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
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
◦ Time of day◦ Age◦ Weather◦ Exercise◦ Emotions◦ Stress◦ Illness◦ Pregnancy◦ Menstrual cycle
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
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
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
a. 100.3 Rb. 100.1 tympanicc. 97 Ax.d. 100.5 PO
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
Normal: 120-90 80-60Hypertension= high BP > 120/80Hypotension= low BP < 90/60
*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
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
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
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
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?
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?