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VITAL SIGNS Tanya Napoli, RN BSN
<ul><li>Discuss the physiologic processes that affect temperature, pulse, respirations, and blood pressure. </li></ul><ul>...
<ul><li>A person’s temperature, pulse, respirations, and blood pressure comprise vital signs. </li></ul><ul><li>The nurse/...
<ul><li>The heat of the body measured in degrees. </li></ul><ul><li>Normal core body temperature ranges from 36.0 C to 37....
<ul><li>Factors affecting body temperature </li></ul><ul><ul><li>Circadian rhythms </li></ul></ul><ul><ul><li>Age </li></u...
<ul><li>A patient with a  normal body temperature  is considered  afebrile. </li></ul><ul><li>An increase in body temperat...
<ul><li>Interventions to reduce fever </li></ul><ul><ul><li>Administration of antipyretics (aspirin or acetaminophen) </li...
<ul><li>Equipment – types of thermometers </li></ul><ul><ul><li>Electronic/digital  </li></ul></ul><ul><ul><li>Tympanic me...
<ul><li>Assessment sites </li></ul><ul><ul><li>Sublingual </li></ul></ul><ul><ul><ul><li>Surface temperature </li></ul></u...
<ul><li>Assessment site </li></ul><ul><ul><li>Rectal </li></ul></ul><ul><ul><ul><li>Core temperature, most accurate </li><...
<ul><li>A throbbing sensation that can be palpated over a peripheral artery or auscultated over the apex of the heart (the...
<ul><li>Tachycardia  – pulse rate of 100 to 180 beats per minute, sustained tachycardia will eventually lead to decreased ...
<ul><li>Pulse amplitude refers to the quality of the pulse and is indicative of left ventricular strength. </li></ul><ul><...
<ul><li>Assessment sites </li></ul><ul><ul><li>Apical pulse is assessed over the apex of the heart using a stethoscope. </...
<ul><li>A .  Exercise -  increased activity- heartbeat increases 20-30 beats per minute to meet the body’s needs.  It shou...
<ul><li>Radial - thumb side, inner surface of wrist. </li></ul><ul><li>Brachial - (antecubital)inner medial surface </li><...
<ul><li>A respiratory cycle involves both inspiration and expiration. </li></ul><ul><ul><li>The number of complete cycles ...
<ul><li>Tachypnea  – refers to a rapid respiratory rate, usually shallow in depth. </li></ul><ul><ul><li>Caused by increas...
<ul><li>A measurement of the force of the blood against the arterial walls. </li></ul><ul><li>Systolic pressure  – measure...
<ul><li>The sounds heard during blood pressure assessment are called Korotkoff sounds. </li></ul><ul><ul><li>The first sou...
<ul><li>Peripheral resistance describes the resistance to blood flow resulting from the arterioles always being partially ...
<ul><li>Cardiac output has a direct effect on blood pressure. </li></ul><ul><ul><li>Cardiac output is equal to the stroke ...
<ul><li>A “normal blood pressure” is less than 120/80 mm Hg. </li></ul><ul><ul><li>There is a wide range of normal, theref...
<ul><li>Hypotension  – below normal blood pressure </li></ul><ul><ul><li>May be normal </li></ul></ul><ul><ul><li>May be p...
<ul><li>Manual blood pressure is assessed with a stethoscope and sphygmomanometer. </li></ul><ul><ul><li>Accurate readings...
 
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Transcript of "Vital signs power point black module"

  1. 1. VITAL SIGNS Tanya Napoli, RN BSN
  2. 2. <ul><li>Discuss the physiologic processes that affect temperature, pulse, respirations, and blood pressure. </li></ul><ul><li>Identify alterations in vital signs. </li></ul><ul><li>Educate patients/family members about assessing vital signs at home. </li></ul>
  3. 3. <ul><li>A person’s temperature, pulse, respirations, and blood pressure comprise vital signs. </li></ul><ul><li>The nurse/MA is responsible for reporting accurate vital sign data and any abnormal readings . </li></ul><ul><li>Frequency of vital sign assessment is dependent upon institutional policy and the patient’s condition. </li></ul>
  4. 4. <ul><li>The heat of the body measured in degrees. </li></ul><ul><li>Normal core body temperature ranges from 36.0 C to 37.5 C (97.0 F to 99.5 F). </li></ul><ul><li>Maintained by the thermoregulatory center in the hypothalamus </li></ul><ul><li>Body’s primary heat source is metabolism – heat is a byproduct of cellular activity </li></ul><ul><li>Body heat is lost primarily via the skin. </li></ul>
  5. 5. <ul><li>Factors affecting body temperature </li></ul><ul><ul><li>Circadian rhythms </li></ul></ul><ul><ul><li>Age </li></ul></ul><ul><ul><li>Gender </li></ul></ul><ul><ul><li>Environmental temperature </li></ul></ul><ul><ul><ul><li>Hypothermia – body temperature below 36.0 C </li></ul></ul></ul><ul><ul><ul><li>Hyperthermia – body temperature above37.5 C, not related to fever </li></ul></ul></ul>
  6. 6. <ul><li>A patient with a normal body temperature is considered afebrile. </li></ul><ul><li>An increase in body temperature due to illness or trauma is called a fever. </li></ul><ul><ul><li>A patient with a fever is considered febrile . </li></ul></ul><ul><ul><li>Onset may be sudden or gradual </li></ul></ul><ul><ul><li>Symptoms include shivering, headache, thirst, flushing of the skin, and increased pulse rate. </li></ul></ul>
  7. 7. <ul><li>Interventions to reduce fever </li></ul><ul><ul><li>Administration of antipyretics (aspirin or acetaminophen) </li></ul></ul><ul><ul><li>Cool sponge baths or shower </li></ul></ul><ul><ul><li>Cool packs </li></ul></ul><ul><ul><li>Cooling blankets </li></ul></ul><ul><ul><li>Removing blankets </li></ul></ul><ul><ul><li>Offer/force fluids if not contraindicated </li></ul></ul>
  8. 8. <ul><li>Equipment – types of thermometers </li></ul><ul><ul><li>Electronic/digital </li></ul></ul><ul><ul><li>Tympanic membrane </li></ul></ul><ul><ul><li>Glass </li></ul></ul><ul><ul><li>Disposable </li></ul></ul>
  9. 9. <ul><li>Assessment sites </li></ul><ul><ul><li>Sublingual </li></ul></ul><ul><ul><ul><li>Surface temperature </li></ul></ul></ul><ul><ul><ul><li>Must be able to close mouth around probe </li></ul></ul></ul><ul><ul><ul><li>Need to wait 15 to 30 minutes after drinking or smoking </li></ul></ul></ul><ul><ul><ul><li>Contraindicated? </li></ul></ul></ul><ul><ul><li>Tympanic </li></ul></ul><ul><ul><ul><li>Considered a core temperature </li></ul></ul></ul><ul><ul><ul><li>Easily accessed </li></ul></ul></ul><ul><ul><ul><li>Ear canal must be large enough to accommodate probe </li></ul></ul></ul><ul><ul><ul><li>Contraindicated? </li></ul></ul></ul>
  10. 10. <ul><li>Assessment site </li></ul><ul><ul><li>Rectal </li></ul></ul><ul><ul><ul><li>Core temperature, most accurate </li></ul></ul></ul><ul><ul><ul><li>Uncomfortable for patients </li></ul></ul></ul><ul><ul><ul><li>Contraindicated? </li></ul></ul></ul><ul><ul><li>Axillary </li></ul></ul><ul><ul><ul><li>Surface temperature </li></ul></ul></ul><ul><ul><ul><li>Site of choice for newborns </li></ul></ul></ul>
  11. 11. <ul><li>A throbbing sensation that can be palpated over a peripheral artery or auscultated over the apex of the heart (the apical pulse). </li></ul><ul><li>Pulse rate is the number of pulsations palpated or heard in one minute. </li></ul><ul><li>Normal pulse rate for adolescents and adults is 60 to 100 beats per minute. </li></ul><ul><li>What are some factors that would affect pulse rate? </li></ul>
  12. 12. <ul><li>Tachycardia – pulse rate of 100 to 180 beats per minute, sustained tachycardia will eventually lead to decreased cardiac output. </li></ul><ul><li>Bradycardia – pulse rate below 60 beats per minute. </li></ul><ul><ul><li>Can be normal </li></ul></ul><ul><ul><li>May be related to medications </li></ul></ul><ul><ul><li>When should you be concerned about bradycardia? </li></ul></ul>
  13. 13. <ul><li>Pulse amplitude refers to the quality of the pulse and is indicative of left ventricular strength. </li></ul><ul><li>The rhythm of the pulse is described as regular or irregular. An irregular pulse pattern is referred to as a dysrhythmia . </li></ul><ul><li>A pulse deficit occurs when the apical pulse and peripheral pulses do not match. </li></ul>
  14. 14. <ul><li>Assessment sites </li></ul><ul><ul><li>Apical pulse is assessed over the apex of the heart using a stethoscope. </li></ul></ul><ul><ul><ul><li>Count for a full 60 seconds. </li></ul></ul></ul><ul><ul><ul><li>Necessary when giving certain medications, such as digoxin </li></ul></ul></ul><ul><ul><ul><li>PMI- Point of maximal impulse- Mitral Valve/Bicuspid </li></ul></ul></ul><ul><ul><li>Peripheral pulse can be palpated over several arteries. </li></ul></ul><ul><ul><ul><li>When would it be important to palpate a pedal pulse? </li></ul></ul></ul>
  15. 15. <ul><li>A . Exercise - increased activity- heartbeat increases 20-30 beats per minute to meet the body’s needs. It should return to normal 3 minutes after activity has stopped. </li></ul><ul><li>B. Age - the younger you are, the faster the rate. </li></ul><ul><li>C. Sex - females; 10 bets per minute more rapid than a man. </li></ul><ul><li>D. Physical Condition of the body- athletes slower, as a result of a more efficient circulatory system. </li></ul><ul><li>*** Heart rate increases when the sympathetic nervous system is stimulated by feelings such as; anxiety, fear, pain or anger. </li></ul>
  16. 16. <ul><li>Radial - thumb side, inner surface of wrist. </li></ul><ul><li>Brachial - (antecubital)inner medial surface </li></ul><ul><li>of elbow. </li></ul><ul><li>- you can palpate and ausculate to listen to the BP. </li></ul><ul><li>Carotid – neck ( either side of the trachea ) </li></ul><ul><li>Femoral - midway in groin </li></ul><ul><li>Dorsalis Pedis- instep of foot </li></ul><ul><li>Popliteal - back of the knee </li></ul>
  17. 17. <ul><li>A respiratory cycle involves both inspiration and expiration. </li></ul><ul><ul><li>The number of complete cycles per minute comprise the respiratory rate. </li></ul></ul><ul><ul><li>Normal rate is 12 to 20 cycles per minute. </li></ul></ul><ul><ul><li>What are some factors that affect respiratory rate? </li></ul></ul><ul><li>Depth and rhythm are also assessed </li></ul><ul><ul><li>Depth of respirations varies from shallow to deep. </li></ul></ul><ul><ul><li>Normal respirations have a regular rhythm. </li></ul></ul>
  18. 18. <ul><li>Tachypnea – refers to a rapid respiratory rate, usually shallow in depth. </li></ul><ul><ul><li>Caused by increased metabolic demand </li></ul></ul><ul><li>Bradypnea – refers to a decrease in respiratory rate. </li></ul><ul><ul><li>May have a pathological cause or can be a side effect of certain medications </li></ul></ul><ul><li>Apnea – refers to periods without respirations. </li></ul><ul><li>Dyspnea – refers to difficult or labored respirations </li></ul>
  19. 19. <ul><li>A measurement of the force of the blood against the arterial walls. </li></ul><ul><li>Systolic pressure – measurement of the force on the arterial walls as the left ventricle contracts. </li></ul><ul><li>* Heart Contracting- Top Number </li></ul><ul><li>Diastolic pressure – measurement of the force on the arterial walls as the left ventricle relaxes. </li></ul><ul><li>* Heart Relaxing- Bottom Number </li></ul><ul><li>Pulse pressure – the difference between the systolic an diastolic pressure. </li></ul>
  20. 20. <ul><li>The sounds heard during blood pressure assessment are called Korotkoff sounds. </li></ul><ul><ul><li>The first sound (or beat) represents the systolic pressure. </li></ul></ul><ul><ul><li>A change in or cessation of the loud, distinct sounds represents the diastolic pressure. </li></ul></ul>
  21. 21. <ul><li>Peripheral resistance describes the resistance to blood flow resulting from the arterioles always being partially contracted. </li></ul><ul><ul><li>This allows continuous flow of blood into the capillaries. </li></ul></ul><ul><ul><li>The elasticity of the artery walls combined with arteriole resistance helps maintain normal blood pressure </li></ul></ul><ul><li>Blood pressure is also affected by several hormonal and humoral mechanisms as the body attempts to maintain homeostasis. </li></ul>
  22. 22. <ul><li>Cardiac output has a direct effect on blood pressure. </li></ul><ul><ul><li>Cardiac output is equal to the stroke volume times the heart rate. </li></ul></ul><ul><ul><li>An increased cardiac output results in increased blood pressure. </li></ul></ul><ul><ul><li>Conversely, blood pressure decreases as cardiac output decreases. </li></ul></ul>
  23. 23. <ul><li>A “normal blood pressure” is less than 120/80 mm Hg. </li></ul><ul><ul><li>There is a wide range of normal, therefore baseline readings are critical. </li></ul></ul><ul><ul><li>An elevation or fall or 20 to 30 mm Hg is significant. </li></ul></ul><ul><li>Hypertension is sustained blood pressure above normal. </li></ul><ul><ul><li>Major risk factor for heart disease and stroke </li></ul></ul>
  24. 24. <ul><li>Hypotension – below normal blood pressure </li></ul><ul><ul><li>May be normal </li></ul></ul><ul><ul><li>May be pathologic </li></ul></ul><ul><ul><li>When should you be concerned? </li></ul></ul><ul><li>Orthostatic hypotension or postural hypotension occurs when blood pressure drops during rising to a sitting or standing position. </li></ul>
  25. 25. <ul><li>Manual blood pressure is assessed with a stethoscope and sphygmomanometer. </li></ul><ul><ul><li>Accurate readings depend on using appropriate-size cuffs </li></ul></ul><ul><li>Electronic blood pressure monitors sense vibrations in the artery wall to determine blood pressure. </li></ul><ul><li>Most common site is the brachial artery. </li></ul><ul><ul><li>When would you choose an alternate site? </li></ul></ul>
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