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Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

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Page 1: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Measuring:-Temperature-Pulse-Blood Pressure-Body mass index

Page 2: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Pulse

Page 3: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Definition of Pulse

The pressure of the blood pushing against the wall of an artery as the heart beats and rests

Page 4: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Common arteries Temporal: side of the forehead Carotid: side of the neck (used for CPR) Brachial: inner aspect of forearm at the

antecubital space (used for BP) Radial: inner aspect of wrist above thumb

(most common place to measure pulse) Femoral: inner aspect of upper thigh Popliteal: behind knee Posterior Tibial: behind medial malleolus Dorsalis pedis: top of foot arch

Page 5: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Examination Pulse rate: expressed in beats per

minute (normal, bradycardia, tachycardia)

Assess the rhythm (regular, irregular “regularly irregular”)

Volume (large, weak, normal)Synchronous (Yes, No) Radiofemoral delay Peripheral pulse (Intact, not felt)

Page 6: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Blood Pressure

Page 7: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Blood PressureThe 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

Page 8: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Equipment

Sphygmomanometer

1. Inflatable cuff

2. Pressure bulb or other device for

inflating cuff

3. Manometer

Stethoscope

Page 9: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Types of sphygmomanometers

1. Aneroid

Circular gauge for registering pressure

Must be checked, and calibrated every 3 to 6 months

Page 10: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Types of sphygmomanometers

2. Electronic

Provides a digital readout of the blood pressure

No stethoscope is needed

Easy to use

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Types of sphygmomanometers

3. Mercury

A column of mercury rises with an increased pressure as the cuff is inflated

Must be checked and calibrated every 6 to 12 months

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Measuring the BP1. Before measuring the BPInstruct your patients to avoid coffee, smoking or any other unprescribed drug with sympathomimetic activity on the day of the measurementMake sure the patient has rested and settled after entering the room

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Measuring the BP2. Position of the PatientSitting position Arm and back are supportedFeet should be resting firmly on the floorFeet not dangling

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3. Size of the cuff The cuff should cover about 80 percent of the arm circumference.(two-thirds of the distance from elbow to shoulder).

If it is too small, the readings will be artificially elevated.

The opposite occurs if the cuff is too large. 4. Position of the armRaise 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 falsely lower, and vice versa.

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5.Palpate and listen Roughly estimate the systolic BP by palpating the radial artery and inflating the cuff until it disappears Palpate for brachial artery pulse and place the stethoscope over itInflate the cuff to a pressure 20-30mmHg above the estimated value.Deflate slowly and listen for pulsation from artery (Korotkoff’s sounds)

Page 16: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Systolic blood pressure is the pressure at which you can first hear the pulse.

Diastolic blood pressure is the last pressure at which you can still hear the pulse

Avoid moving your hands or the head of the stethoscope while you are taking readings as this may produce noise that can obscure the Sounds of Korotkoff.

Recheck after one minute if the reading is high

Tell the patient their reading and thank him

Page 17: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Interpretation 1. Normal blood pressureNormal SBP<120, DBP<802. Hypotension SBP < 90, DBP< 60, or a pressure 25 mmHg lower than usual3. Hypertension (Adults)

Classification SBP mmHg DBP mmHg

Prehypertension 120–139 or 80–89

Stage 1 Hypertension

140–159 or 90–99

Stage 2 Hypertension

160-179 or 100-109

Hypertensive crisis ≥180 ≥ 110

Page 18: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Temperature

Page 19: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Importance of Temperature

To maintain the Ideal Homeostasis The Rate of chemical reactions in

body is regulated by the temperature

If temperature is too high or too low, body’s fluid balance is also affected

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Types of Body Temperature

1. Core Temperature Temperature of the deep tissues of the body Remains relatively constant unless exposed to

severe extremes in environmental temperature Assessed by using a thermometer

2. Surface Temperature Temperature of the skin May vary a great deal in response to the

environment Assessed by touching the skin, or skin pads

Page 21: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Measuring Temperature Measured using a thermometer

Fahrenheit or Celsius scale

Factors that may alter temp Eating, drinking hot or cold liquids

and/or smoking can alter oral tempMake sure the patient has had nothing

to eat, drink or smoke for at least 15 minutes prior to taking temp

Fo Co

Page 22: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Normal Variation In Body Temperature

Usually lower in morning after body has rested

Higher in evening after muscular activity and food intake with metabolism

Parts of the body where temp is measured can also lead to variations

Page 23: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Types of Thermometers

1. Glass thermometers Consist of a slender

glass tube containing mercury, which expands when exposed to heat

Not commonly used because of risk of mercury poisoning and trauma if the glass breaks

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Types of Thermometers

2. Heat-sensitive patches

Patch placed on the skin

color changes on the patch indicate temperature readings

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Types of Thermometers

3. Electronic thermometers Register temp on a

viewer in a few seconds Used to take oral, rectal,

axillary and/or groin temps

Disposable cover is placed over probe prior to use to prevent cross-contamination from patient to patient

Page 26: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Types of Thermometers

4.Tympanic thermometer Special form of

electronic thermometer; inserted into auditory canal

Disposable cover is placed over probe prior to use to prevent cross-contamination from patient to patient

Page 27: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Areas to measure from

1. Oral Placed in the mouth

under the tongue Most common,

convenient and comfortable method

Clinical thermometer left in place for 3 to 5 minutes

Page 28: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Areas to measure from

2. Rectal Most accurate

because it is an internal measurement

Clinical thermometer left in place for 3 to 5 minutes

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Areas to measure from3. Axillary or groin

Axillary is taken in armpit while upper arm is held close to body and thermometer is inserted between two folds of skin

Groin is taken between two folds of skin formed by the inner part of the thigh and lower abdomen

Less accurate because they are external temps

Clinical thermometer left in place for 10 minutes

Page 30: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Areas to measure from4. Aural

Taken with a special thermometer that is place din the ear or auditory canal

Thermometer detects and measures the thermal, infrared energy radiating from blood vessels in the tympanic membrane

Since this provides a measurements of body core temp, there is no normal range for aural

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Causes of high Body Temperature Illness and infectionExercise and/or excitementHigh temperatures in the environment

Causes of low Body Temperature Starvation or fastingSleepDecrease in muscle activityMouth breathingCold temperatures in the environment

Page 32: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Interpretation 1. Normal body temperature:

2. Fever (Hyperthermia): temp above the normal range3. Hypothermia: Core body temperature less than 35oC (below 95° F).4. Hyperpyrexia: Body temp exceeds 40-41oC (104-106°F) rectally

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Body weight

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Indications Monitor treatment response and

disease progression in:Heart disease Renal disease Liver disease

Assess the nutritional status of the patient

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Note that the weight of patient vary during the day it is better to weigh the patient the

same time each day and preferably with the same cloths (if possible)

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Procedure Explain procedure to the patient and take

permission Remove shoes, heavy objects and jacket Balance the scale at zero( 0)levelAllow patient to climb the scaleOn the weighing scale, balance scale while

patient is on it Read the patient’s weight from the

weighing scale and record readingTell the patient their reading and thank him

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Height

Page 38: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Indication To assess the growth in childrenTo assess the nutritional state of

patient (calculate the BMI)

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Procedure The adult weighing scale which has graduated

height indices Ask the patient to remove shoes, hat Adjust scale –by forwarding headpiece up right The patient stand facing you with his/her feet

parallel, with heels and back of head touching the graduated measurement board /mark

Allow his/her arms to hang freely in a natural standing manner

Lower the head piece gently to make contact with the top of the head of the patient

Take reading and remove the lead piece Allow pateint to get down, tell him his reading

and thank him

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Body Mass Index

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How to calculate

Page 42: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

BMI (Sedentary adults)

Underweight < 20 Healthy Weight 20 - 24.9 Overweight 25 – 29.9 Obese ( Class 1 ) 30 – 34.9 Obese ( Class 2 ) 35 – 40 Morbid Obesity > 40

Careful in athlete, elderly, and children (Why)

Page 43: Measuring: -Temperature -Pulse -Blood Pressure -Body mass index

Summary Measuring body temperature, Pulse, Blood

Pressure, Height and Weight

Simple, very useful basic information Helps assessing health condition of

patients Should be performed accurately Know and avoid common pitfalls