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Vital Signs
Ahmad Thanin
What are
Vital Signs?
Vital Signs are a group of the four to six most
important medical signs that indicate the
status of the body’s vital (life-sustaining)
functions.
these measurements are taken to help assess
the general physical health of a person, give
clues to possible diseases, and show progress
toward recovery.
The normal ranges for a person’s vital signs
vary with age, weight, gender, and overall
health.
Primary vital
signs
There are four primary vital signs which are
standard in most medical settings:
• Body temperature
• Heart rate or Pulse
• Respiratory rate
• Blood pressure.
The equipment needed is
• Thermometer.
• Sphygmomanometer
• Stethoscope
• Watch.
Body Temperature
There are five places on the body that a medical assistant can take
the body’s temperature, they include
• Mouth,
• Axilla
• Rectum
• Ear
• Forehead.
The part of the body is chosen based on age, condition, and state of
consciousness.
Body Temperature
• temperature is taken by placing the thermometer under the tongue in
the mouth.
Oral Assessment
• temperature is taken by placing the thermometer in the armpit of the
patient.
Axillary Assessment
• the rectal method is typically used on infants and young children.
Rectal Assessment
• temperature is taken by placing the thermometer in the ear and can
typically be used on young children and uncooperative patients.
Aural Assessment
• temperature is taken by placing a temporal artery thermometer on the
forehead.
Forehead Assessment
HEAT PRODUCTION AND LOST
Heat is produced in the body when nutrients are broken down in the cells.
Heat can be produced by contraction of the muscles, during digestion, when shivering, from fever
or strong emotion.
Heat is lost from the body in urine, feces, water vapor from the lungs and perspiration.
•Radiation
•the transfer of heat in electromagnetic waves generated by the thermal motion of charged particles in matter.
•Conduction
•the transfer of heat from one object to another through direct contact.
•Convection
•the transfer of heat through cool air currents that cause the body to lose heat.
•Evaporation
•losing heat through the conversion of water to gas, for example the evaporation of sweat.
There are four different types of heat loss, they include:
High temperatures in the body can indicate
disease or illness
Fever
• a body temperature greater than
100.4 degrees.
Low Grade Fever
• a body temperature between 99
degrees and 100.4 degrees.
Hyperpyrexia
• A body temperature greater than
105.8 degrees.
• A body temperature greater than
109.4 degrees is fatal.
Hypothermia
• a body temperature less than 97
degrees Fahrenheit.
• The body usually can’t survive with
a temperature lower than 93.2
degrees.
Basal Body Temperature
• the lowest temperature attained by
the body during rest.
Core Temperature
• the temperature in deep structures
of the body including the liver.
• Rectal temperature is the standard
measurement used to establish
core temperature.
Consider the following factors while taking a patient’s body
temperature.
Age
• infants and
children tend
to have higher
temperatures
whereas the
elderly can
have lower
temperature.
Diurnal
Variations
• body
metabolism
and muscle
contraction
can slow
down during
sleep causing
the body
temperature
to be the
lowest in the
morning.
Emotional
States
• strong
emotion can
cause the
body
temperature
to increase.
Environment
• cold weather
or hot
weather
destinations
can cause the
body
temperature
to be slightly
lower or
higher than
average.
Exercise
• vigorous
activity can
cause
increase
muscle
contraction
raising the
body’s
temperature.
Pregnancy
• during
pregnancy
cell
metabolism
increases and
can raise the
body
temperature.
TYPES OF
THERMOMETERS
Heart Rate
The pulse can be checked to see how well the heart is working or in an emergency to see if the heart is pumping
enough blood.
Pulse can help diagnose symptoms of illness and disease.
A medical assistant can check for blood flow after an injury or when a blood vessel may be blocked.
The pulse is created by the heart contracting and forcing blood into the heart’s aorta.
The aorta must expand because it already has blood and must make room for the new blood.
This creates a pulse wave through the walls of the arterial system.
The heart rate is measured by counting the number of pulses or beats per minute (bpm).
There are many different pulse sites and pulse rate influencers.
how to assess readings of the patient’s heart
rate.​
Radial Pulse
•the most common place to
measure the pulse is from
the inside of the wrist just
below the thumb.
Apical Pulse
•measurement with a
stethoscope just over the
apex of the heart.
Brachial Pulse
•pulse taken on the inside of
the elbow.
Ulnar Pulse
•pulse taken on the little
finger side of the wrist and
can be used to measure
circulation in the hands.
Temporal Pulse
•measurement on the front
of the ear just about eye
level.
Carotid
•the best place to find a
pulse quickly at the side of
the neck.
Femoral Pulse
•pulse taken in the middle of
the groin and can be used
to measure circulation in
the lower legs.
Popliteal Pulse
•pulse taken at the back of
the knee.
Posterior Tibial Pulse
•pulse taken on the inner
ankle and can be used to
measure circulation in the
feet.
Dorsalis Pedis Pulse
•pulse taken on the upper
surface of the foot, also
used to measure circulation
to the foot.
Pulse rate can vary based on different factors
Age
• as age increases, the pulse
rate gradually decreases.
Gender
• women tend to have
slightly quicker pulses
than men.
Physical Activity
• can increase pulse rate
temporarily.
Emotional States
• can also temporarily
increase pulse rate
Metabolism
• an increased body
metabolism can increase
the pulse rate
Air Temperature
• when temperatures
increase outside, the body
compensates by pumping
a little more blood.
Body Size
• those that are obese may
have a higher pulse rate.
Medications
• may increase or decrease
the pulse rate depending
on side effects.
• Beta blockers are a
common medicine to
reduce heart rate.
A pulse rate assessment is used to establish the patient’s
baseline pulse and re-assess after a procedure, while taking
medication or to assess the heart for disease.
Pulse should be taken by the medical assistant with
moderate pressure using the three middle fingers.
Excessive pressure can cause the pulse to close off and little
pressure may not be enough to detect a pulse.
Pulse Rate
• the number of heart beats that occur in 1 minute.
• The normal resting pulse rate, in an adult, ranges from 60 to 100 beats
per minute
• abnormally fast heart rate of more than 100 beats per minute.
• May be an indicator of hemorrhaging or heart disease.
Tachycardia
• abnormally slow heart rate, less than 60 beats per minute.
Bradycardia
• pulse rhythm indicates the time interval between heart beats.
• A normal rhythm is a consistent time interval between heart beats.
Pulse Rhythm
• unequal or irregular intervals between heart beats.
Dysrhythmia
• taking the measurements at the heart and on the inside of the wrist at the same time to determine symmetry.
• A pulse deficiency exists if they are out of balance. This may indicate that not all of the heart beats are reaching
the peripheral arteries.
Apical-Radial Pulse
• the strength of the heartbeat.
• If the amount of blood pumped into the aorta is consistent, the patient will have a strong pulse.
Pulse Volume
Blood Pressure
Blood pressure (BP) is a measurement of the pressure exerted by the blood on the walls of the
arteries.
The blood pressure is taken on every visit to establish a baseline for future visits.
•measurement of the blood pushed out of the heart into the aorta and pulmonary aorta that is exerting pressure on the walls of
the arteries.
Systolic Pressure
•measurement when the heart relaxes between contractions.
Diastolic Pressure
The equipment needed to measure manual blood pressure includes a stethoscope and a
sphygmomanometer.
The numerator is the systolic pressure, and the denominator is the diastolic pressure.
A standard unit for
measuring blood pressure is
millimeters of mercury (mm
Hg).
A normal blood pressure
reading is 110/70.
Prehypertension
• blood pressure reading of 120/80
Hypertension
• high blood pressure; excessive
pressure on the walls of the
arteries and a reading higher than
140/90.
Hypotension
• low blood pressure; reduced
pressure on the walls of the
arteries and a reading lower than
95/60.
The pulse pressure is the
difference between systolic
and diastolic pressure.
• A pulse pressure between 30 and
50 mm Hg is in the normal range.
Measuring blood
pressure
Systolic pressure:
• The pressure in the artery during the ventricular contraction
phase of the heart cycle.
• The pressure in the vessel is highest at this time.
Diastolic pressure:
• The pressure in the artery when the ventricles are relaxed.
• The pressure is at its lowest point, though it does not drop
all the way to zero.
Certain factors that can increase or decrease
blood pressure when checking vital signs
Age
•as age increases, blood pressure
gradually increases.
Gender
•women usually have a lower
blood pressure than men of the
same age.
•After menopause, the blood
pressure can become higher in
women.
Diurnal Variations
•in the morning the blood
pressure is lower. Blood pressure
rises with the metabolism and
activity throughout the day.
Emotional States
•strong emotions can increase
blood pressure.
Exercise
•physical activity can temporarily
increase blood pressure.
Body Position
•blood pressure can be different
when a patient is sitting versus
lying and standing.
Medication
•some side effects of medications
may include an increase or
decrease of blood pressure.
Respiration Rate
The purpose of respiration is to exchange oxygen and carbon dioxide.
The assessment should be done without the patients’ knowledge as they may change the rate it they know they
are being tested.
During inhalation the lungs expand with oxygen from the atmosphere.
As the lungs exhale carbon dioxide is removed from the body.
A normal healthy adult will breathe in and out 12 to 20 times per minute.
Tachypnea
• An abnormal respiration rate higher than 20 breathes per minute.
Bradypnea
• reparation rate under 12 breathes per minute.
factors can affect the normal respiration rate
in healthy adults
• as age increases, the respiratory rate decreases.
Age
• strong emotions can temporarily increase respiration rates.
Emotional State
• the lungs will increase respiratory rate in order to expel excess heat.
Fever
• some side effects of medicines include the increase and decrease of respiration rates.
Medications
The respiration rhythm should be even and
regular with equal pauses between inhaling
and exhaling.
The respiration depth is described as normal,
deep or shallow based on the movement of
the chest.
Normal depth is described as the baseline
respiration depth.
Deep respiration involves an increased
amount of air inhaled whereas shallow
respiration involves a slow exchange of oxygen
and carbon dioxide.
•an abnormal increase in the rate and depth of respiration.
•Can be caused simply by exercise but can also be a sign of problems if at rest.
Hyperpnea
•abnormally fast and deep breathing, typically associated with acute anxiety and may be supplemented by dizziness and weakness.
Hyperventilation
•an abnormal decrease in rate and depth approximately half of baseline respiration rate.
•Hypopnea can be found primarily with sleep disorders.
Hypopnea
The patient’s color can tip off a medical assistant to problems while taking vital signs.
•a reduction in oxygen supply to the tissue
Hypoxia
•a bluish discoloration of the skin and mucous membranes.
Cyanosis
Different types of abnormalities caused by
physical activity or disorders of the body function
Apnea
• temporary absence of respiration.
Dyspnea
• difficulty breathing and shortness of
breath.
Orthopnea
• occurs from a disorder of the heart and
lungs including asthma, pneumonia or
congestive heart failure.
Platypnea
• shortness of breath that is relieved
when lying down and worsens when
sitting or standing.
• Due to either hepatopulmonary
syndrome or anatomical cardiovascular
defect.
Trepopnea
• shortness of breath that is sensed
while lying on one side of the body but
not the other. Can result from disease
in one lung or chronic congestive heart
failure.
Biot’s Respiration
• abnormal pattern of breathing
characterized by groups of quick,
shallow inspirations followed by regular
or irregular periods of apnea.
Heyne-Stokes Respiration
• an abnormal pattern of breathing
characterized by progressively deeper
breathing followed by a gradual
decrease that results in a temporary
stop in breathing.
Kussmaul Breathing
• a deep and labored breathing pattern
often associated with severe metabolic
acidosis, diabetic ketoacidosis and
kidney failure.
Pulse Oximetry
• Pulse oximetry is often performed on patients complaining of respiratory problems.
• Pulse oximetry is the procedure used to measure the oxygen saturation of hemoglobin in
arterial blood.
• Taking a patients’ pulse oximetry helps the medical assistant and physician understand
how much oxygen is being delivered to the tissues of the body.
• Pulse oximetry is typically used during or after surgery that uses sedation, to see how well
lung medicines are working, to check a person’s ability to handle increased activity levels,
to see if a ventilator is needed, or to check a patient that has sleep apnea.
• It can also be used when a patient has a heart attack, heart failure, anemia, lung cancer,
asthma or pneumonia.
• The Pulse Oximeter is the device used to
measure and display the oxygen
saturation of the blood.
• It is attached to the tip of the finger and
transmits infrared light and red light
through the patient’s tissues to a light
detector on the other side of the probe.
• Hemoglobin that is bright red and rich in
oxygen will absorb more of the infrared
light emitted.
• A ratio determines the oxygen saturation
of the patient’s hemoglobin or SpO2.
• The pulse reading represents the percentage of
hemoglobin saturated with oxygen.
• Every molecule of hemoglobin can carry four oxygen
molecules.
• The more hemoglobin that is saturated with oxygen,
the higher the oxygen saturation of the blood.
• A healthy oxygen saturation level is 95% to 99%.
• Hypoxemia
• oxygen saturation level lower than 95%
• Hypoxia
• a reduction in the oxygen supply to the tissues of
the body that can lead to tissue damage and even
death.
Conditions that can cause a decreased SpO2 rating
include:
• lung condition with an inability to exhale normally that can cause difficulty breathing.
Chronic Obstructive Pulmonary Disease (COPD)
• lung damage that allows air to be trapped in the lungs.
Emphysema
• a chronic condition where the heart doesn’t pump blood as well as it should, causing shortness of breath
at night, during exercise or while lying down.
Congestive Heart Failure
• damage in the heart’s major blood vessels that can cause shortness of breath.
Coronary Artery Disease
The factors that can affect pulse oximetry
•can be difficult with patients that have small or large fingers.
Incorrect Positioning of the Probe
•a dark, opaque coating on the fingernail may result in low readings as a result of interference of the light penetration
through the finger.
Fingernail Polish
•may cause the pulse to be so weak that the oximeter cannot make a reading.
Poor Peripheral Blood Flow
•if shining directly on the probe it can cause an inaccurate reading.
Ambient Light
•motion affects the ability of the light to travel from one side of the pulse oximeter to the other.
•The medical assistant will ask that the patient remain still during the procedure.
Patient Movement
MEASURING WEIGHT AND
HEIGHT
Standing, chair, and lift scales are used.
Measuring weight and height
• The person only wears a gown or pajamas.
• The person voids before being weighed.
• Weigh the person at the same time of day.
• Use the same scale.
• Balance the scale at zero before weighing the
person.
PAIN
Pain means to ache, hurt, or be sore.
Pain is a warning from the body.
Pain is personal.
• Acute pain – felt suddenly from an injury, disease,
trauma, or surgery
• Chronic pain – lasts longer than 6 months. Pain can be
constant or occur on and off.
• Radiating pain – felt at the site of tissue damage and in
nearby areas.
• Phantom pain – felt in a body part that is no longer
there.
Types of pain
Document
the Results
Record the pulse and respirations
according to facility policy
Vital signs

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Vital signs

  • 2. What are Vital Signs? Vital Signs are a group of the four to six most important medical signs that indicate the status of the body’s vital (life-sustaining) functions. these measurements are taken to help assess the general physical health of a person, give clues to possible diseases, and show progress toward recovery. The normal ranges for a person’s vital signs vary with age, weight, gender, and overall health.
  • 3. Primary vital signs There are four primary vital signs which are standard in most medical settings: • Body temperature • Heart rate or Pulse • Respiratory rate • Blood pressure. The equipment needed is • Thermometer. • Sphygmomanometer • Stethoscope • Watch.
  • 4. Body Temperature There are five places on the body that a medical assistant can take the body’s temperature, they include • Mouth, • Axilla • Rectum • Ear • Forehead. The part of the body is chosen based on age, condition, and state of consciousness.
  • 5. Body Temperature • temperature is taken by placing the thermometer under the tongue in the mouth. Oral Assessment • temperature is taken by placing the thermometer in the armpit of the patient. Axillary Assessment • the rectal method is typically used on infants and young children. Rectal Assessment • temperature is taken by placing the thermometer in the ear and can typically be used on young children and uncooperative patients. Aural Assessment • temperature is taken by placing a temporal artery thermometer on the forehead. Forehead Assessment
  • 6. HEAT PRODUCTION AND LOST Heat is produced in the body when nutrients are broken down in the cells. Heat can be produced by contraction of the muscles, during digestion, when shivering, from fever or strong emotion. Heat is lost from the body in urine, feces, water vapor from the lungs and perspiration. •Radiation •the transfer of heat in electromagnetic waves generated by the thermal motion of charged particles in matter. •Conduction •the transfer of heat from one object to another through direct contact. •Convection •the transfer of heat through cool air currents that cause the body to lose heat. •Evaporation •losing heat through the conversion of water to gas, for example the evaporation of sweat. There are four different types of heat loss, they include:
  • 7. High temperatures in the body can indicate disease or illness Fever • a body temperature greater than 100.4 degrees. Low Grade Fever • a body temperature between 99 degrees and 100.4 degrees. Hyperpyrexia • A body temperature greater than 105.8 degrees. • A body temperature greater than 109.4 degrees is fatal. Hypothermia • a body temperature less than 97 degrees Fahrenheit. • The body usually can’t survive with a temperature lower than 93.2 degrees. Basal Body Temperature • the lowest temperature attained by the body during rest. Core Temperature • the temperature in deep structures of the body including the liver. • Rectal temperature is the standard measurement used to establish core temperature.
  • 8. Consider the following factors while taking a patient’s body temperature. Age • infants and children tend to have higher temperatures whereas the elderly can have lower temperature. Diurnal Variations • body metabolism and muscle contraction can slow down during sleep causing the body temperature to be the lowest in the morning. Emotional States • strong emotion can cause the body temperature to increase. Environment • cold weather or hot weather destinations can cause the body temperature to be slightly lower or higher than average. Exercise • vigorous activity can cause increase muscle contraction raising the body’s temperature. Pregnancy • during pregnancy cell metabolism increases and can raise the body temperature.
  • 9.
  • 11. Heart Rate The pulse can be checked to see how well the heart is working or in an emergency to see if the heart is pumping enough blood. Pulse can help diagnose symptoms of illness and disease. A medical assistant can check for blood flow after an injury or when a blood vessel may be blocked. The pulse is created by the heart contracting and forcing blood into the heart’s aorta. The aorta must expand because it already has blood and must make room for the new blood. This creates a pulse wave through the walls of the arterial system. The heart rate is measured by counting the number of pulses or beats per minute (bpm). There are many different pulse sites and pulse rate influencers.
  • 12. how to assess readings of the patient’s heart rate.​ Radial Pulse •the most common place to measure the pulse is from the inside of the wrist just below the thumb. Apical Pulse •measurement with a stethoscope just over the apex of the heart. Brachial Pulse •pulse taken on the inside of the elbow. Ulnar Pulse •pulse taken on the little finger side of the wrist and can be used to measure circulation in the hands. Temporal Pulse •measurement on the front of the ear just about eye level. Carotid •the best place to find a pulse quickly at the side of the neck. Femoral Pulse •pulse taken in the middle of the groin and can be used to measure circulation in the lower legs. Popliteal Pulse •pulse taken at the back of the knee. Posterior Tibial Pulse •pulse taken on the inner ankle and can be used to measure circulation in the feet. Dorsalis Pedis Pulse •pulse taken on the upper surface of the foot, also used to measure circulation to the foot.
  • 13.
  • 14. Pulse rate can vary based on different factors Age • as age increases, the pulse rate gradually decreases. Gender • women tend to have slightly quicker pulses than men. Physical Activity • can increase pulse rate temporarily. Emotional States • can also temporarily increase pulse rate Metabolism • an increased body metabolism can increase the pulse rate Air Temperature • when temperatures increase outside, the body compensates by pumping a little more blood. Body Size • those that are obese may have a higher pulse rate. Medications • may increase or decrease the pulse rate depending on side effects. • Beta blockers are a common medicine to reduce heart rate.
  • 15. A pulse rate assessment is used to establish the patient’s baseline pulse and re-assess after a procedure, while taking medication or to assess the heart for disease. Pulse should be taken by the medical assistant with moderate pressure using the three middle fingers. Excessive pressure can cause the pulse to close off and little pressure may not be enough to detect a pulse. Pulse Rate • the number of heart beats that occur in 1 minute. • The normal resting pulse rate, in an adult, ranges from 60 to 100 beats per minute
  • 16. • abnormally fast heart rate of more than 100 beats per minute. • May be an indicator of hemorrhaging or heart disease. Tachycardia • abnormally slow heart rate, less than 60 beats per minute. Bradycardia • pulse rhythm indicates the time interval between heart beats. • A normal rhythm is a consistent time interval between heart beats. Pulse Rhythm • unequal or irregular intervals between heart beats. Dysrhythmia • taking the measurements at the heart and on the inside of the wrist at the same time to determine symmetry. • A pulse deficiency exists if they are out of balance. This may indicate that not all of the heart beats are reaching the peripheral arteries. Apical-Radial Pulse • the strength of the heartbeat. • If the amount of blood pumped into the aorta is consistent, the patient will have a strong pulse. Pulse Volume
  • 17.
  • 18. Blood Pressure Blood pressure (BP) is a measurement of the pressure exerted by the blood on the walls of the arteries. The blood pressure is taken on every visit to establish a baseline for future visits. •measurement of the blood pushed out of the heart into the aorta and pulmonary aorta that is exerting pressure on the walls of the arteries. Systolic Pressure •measurement when the heart relaxes between contractions. Diastolic Pressure The equipment needed to measure manual blood pressure includes a stethoscope and a sphygmomanometer. The numerator is the systolic pressure, and the denominator is the diastolic pressure.
  • 19. A standard unit for measuring blood pressure is millimeters of mercury (mm Hg). A normal blood pressure reading is 110/70. Prehypertension • blood pressure reading of 120/80 Hypertension • high blood pressure; excessive pressure on the walls of the arteries and a reading higher than 140/90. Hypotension • low blood pressure; reduced pressure on the walls of the arteries and a reading lower than 95/60. The pulse pressure is the difference between systolic and diastolic pressure. • A pulse pressure between 30 and 50 mm Hg is in the normal range.
  • 20. Measuring blood pressure Systolic pressure: • The pressure in the artery during the ventricular contraction phase of the heart cycle. • The pressure in the vessel is highest at this time. Diastolic pressure: • The pressure in the artery when the ventricles are relaxed. • The pressure is at its lowest point, though it does not drop all the way to zero.
  • 21. Certain factors that can increase or decrease blood pressure when checking vital signs Age •as age increases, blood pressure gradually increases. Gender •women usually have a lower blood pressure than men of the same age. •After menopause, the blood pressure can become higher in women. Diurnal Variations •in the morning the blood pressure is lower. Blood pressure rises with the metabolism and activity throughout the day. Emotional States •strong emotions can increase blood pressure. Exercise •physical activity can temporarily increase blood pressure. Body Position •blood pressure can be different when a patient is sitting versus lying and standing. Medication •some side effects of medications may include an increase or decrease of blood pressure.
  • 22.
  • 23. Respiration Rate The purpose of respiration is to exchange oxygen and carbon dioxide. The assessment should be done without the patients’ knowledge as they may change the rate it they know they are being tested. During inhalation the lungs expand with oxygen from the atmosphere. As the lungs exhale carbon dioxide is removed from the body. A normal healthy adult will breathe in and out 12 to 20 times per minute. Tachypnea • An abnormal respiration rate higher than 20 breathes per minute. Bradypnea • reparation rate under 12 breathes per minute.
  • 24. factors can affect the normal respiration rate in healthy adults • as age increases, the respiratory rate decreases. Age • strong emotions can temporarily increase respiration rates. Emotional State • the lungs will increase respiratory rate in order to expel excess heat. Fever • some side effects of medicines include the increase and decrease of respiration rates. Medications
  • 25. The respiration rhythm should be even and regular with equal pauses between inhaling and exhaling. The respiration depth is described as normal, deep or shallow based on the movement of the chest. Normal depth is described as the baseline respiration depth. Deep respiration involves an increased amount of air inhaled whereas shallow respiration involves a slow exchange of oxygen and carbon dioxide.
  • 26. •an abnormal increase in the rate and depth of respiration. •Can be caused simply by exercise but can also be a sign of problems if at rest. Hyperpnea •abnormally fast and deep breathing, typically associated with acute anxiety and may be supplemented by dizziness and weakness. Hyperventilation •an abnormal decrease in rate and depth approximately half of baseline respiration rate. •Hypopnea can be found primarily with sleep disorders. Hypopnea The patient’s color can tip off a medical assistant to problems while taking vital signs. •a reduction in oxygen supply to the tissue Hypoxia •a bluish discoloration of the skin and mucous membranes. Cyanosis
  • 27. Different types of abnormalities caused by physical activity or disorders of the body function Apnea • temporary absence of respiration. Dyspnea • difficulty breathing and shortness of breath. Orthopnea • occurs from a disorder of the heart and lungs including asthma, pneumonia or congestive heart failure. Platypnea • shortness of breath that is relieved when lying down and worsens when sitting or standing. • Due to either hepatopulmonary syndrome or anatomical cardiovascular defect. Trepopnea • shortness of breath that is sensed while lying on one side of the body but not the other. Can result from disease in one lung or chronic congestive heart failure. Biot’s Respiration • abnormal pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea. Heyne-Stokes Respiration • an abnormal pattern of breathing characterized by progressively deeper breathing followed by a gradual decrease that results in a temporary stop in breathing. Kussmaul Breathing • a deep and labored breathing pattern often associated with severe metabolic acidosis, diabetic ketoacidosis and kidney failure.
  • 28.
  • 29. Pulse Oximetry • Pulse oximetry is often performed on patients complaining of respiratory problems. • Pulse oximetry is the procedure used to measure the oxygen saturation of hemoglobin in arterial blood. • Taking a patients’ pulse oximetry helps the medical assistant and physician understand how much oxygen is being delivered to the tissues of the body. • Pulse oximetry is typically used during or after surgery that uses sedation, to see how well lung medicines are working, to check a person’s ability to handle increased activity levels, to see if a ventilator is needed, or to check a patient that has sleep apnea. • It can also be used when a patient has a heart attack, heart failure, anemia, lung cancer, asthma or pneumonia.
  • 30. • The Pulse Oximeter is the device used to measure and display the oxygen saturation of the blood. • It is attached to the tip of the finger and transmits infrared light and red light through the patient’s tissues to a light detector on the other side of the probe. • Hemoglobin that is bright red and rich in oxygen will absorb more of the infrared light emitted. • A ratio determines the oxygen saturation of the patient’s hemoglobin or SpO2.
  • 31. • The pulse reading represents the percentage of hemoglobin saturated with oxygen. • Every molecule of hemoglobin can carry four oxygen molecules. • The more hemoglobin that is saturated with oxygen, the higher the oxygen saturation of the blood. • A healthy oxygen saturation level is 95% to 99%. • Hypoxemia • oxygen saturation level lower than 95% • Hypoxia • a reduction in the oxygen supply to the tissues of the body that can lead to tissue damage and even death.
  • 32. Conditions that can cause a decreased SpO2 rating include: • lung condition with an inability to exhale normally that can cause difficulty breathing. Chronic Obstructive Pulmonary Disease (COPD) • lung damage that allows air to be trapped in the lungs. Emphysema • a chronic condition where the heart doesn’t pump blood as well as it should, causing shortness of breath at night, during exercise or while lying down. Congestive Heart Failure • damage in the heart’s major blood vessels that can cause shortness of breath. Coronary Artery Disease
  • 33. The factors that can affect pulse oximetry •can be difficult with patients that have small or large fingers. Incorrect Positioning of the Probe •a dark, opaque coating on the fingernail may result in low readings as a result of interference of the light penetration through the finger. Fingernail Polish •may cause the pulse to be so weak that the oximeter cannot make a reading. Poor Peripheral Blood Flow •if shining directly on the probe it can cause an inaccurate reading. Ambient Light •motion affects the ability of the light to travel from one side of the pulse oximeter to the other. •The medical assistant will ask that the patient remain still during the procedure. Patient Movement
  • 34.
  • 35. MEASURING WEIGHT AND HEIGHT Standing, chair, and lift scales are used. Measuring weight and height • The person only wears a gown or pajamas. • The person voids before being weighed. • Weigh the person at the same time of day. • Use the same scale. • Balance the scale at zero before weighing the person.
  • 36. PAIN Pain means to ache, hurt, or be sore. Pain is a warning from the body. Pain is personal. • Acute pain – felt suddenly from an injury, disease, trauma, or surgery • Chronic pain – lasts longer than 6 months. Pain can be constant or occur on and off. • Radiating pain – felt at the site of tissue damage and in nearby areas. • Phantom pain – felt in a body part that is no longer there. Types of pain
  • 37. Document the Results Record the pulse and respirations according to facility policy