U10 Pt Procedures & Vital Signs

U10 Pt Procedures & Vital U10 Pt Procedures & Vital SignsSigns

Patient ProceduresPatient ProceduresALWAYS BEGIN ALWAYS BEGIN

TESTS/PROCDURES TESTS/PROCDURES WITH THE WITH THE

6 Rules of PATIENT 6 Rules of PATIENT PROCEDURESPROCEDURES

Patient ProceduresPatient Procedures6 rules6 rules

Introduce Introduce yourselfyourself

Patient ProceduresPatient Procedures

Introduce yourselfIntroduce yourself

Identify the pt.--Identify the pt.--Make sure you are Make sure you are with the correct ptwith the correct pt

Patient ProceduresPatient Procedures

Introduce yourselfIntroduce yourself Identify the pt.--Make sure you are with Identify the pt.--Make sure you are with

the correct ptthe correct pt

Explain the Explain the procedure to the ptprocedure to the pt

Patient ProceduresPatient Procedures Introduce yourselfIntroduce yourself Identify the pt.--Make sure you are with the correct ptIdentify the pt.--Make sure you are with the correct pt Explain the procedure to the ptExplain the procedure to the pt

Explain to the pt that if they Explain to the pt that if they feel uncomfortable/pain at feel uncomfortable/pain at any time, they are to tell you any time, they are to tell you and that you will stop the and that you will stop the procedure.procedure.

Patient ProceduresPatient Procedures Introduce yourselfIntroduce yourself Make sure you are with the correct ptMake sure you are with the correct pt Explain the procedure to the ptExplain the procedure to the pt Explain to the pt that if they feel Explain to the pt that if they feel

uncomfortable/pain at any time, they are uncomfortable/pain at any time, they are to tell you and that you will stop the to tell you and that you will stop the procedure.procedure.

Ask the pt if they Ask the pt if they understand or if they understand or if they have any questionshave any questions

Patient ProceduresPatient Procedures Introduce yourselfIntroduce yourself Make sure you are with the correct ptMake sure you are with the correct pt Explain the procedure to the ptExplain the procedure to the pt Explain to the pt that if they feel Explain to the pt that if they feel

uncomfortable/pain at any time, they are uncomfortable/pain at any time, they are to tell you and that you will stop the to tell you and that you will stop the procedureprocedure

Ask the pt if they understand or if they Ask the pt if they understand or if they have any questionshave any questions

Record ResultsRecord Results

Vital SignsVital Signs Tests/procedures that are Tests/procedures that are

indicators of internal indicators of internal homeostasis (homeostasis (homeostasis homeostasis is the maintaining of a is the maintaining of a constant internal constant internal environment—breathing, environment—breathing, heart rate, body heart rate, body temperature, internal temperature, internal functionsfunctions).).

Vital SignsVital Signs

Represents the Represents the general health of general health of the pt at that the pt at that point in timepoint in time

Important factors of Vital SignsImportant factors of Vital Signs Understand how to do the Understand how to do the

procedure/testprocedure/test

Important factors of Vital SignsImportant factors of Vital Signs Understand how to do the Understand how to do the

procedure/testprocedure/test Know how to perform the Know how to perform the

procedure or test with procedure or test with confidenceconfidence

Important factors of Vital SignsImportant factors of Vital Signs Understand how to do the Understand how to do the

procedure/testprocedure/test Know how to perform the Know how to perform the

procedure or test with procedure or test with confidenceconfidence

Must be accurateMust be accurate

Important factors of Vital SignsImportant factors of Vital Signs Understand how to do the Understand how to do the

procedure/testprocedure/test Know how to perform the Know how to perform the

procedure or test with procedure or test with confidenceconfidence

Must be accurateMust be accurate Must be able to keep the pt Must be able to keep the pt

comfortable.comfortable.

Factors that may influence Factors that may influence VSVS

PhysicalPhysicalWalking, running, illness, Walking, running, illness, stairs etc….stairs etc….

Factors that may influence Factors that may influence VSVS

PhysicalPhysical

Emotional-afraid, bad day, Emotional-afraid, bad day, stress etc….. stress etc…..

Factors that may influence Factors that may influence VSVS

PhysicalPhysical Emotional-afraid, bad day, stress etc…..Emotional-afraid, bad day, stress etc….. EquipmentEquipment

FailuresFailuresTo big or smallTo big or smallLow batteriesLow batteries

Vital SignsVital Signs

TemperatureTemperature Pulse/Heart ratePulse/Heart rate Respiratory RateRespiratory Rate Blood pressureBlood pressure HtHt WtWt

TemperatureTemperature

Physiology: The body Physiology: The body maintains a constant maintains a constant temperature, this helps to temperature, this helps to maintain maintain homeostasis (the homeostasis (the internal environment of the internal environment of the body)body), this is controlled by the , this is controlled by the brain.brain.

TemperatureTemperature

Physiology: The body moves Physiology: The body moves blood to the core of the blood to the core of the body to increase the body to increase the temperature of the blood, temperature of the blood, which in turns increases the which in turns increases the body temperature----fever.body temperature----fever.

Factors that influence Factors that influence TemperatureTemperature

LiquidsLiquids

Factors that influence Factors that influence TemperatureTemperature

LiquidsLiquids WeatherWeather

Factors that influence Factors that influence TemperatureTemperature

LiquidsLiquids WeatherWeather ExerciseExercise

Factors that influence Factors that influence TemperatureTemperature

LiquidsLiquids WeatherWeather ExerciseExercise InfectionsInfections

Factors that influence Factors that influence TemperatureTemperature

LiquidsLiquids WeatherWeather ExerciseExercise InfectionsInfections StressStress

Is a Fever a good Is a Fever a good thing?thing?

Yes—the increase in Yes—the increase in temperature helps temperature helps the body destroy any the body destroy any pathogens. Pathogens pathogens. Pathogens are temperature are temperature sensitive.sensitive.

Is a Fever a good thing?Is a Fever a good thing?

Yes—the increase in temperature helps Yes—the increase in temperature helps the body destroy any pathogens. the body destroy any pathogens. Pathogens are temperature sensitive.Pathogens are temperature sensitive.

Sometimes not--- a prolonged Sometimes not--- a prolonged fever (having a fever for a fever (having a fever for a long period of time), can long period of time), can cause brain injuriescause brain injuries..

Temperature SitesTemperature Sites

Oral--mouthOral--mouth

Temperature SitesTemperature Sites

Oral—mouthOral—mouth

Rectal- ummmmmRectal- ummmmm

Temperature SitesTemperature Sites

Oral—mouthOral—mouth Rectal- ummmmmRectal- ummmmm

Tympanic--earTympanic--ear

Temperature SitesTemperature Sites

Oral—mouthOral—mouth Rectal- ummmmmRectal- ummmmm Tympanic—earTympanic—ear

Axillary- arm pitAxillary- arm pit

Temperature SitesTemperature Sites

Oral—mouthOral—mouth Rectal- ummmmmRectal- ummmmm Tympanic—earTympanic—ear

Axillary- arm pitAxillary- arm pit Temporal Temporal

Scan-forehead/behind the earScan-forehead/behind the ear

Temperature Temperature Value/ReadingsValue/Readings

Normal- 98.6 degrees FNormal- 98.6 degrees F

Temperature Temperature Value/ReadingsValue/Readings

Normal- 98.6 degrees FNormal- 98.6 degrees F

Rectal temperature: Rectal temperature: subtract 1 degreesubtract 1 degree

Temperature Temperature Value/ReadingsValue/Readings

Normal- 98.6 degrees FNormal- 98.6 degrees F

Rectal temperature: subtract 1 Rectal temperature: subtract 1 degreedegree

Axillary temperature- add 1 Axillary temperature- add 1 degreedegree

Types of thermometersTypes of thermometers

GlassGlass

Types of thermometersTypes of thermometers

GlassGlass

digitaldigital

Types of thermometersTypes of thermometers

GlassGlass DigitalDigital

Digital ProbeDigital Probe

Types of thermometersTypes of thermometers

GlassGlass DigitalDigital Digital ProbeDigital Probe

TympanicTympanic

Types of thermometersTypes of thermometers

GlassGlass DigitalDigital Digital ProbeDigital Probe TympanicTympanic Temporal ScanTemporal Scan

Pulse/Heart RatePulse/Heart Rate

The number of times the The number of times the heart beats per minute.heart beats per minute.

Pulse/Heart RatePulse/Heart Rate

The number of times the The number of times the heart beats per minute.heart beats per minute.

Documented as ___B/M Documented as ___B/M ( beats per minute)( beats per minute)

Pulse/Heart RatePulse/Heart RateFactors the affect the Factors the affect the HR.HR.ExerciseExercise

Pulse/Heart RatePulse/Heart RateFactors the affect the Factors the affect the HR.HR.ExerciseExerciseFoodFood

Pulse/Heart RatePulse/Heart RateFactors the affect the Factors the affect the HR.HR.ExerciseExerciseFoodFoodIllnessIllness

Pulse/Heart RatePulse/Heart RateFactors the affect the HR.Factors the affect the HR.

ExerciseExerciseFoodFoodIllnessIllnessStressStress

Pulse/Heart RatePulse/Heart RateFactors the affect the HR.Factors the affect the HR.

ExerciseExerciseFoodFoodIllnessIllnessStressStressMedications—OTC, Rx, illegalMedications—OTC, Rx, illegal

3. Carotid3. Carotid 4. Brachial4. Brachial 5. Radial 5. Radial

********** 7. Popliteal7. Popliteal

Taking a pulseTaking a pulse

Never use your thumb.Never use your thumb.

Your thumb has a smallYour thumb has a small

pulse that can be felt.pulse that can be felt.

Pulse is taken on the Pulse is taken on the

thumb (radial) sidethumb (radial) side

of the pts wrist.of the pts wrist.

Pulse CharacteristicsPulse Characteristics

Rate: how fast the heart is Rate: how fast the heart is beatingbeating

Pulse CharacteristicsPulse Characteristics

Rate: how fast the heart is Rate: how fast the heart is beatingbeating Average 70 bpmAverage 70 bpm

Range for Adults 60-90 bpmRange for Adults 60-90 bpmRange for children/infants 115-Range for children/infants 115-125 bpm125 bpm

Range for Athletes 40-60 bpm Range for Athletes 40-60 bpm

Pulse CharacteristicsPulse Characteristics

Rhythm – time Rhythm – time between the beats.between the beats.

Pulse CharacteristicsPulse Characteristics

Volume- the force of Volume- the force of the pulse.the pulse.

Pulse CharacteristicsPulse Characteristics

Elasticity- the feel of Elasticity- the feel of the vessel through the vessel through the skin.the skin.

Respiration ( breaths)/RRRespiration ( breaths)/RR

Documented as the # of Documented as the # of breaths per minutebreaths per minute

Respiration / RRRespiration / RR

Documented as the # of Documented as the # of breaths per minutebreaths per minute

It is automatically It is automatically assumed that the recorded assumed that the recorded # is the number of breaths # is the number of breaths per minute.per minute.

Respiration / RRRespiration / RR

Documented as the # of Documented as the # of breaths per minutebreaths per minute

It is automatically assumed It is automatically assumed that the recorded # is the that the recorded # is the number of breaths per minute.number of breaths per minute.

INHALE + EXHALE = 1 breathINHALE + EXHALE = 1 breath

Respiration Respiration

Rate: 12-20 breaths Rate: 12-20 breaths per minuteper minute

Respiration ( breaths)Respiration ( breaths)

Rate: 12-20 breaths per Rate: 12-20 breaths per minuteminuteChildren and infants have a Children and infants have a higher ratehigher rate

Athletes have a slower rate.Athletes have a slower rate.

RespirationRespiration

Rhythm- the time Rhythm- the time between each breath.between each breath.

RespirationRespiration

Depth- how deep the Depth- how deep the breath is—deep, shallow, breath is—deep, shallow, or normalor normal

RespirationRespiration

Counting- watch the Counting- watch the shoulders rise and fallshoulders rise and fall

RespirationRespiration

Counting- watch the Counting- watch the shoulders rise and fallshoulders rise and fall

DO NOT tell the pt your are DO NOT tell the pt your are counting their breathingcounting their breathing

RespirationRespiration

Counting- watch the Counting- watch the shoulders rise and fallshoulders rise and fall

DO NOT tell the pt you are DO NOT tell the pt you are counting their breathingcounting their breathing

Pt modesty—do not stare Pt modesty—do not stare at the pts chest.at the pts chest.

Blood PressureBlood PressureThe amount of The amount of pressure in the pressure in the arteries when the arteries when the heart contracts and heart contracts and relaxes.relaxes.

Blood PressureBlood PressureThe amount of The amount of pressure in the arteries pressure in the arteries when the heart when the heart contracts and relaxes.contracts and relaxes.

The pressure is The pressure is measured in measured in mm hgmm hg= = millimeters of mercurymillimeters of mercury

Blood PressureBlood Pressure

Blood pressure Blood pressure measurement.measurement.

Blood PressureBlood Pressure

Blood pressure measurement.Blood pressure measurement.110/70110/70 mm hg mm hg

Blood PressureBlood Pressure Blood pressure measurement.Blood pressure measurement. 110/70110/70 mm hg mm hg 110110 (the first/top (the first/top number) number) SystolicSystolic-the -the pressure in the artery pressure in the artery when the heart when the heart contracts.contracts.

Blood PressureBlood Pressure Blood pressure measurement.Blood pressure measurement. 110/70110/70 mm hg mm hg 110110 (the first/top number) (the first/top number) SystolicSystolic-the -the

pressure in the artery when the heart pressure in the artery when the heart contracts.contracts.

7070 (the second/bottom (the second/bottom number) number) DiastolicDiastolic- the - the pressure in the artery pressure in the artery when the heart is relaxedwhen the heart is relaxed

Factors that affect Blood Factors that affect Blood PressurePressure

Food, fat, saltFood, fat, salt

Factors that affect Blood Factors that affect Blood PressurePressure

Food, fat, saltFood, fat, salt

FamilyFamily

Factors that affect Blood Factors that affect Blood PressurePressure

Food, fat, saltFood, fat, salt FamilyFamily

White coat syndrome-fear of White coat syndrome-fear of doctorsdoctors

Factors that affect Blood Factors that affect Blood PressurePressure

Food, fat, saltFood, fat, salt FamilyFamily White coat syndrome-fear of doctorsWhite coat syndrome-fear of doctors

ExerciseExercise

Factors that affect Blood Factors that affect Blood PressurePressure

Food, fat, saltFood, fat, salt FamilyFamily White coat syndrome-fear of doctorsWhite coat syndrome-fear of doctors ExerciseExercise

StressStress

Factors that affect Blood Factors that affect Blood PressurePressure Food, fat, saltFood, fat, salt

FamilyFamily White coat syndrome-fear of doctorsWhite coat syndrome-fear of doctors ExerciseExercise StressStress

SmokingSmoking

Blood Pressure Blood Pressure MeasurementsMeasurements

Normal Values 110/70---Normal Values 110/70---128/90128/90

High blood pressure=130/90 High blood pressure=130/90 or higheror higherHigh blood pressure High blood pressure increases the risk of stroke, increases the risk of stroke, kidney damage, and heart kidney damage, and heart attacks.attacks.

Blood Pressure EquipmentBlood Pressure Equipment

StethoscopeStethoscope

Ear Piece

Bell

Diaphragm

Sound sensitive

tube

Blood Pressure EquipmentBlood Pressure Equipment

Blood pressure cuffBlood pressure cuff Cuff

Bulb

Sphygmomanometer

Height and Weight Height and Weight Measuring the ht and wt of Measuring the ht and wt of

pt can help determine the pt can help determine the conditioncondition of the pts body. of the pts body.

Height and Weight Height and Weight Measuring the ht and wt of Measuring the ht and wt of

pt can help determine the pt can help determine the conditioncondition of the pts body. of the pts body.

Help measure long term Help measure long term fluctuations with in the fluctuations with in the body.body.

Height and Weight Height and Weight Examples:Examples:

Height and Weight Height and Weight Examples:Examples: Sudden wt loss may indicate Sudden wt loss may indicate

cancer, diabetes, or other cancer, diabetes, or other metabolic conditionsmetabolic conditions

Height and Weight Height and Weight Examples:Examples: Sudden wt loss may indicate Sudden wt loss may indicate

cancer, diabetes, or other cancer, diabetes, or other metabolic conditionsmetabolic conditions

Quick weight gain can also Quick weight gain can also indicate the onset of medical indicate the onset of medical conditions such as cancer.conditions such as cancer.

Height and Weight Height and Weight Examples:Examples: Sudden wt loss may indicate Sudden wt loss may indicate

cancer, diabetes, or other cancer, diabetes, or other metabolic conditionsmetabolic conditions

Quick weight gain can also Quick weight gain can also indicate the onset of medical indicate the onset of medical conditionsconditions

A decrease in ht can be a sign of A decrease in ht can be a sign of conditions such as osteoporosis conditions such as osteoporosis

Height and Weight Height and Weight

Ht and wt are measured Ht and wt are measured using a certified scale, you using a certified scale, you should not guess, but at should not guess, but at times the pt may refuse to times the pt may refuse to get on the scale, just get on the scale, just document the pts refusal.document the pts refusal.