محاضرة تعليمية عن العلامات الحيوية بشكل مبسط وسهل التذكر مفيد ة جدا

1. ‫اعداد‬
‫سحاب‬ ‫امير‬ ‫علي‬ ‫الفني‬ ‫الممرض‬

2. General
Vital signs

3. Vital sign ‫الحٌوٌة‬ ‫العالمات‬
‫العالمات‬
‫الحيوية‬
:
‫عالمات‬ ً‫ه‬
‫على‬ ‫الفرد‬ ‫أن‬ ‫إلى‬ ‫تشٌر‬ ‫جسدٌة‬
‫القلب‬ ‫ضربات‬ ‫مثل‬ ، ‫الحٌاة‬ ‫قٌد‬
‫الحرارة‬ ‫ودرجة‬ ‫التنفس‬ ‫ومعدل‬
‫الدم‬ ‫وضغط‬
‫األكسجٌن‬ ‫وتشبع‬
‫ا‬ً‫مؤخر‬

4. ‫؟‬ ‫الحٌوٌة‬ ‫العالمات‬ ‫تقٌٌم‬ ‫ٌتم‬ ‫متى‬
 ‫تلك‬ ‫اجراءات‬ ‫وحسب‬ ‫صحٌة‬ ‫مؤسسة‬ ‫اي‬ ‫او‬ ‫المستشفى‬ ‫المرٌض‬ ‫دخول‬ ‫عند‬
‫الطبٌب‬ ‫توجٌهات‬ ‫بعد‬ ‫المؤسسة‬
 ‫الصحٌة‬ ‫المرٌض‬ ‫وحالة‬ ‫وضعٌة‬ ً‫ف‬ ‫تغٌٌر‬ ‫ٌحدث‬ ‫وقت‬ ‫اي‬ ً‫ف‬
 ‫تشخٌصٌة‬ ‫او‬ ‫جراحٌة‬ ‫اجراءات‬ ‫اي‬ ‫وبعد‬ ‫قبل‬
 ‫المخاطر‬ ‫من‬ ‫ٌزٌد‬ ‫المرٌض‬ ‫ٌفعله‬ ‫نشاط‬ ‫اي‬ ‫وبعد‬ ‫قبل‬
 ‫واالوعٌة‬ ً‫التنفس‬ ‫والجهاز‬ ‫القلب‬ ‫وظائف‬ ‫على‬ ‫تؤثر‬ ً‫الت‬ ‫االدوٌة‬ ‫اخذ‬ ‫وبعد‬ ‫قبل‬
‫الدموٌة‬

5. Vital sign
 ‫الحٌوٌة‬ ‫العالمات‬ ‫تتغٌر‬
‫مع‬ ‫الطبٌعٌة‬
‫العمر‬ ‫تقدم‬
‫و‬
‫الجنس‬
‫والوزن‬
‫و‬
‫التمارٌن‬
‫و‬
‫الحالة‬

6. ‫الحيوية‬ ‫العالمات‬ ‫على‬ ‫للحصول‬ ‫ارشادات‬
‫الحيوية‬ ‫العالمات‬ ‫على‬ ‫للحصول‬ ‫يلي‬ ‫بما‬ ‫القيام‬ ‫الممرض‬ ‫على‬ ‫يجب‬
:
1
-
‫صحٌح‬ ‫بشكل‬ ‫الحٌوٌة‬ ‫العالمات‬ ‫قٌاس‬
2
-
‫مناسب‬ ‫بشكل‬ ‫النتائج‬ ‫ربط‬ ‫و‬ ‫القٌم‬ ‫تلك‬ ‫وتفسٌر‬ ‫فهم‬ ‫على‬ ‫قادر‬ ‫ٌكون‬ ‫ان‬
3
-
‫الحاجة‬ ‫حسب‬ ‫المناسبة‬ ‫التدخالت‬ ‫ابدأ‬

7. Temperature- ‫الحرارة‬
Vital signs

8. Temperature
 ‫إما‬ ‫الحرارة‬ ‫درجة‬ ‫قاس‬ُ‫ت‬
‫أو‬ ‫المئوٌة‬ ‫بالدرجة‬
‫حمى‬ ‫مع‬ ، ‫فهرنهاٌت‬
‫من‬ ‫أكبر‬ ‫بأنها‬ ‫عرف‬ُ‫ت‬
38c -
38.5 c ‫درجة‬
‫أو‬ ‫مئوٌة‬f 101
-
101.5
‫فهرنهاٌت‬
.

10. Temperature
‫طرق‬ ‫بعدة‬ ‫الجسم‬ ‫حرارة‬ ‫درجة‬ ‫قياس‬ ‫يتم‬
:
1
-
‫للحرارة‬ ‫حساسة‬ ‫الصقات‬
:
‫الجسم‬ ‫على‬ ‫الصقات‬ ‫بوضع‬ ‫الطرٌقة‬ ‫هذه‬ ‫وتتم‬
‫الحرارة‬ ‫درجة‬ ‫قراءات‬ ‫الى‬ ‫اللونٌة‬ ‫التغٌرات‬ ‫وتشٌر‬
.
2
-
‫االلكتروني‬ ‫الحرارة‬ ‫قياس‬ ‫ميزان‬
:
‫من‬ ‫ٌتكون‬
‫مستور‬ ‫ثر‬
‫لدرجة‬ ً‫إلكترون‬ ‫وعرض‬ ‫الحرارة‬ ‫درجة‬ ‫الستشعار‬
‫الحرارة‬
.
‫تحت‬ ‫أو‬ ‫المستقٌم‬ ‫أو‬ ‫الفم‬ ‫طرٌق‬ ‫عن‬ ‫الرقمٌة‬ ‫الحرارة‬ ‫موازٌن‬ ‫تستخدم‬
‫ٌمكنه‬ ‫الذراع‬
‫الحرارة‬ ‫درجة‬ ‫قراءة‬
‫من‬
34.5
-
40
.
3
-
‫الطبلي‬ ‫الحرارة‬ ‫ميزان‬
‫السمعٌة‬ ‫القناة‬ ً‫ف‬ ‫وضعه‬ ‫ٌتم‬ ‫الحرارة‬ ‫مٌزان‬ ‫من‬ ‫خاص‬ ‫شكل‬
.

11. Type and method take temperature
 Heat sensitive patches

12. Electronic thermometer

13. Tympnic thermometer

14. TEMPERATURE
Fever ,pyrexia ,hyperthermia *
‫الحرارة‬ ‫ارتفاع‬
‫او‬
1
-
ً‫الطبٌع‬ ‫من‬ ‫اكثر‬ ‫الحرارة‬ ‫تكون‬ ‫عنما‬
2
-
ً‫فٌروس‬ ‫او‬ ‫بكتٌري‬ ‫التهاب‬ ‫سبب‬ ‫للجسم‬ ‫دفاعٌة‬ ‫فعل‬ ‫ردة‬ ‫نتٌجة‬ ‫ٌحدث‬ ‫عاده‬ ‫الحرارة‬ ‫ارتفاع‬
Inflammation ‫او‬
‫الحرارة‬ ‫ارتفاع‬ ‫تصنيف‬
•
‫ثابت‬ ‫ارتفاع‬
:
‫نزول‬ ‫بدون‬ ‫مرتفعة‬ ‫حرارة‬ ‫درجة‬ ‫وتبقى‬
•
‫متغٌرة‬
:
‫وتنخفض‬ ‫ترتفع‬
•
‫متقطعة‬
:
‫المرٌض‬ ‫ٌتحسن‬ ‫حتى‬ ‫ابدا‬ ً‫الطبٌع‬ ‫الى‬ ‫ترجع‬ ‫ال‬ ‫الحرارة‬
‫الحرارة‬ ‫انخفاض‬
‫الطبٌعٌة‬ ‫النسبة‬ ‫عن‬ ‫الحرارة‬ ‫انخفاض‬

15. Hypothermia
 Hypothermia is
defined as a drop
in body
temperature below
35.4 C.

16. Pulse
Vital signs

17. Pulse rate
 The normal
pulse for
healthy adults
ranges from 60
to 100 beats
per minute.

18. Pulse rate
‫عند‬ ‫وٌزداد‬ ‫النبض‬ ‫معدل‬ ‫ٌتغٌر‬
‫االصابة‬ ‫و‬ ‫والمرض‬ ‫التمارٌن‬ ‫اداء‬
‫النساء‬ ‫وتمٌل‬ ‫العواطف‬ ‫تغٌٌر‬ ‫و‬
‫من‬ ‫اعلى‬ ‫نبض‬ ‫معدالت‬ ‫الى‬
‫الرجال‬
.

19. Pulse
 Tachycardia
 The pulse is faster than 100 beats per
minute.
 It may result from shock, hemorrhage,
exercise, fever, acute pain, and drugs.
 Bradycardia
 The pulse is slower than 60 beats per
minute.
 It may result from unrelieved severe pain,
drugs, resting, and heart block.

20. Site of taking pulse

21. Respiration rate
Vital signs

22. Respiratory Rate
 Try to do this as
surreptitiously as
possible.
Observing the
rise and fall of
the patient's
hospital gown
while you appear
to be taking their
pulse.

23. Respiratory Rate
 Respiration rates
may increase
with fever,
illness,…. When
checking
respiration, also
note whether a
person has any
difficulty
breathing.

24. Abnormal Respiratory Rate
 Respiration rates
over 25 or under
12 breaths per
minute (when at
rest) may be
considered
abnormal
under 12 breaths
over 25 breaths

25. Blood pressure
Vital signs

26. Remember the following for
accuracy of your readings
 Instruct your
patients to avoid
coffee, smoking or
any other
unprescribed drug
with
sympathomimetic
activity on the day
of the
measurement

27. Position of the Patient
 Sitting position
 Arm and back are
supported.
 Feet should be
resting firmly on the
floor
 Feet not dangling.

28. Position of the arm
 Raise patient arm so that the brachial artery is roughly
at the same height as the heart. If the arm is held too
high, the reading will be artifactually lowered, and vice
versa.

29. Blood Pressure
 The pressure exerted by the circulating
volume of blood on the arterial walls, veins,
and chambers of the heart.
 Systolic
 The higher number; represents the ventricles
contracting
 Diastolic
 The second number; represents the pressure within
the artery between beats
 Pulse Pressure
 Difference between the systolic and diastolic

30. Blood Pressure
 If it is too small, the
readings will be
artificially elevated.
 The opposite
occurs if the cuff is
too large.

31. In order to measure the BP
 Systolic blood
pressure is the
pressure at which
you can first hear
the pulse.

32. In order to measure the BP
 Diastolic blood pressure is the last pressure at
which you can still hear the pulse

33. In order to measure the BP
 Avoid moving your
hands or the head
of the stethescope
while you are
taking readings as
this may produce
noise that can
obscure the
Sounds of
Koratkoff.

34. Remember the following for
accuracy of your readings
 If the BP is surprisingly
high or low, repeat the
measurement towards
the end of your exam
(Repeated blood
pressure
measurement can
be uncomfortable).

35. What Abnormal Results
Mean

36. Blood pressure
 The minimal SBP
required to
maintain perfusion
varies with the
individual.
Interpretation of
low values must
take into account
the clinical
situation.

37. Blood pressure for adult
 Physician will want
to see multiple
blood pressure
measurements
over several days
or weeks before
making a diagnosis
of hypertension
and initiating
treatment.

38. What Abnormal Results Mean
 Pre-high blood
pressure: systolic
pressure
consistently 120 to
139, or diastolic 80
to 89
 Stage 1 high blood
pressure: systolic
pressure
consistently 140 to
159, or diastolic 90
to 99

39. What Abnormal Results
Mean
 Stage 2 high blood
pressure: systolic
pressure
consistently 160 or
over, or diastolic
100 or over

40. What Abnormal Results
Mean
 Hypotension (blood
pressure below
normal): may be
indicated by a
systolic pressure
lower than 90, or a
pressure 25 mmHg
lower than usual

41. Hypertension
 High blood pressure greater
than 139-89..

42. Blood pressure may be affected
by many different conditions

43. Blood pressure may be affected
by many different conditions
 Cardiovascular
disorders
 Neurological
conditions
 Kidney and
urological disorders

44. Blood pressure may be affected
by many different conditions
 Pre eclampsia in
pregnant women
 Psychological
factors such as
stress, anger, or
fear
Eclampsia

45. Remember the following for
accuracy of your readings
 First measuring
BP when the
patient is supine
and then
repeating them
after they have
stood for 2
minutes, which
allows for
equilibration.

47. Oxygen Saturation
Vital signs

48. Oxygen Saturation
 Over the past
decade, Oxygen
Saturation
measurement of
gas exchange and
red blood cell
oxygen carrying
capacity has
become available
in all hospitals and
many clinics.

49. Oxygen Saturation
 Oxygen
Saturation provide
important
information about
cardio-pulmonary
dysfunction and is
considered by
many to be a fifth
vital sign.