > 24  Noisy  Shallow  irregular
  • 25.  Hypoventilation-slow Normal= 12- & shallow 20/minute  Hyperventilation: rapid Tachypnea= >24/min & deep Bradypnea=< 10/min  Dyspnea: difficulty Apnea= no breathing breathing  Cheyne –stokes: irregular breathing  Cyanosis-
  • 26.  Controlled by: Definition: amount of force exerted against  1. Force of heart contraction the walls of an artery  2. Amt. Of blood pumped by blood with each heart beat  3. Ease of blood flowing through the vessels
  • 27. Heart 1st soundSystole Contracts HeardDiastole Heart 2nd sound resting heard
  • 28.  Normal: 120-90 80-60Hypertension= high BP > 120/80Hypotension= low BP < 90/60
  • 29. *Age- increase c age *Wgt.- obese/overwgt.*Sex- higher in male increases*Blood volume *Race- higher in blacks*Stress *Diet- increase c NA,*Pain*Exercise- caffiene increase during *Position decrease overall *Smoking- raises BP *Alcohol- raises BP
  • 30.  Don’t take immediately after exercise Check position dr. wants BP taken in- sitting, laying, standing Put cuff on bare arm Make sure cuff fits properly Place diaphragm over brachial pulse site Reduce noise Make sure you can see sphygmomanometer Keep arm at heart level, palm up
  • 31.  Find radial pulse, inflate cuff until you can’t feel pulse, deflate cuff then pump up 30mm/hg more If unsure of BP recheck in 30-60 seconds If still unsure ask someone to verify Use arm only 2x, then use other arm
  • 32.  Do not take BP in arm if pt has had: *mastectomy on that side *had recent blood draw in that arm *paralyzed on that side *has IV in that arm
  • 33.  Stethoscope Sphygmomanometer ◦ Aneroid ◦ Electronic ◦ Mercury
  • 34.  You need to take routine vital signs on a nursing home resident. The pt. tells you that her husband just left & she is very upset b/c they had an argument. She tells you “I just need to get up & walk around for awhile, I am so angry at him.” What should you do?
  • 35.  How can you apply an awareness of vital signs & other health indicators to your everyday life & the lives of those around you? Compare/contrast the types of thermometers, which is easiest to use? You have just measured a pt. vital signs & it doesn’t seem normal to you. What should you do? Why & how should health care workers be sensitive & provide privacy for a pt. when taking & recording body measurements?