Understanding vital signs, height, and weight · PDF fileUnderstanding vital signs, height, and Unit B ... Understand vital signs, height, ... Training Lab Assignment

Understanding Understanding vital vital signs, height,signs, height, and and

Unit BUnit BResident Care SkillsResident Care Skills

Essential Standard NA4.00 Essential Standard NA4.00 Understand nurse aide skills related to the residen ts’ vital function and movementUnderstand nurse aide skills related to the residen ts’ vital function and movement

Indicator 4.01Indicator 4.01Understand vital signs, height, and weight skills. Understand vital signs, height, and weight skills.

signs, height,signs, height, and and

weightweight measurement measurement skills. skills.

4.01 Nursing Fundamentals 7243 1

FF YY II -- Intentional RepeatIntentional Repeat

There is intentional repeat of some HSII There is intentional repeat of some HSII course content in Nursing Fundamentals. course content in Nursing Fundamentals.

Repeating Repeating course content distributes learning course content distributes learning Repeating Repeating course content distributes learning course content distributes learning over time and increases long term memory. over time and increases long term memory.

Academic and Academic and skill skill competence must be competence must be maintained at a maintained at a very high very high level for level for direct direct resident careresident care. .


IntroductionIntroduction

Indicator Indicator 4.01 4.01 introduces introduces skills the nurse aide will need skills the nurse aide will need skills the nurse aide will need skills the nurse aide will need to measure and record the to measure and record the resident’s resident’s vital signsvital signs , , heightheightand and weightweight . .


provide information provide information about about changeschanges in in normal body function normal body function

Vital Signs Vital Signs

normal body function normal body function and the and the resident’s resident’s response to treatmentresponse to treatment . .


Often the Often the FIRST FIRST sign sign that that

Vital Signs Vital Signs

sign sign that that there is a there is a problem!problem!


TPR+BP = TPR+BP = Vital SignsVital Signs4.01 Nursing Fundamentals 7243 6

TPR+BP = Vital SignsTPR+BP = Vital Signs

• Reflect the function of three body processes that are essential for life.–Regulation of body temperature–Heart function–Heart function–Breathing



• Abbreviations:–Temperature – T–Pulse – P–Pulse – P–Respirations – R–Blood Pressure – BP–Vital signs - TPR and BP



• Purpose–Measured to detect

any changes in normal body normal body function

–Used to determine response to treatment


TTPR+BP = Vital SignsPR+BP = Vital Signs

TemperatureTemperature


TTPR+BP = Vital SignsPR+BP = Vital SignsTemperatureTemperature

• Heat production–muscles–glands

• Heat loss–respiration–perspiration–glands

–oxidation of food

–perspiration–excretion


TTPR+BP = Vital SignsPR+BP = Vital SignsTemperatureTemperature

Balance between heat production and heat loss is body

temperaturetemperaturetemperaturetemperature


Factors Affecting Temperature

• Exercise• Illness• Age• Time of day

• Infection• Emotions• Hydration• Clothing• Time of day

• Medications• Clothing• Environmental

temperature/air movement


Equipment - Thermometer

• Instrument used to measure body temperature

• Types–Non-mercury glass–Non-mercury glass

• oral• rectal


Equipment - Thermometer

• Types (continued)–chemically treated paper –

disposable–plastic – disposable–plastic – disposable–electronic - probe covered with

disposable shield–tympanic - electronic probe used in

the ear4.01 Nursing Fundamentals 7243 15

Electronic ThermometersElectronic Thermometers

ElectronicElectronicCan be used for oral, Can be used for oral, rectal, or axillaryrectal, or axillaryBlueBlue probe for oralprobe for oralRedRed probe for rectalprobe for rectalRedRed probe for rectalprobe for rectal

Disposable probe covers Disposable probe covers prevent crossprevent cross--contaminationcontamination


Aural/Tympanic TemperatureAural/Tympanic Temperature- taken in the ear

- measures the thermal infrared energy radiating from the blood vessels in the eardrum- position and ear wax - position and ear wax can affect readings-left in until it beeps-temperature is calculated into an equivalent by mode


Positioning the Patients Ear for Positioning the Patients Ear for Tympanic temperatureTympanic temperature

• Children under 2– Pull ear pinna down and

back

• Adults and children over 2– Pull ear pinna up and back– Pull ear pinna up and back

• Positioning the pinna correctly straightens the auditory canal so the probe will point directly at the tympanic membrane



Placement of the Oral Placement of the Oral ThermometerThermometer

Put the bulb tip Put the bulb tip of the of the of the of the thermometer in thermometer in the the “hot “hot pocket” pocket” under under the tongue. the tongue.


Normal Temperature Range For Adults

• Oral - 97.6° - 99.6° F (Fahrenheit) or 36.5° -37.5° C (Celsius)

• Rectal - 98.6° - 100.6° F or 37.0° - 38.1° C

• Axillary - 96.6° - 98.6° F or 36.0° - 37.0° C


“Tic -Tac-Know”Normal Range For Adult Temperature

FREE SPACE

98.6°F is the FREE SPACE



ORALORAL 98.6°FORALORAL 98.6°F

98.698.6°°F is the F is the averageaverage oral temperature oral temperature for adults and it falls in the for adults and it falls in the middle of the middle of the

normal range. normal range.



ORALORAL 98.698.6°°FF 99.699.6°°FFORALORAL 98.698.6°°FF 99.699.6°°FF

Add one degree to 98.6°F then place the results in the oral space to the right



ORALORAL 97.697.6 98.698.6 99.699.6ORALORAL 97.697.6 98.698.6 99.699.6

Subtract one degree from 98.6 then place the results in the oral space to the left



ORALORAL 97.697.6°° 98.698.6 99.699.6ORALORAL 97.697.6°° 98.698.6 99.699.6

The The averageaverage adult temperature taken adult temperature taken orally is orally is 98.698.6°°FF and the and the

RANGERANGE is is 97.697.6°°FF to to 99.699.6°°F.F.



Body heat Body heat REGISTERSREGISTERS one degree one degree warmerwarmer when the when the temperature is taken temperature is taken RECTALLY ®RECTALLY ® . Add one degree to . Add one degree to 98.698.6°°F then place the results in the space below 9 8.6F then place the results in the space below 98.6°°F F

ORALORAL 97.697.6°°FF 98.698.6°°FF 99.699.6°°FF

RECTALRECTAL 99.699.6°°FF



ORALORAL 97.697.6°°FF 98.698.6°°FF 99.699.6°°FFORALORAL 97.697.6°°FF 98.698.6°°FF 99.699.6°°FF

RECTALRECTAL 99.699.6°°FF 100.6100.6°°FF

Add one degree to 99.6Add one degree to 99.6°°F then place the results in the F then place the results in the rectal space to the right.rectal space to the right.




RECTALRECTAL 98.698.6 99.699.6°°FF 100.6100.6°°FF

Subtract one degree from 99.6Subtract one degree from 99.6°°F then place the F then place the results in the rectal space to the left.results in the rectal space to the left.





The The averageaverage adult temperature taken adult temperature taken RECTALLYRECTALLY is is 99.699.6°°FF and the and the

RANGERANGE is is 98.698.6°°FF to to 100.6100.6°°F.F.



AXILLARY AXILLARY 97.697.6

Body heat Body heat REGISTERSREGISTERS one degree one degree COOLERCOOLER when the temperature when the temperature is taken is taken AXILLARY (Ax) AXILLARY (Ax) or in the or in the GROIN. GROIN. Subtract one degree from Subtract one degree from

98.698.6°°F then place the results in the space F then place the results in the space aboveabove 98.698.6°°FF

AXILLARY AXILLARY oror GROINGROIN

97.697.6

ORALORAL 97.697.6°°FF 98.698.6°°FF 99.699.6°°FF





97.697.6°°FF 98.698.6

ORALORAL 97.697.6°°FF 98.698.6°°FF 99.699.6°°FF


Add one degree to 97.6Add one degree to 97.6°°F then place the results to the right F then place the results to the right of 97.6of 97.6°°FF




96.796.7°° 97.697.6°°FF 98.698.6

ORALORAL 97.697.6°°FF 98.698.6°°FF 99.699.6°°FF


Subtract one degree from 97.6Subtract one degree from 97.6°°F then place the res ults to F then place the results to the left of 97.6the left of 97.6°°FF




96.796.7°° 97.697.6°°FF 98.698.6



YOU MUST RECORD THE YOU MUST RECORD THE LOCATION WHERE THE LOCATION WHERE THE TEMPERATURE WAS TAKENTEMPERATURE WAS TAKEN IN ORDER TO INTERPRET IN ORDER TO INTERPRET

NORMAL FROM ABNORMAL !NORMAL FROM ABNORMAL !




(Ax) (Ax) or or GroinGroin

<Pic of <Pic of Groin>Groin>

ORALORAL OOIf no locationIf no location is is

indicated, the oral indicated, the oral ORALORAL OO indicated, the oral indicated, the oral route is assumedroute is assumed

RECTALRECTAL (R)(R)

YOU MUST RECORD THE LOCATION WHERE THE YOU MUST RECORD THE LOCATION WHERE THE TEMPERATURE WAS TAKEN IN ORDER TO INTERPRET TEMPERATURE WAS TAKEN IN ORDER TO INTERPRET

NORMAL FROM ABNORMAL !NORMAL FROM ABNORMAL !


To Read A Non -mercury Glass Thermometer

• Hold eye level• Locate solid column of liquid in the

glass• Observe lines on scale at upper

side of column of liquid in the glass


To Read A Non -mercury Glass Thermometer

(continued)• Read at point where liquid ends• If liquid falls between two lines, read it

to closest lineto closest line–long line represents degree–short line represents 0.2 of a degree

Fahrenheit




Sites To Take A Temperature

• Oral – most common• Rectal – registers one degree

Fahrenheit higher than oral• Axillary – least accurate; registers • Axillary – least accurate; registers

one degree Fahrenheit lower than oral

• Tympanic – probe inserted into the ear canal


Sites To Take A Temperature(continued)

Condition of resident determines which is the best site for measuring best site for measuring body temperature


Temperature: Safety Precautions

• Hold rectal and axillary thermometers in place

• Stay with resident when taking temperature

• Check glass thermometers for chips• Prior to use, shake liquid in glass

down• Shake thermometer away from

resident and hard objects4.01 Nursing Fundamentals 7243 42

Temperature: Safety Precautions(continued)

• Wipe from “handle” end toward bulb tip of thermometer prior to readingreading

• Delay taking oral temperature for 10 - 15 minutes if resident has been smoking, eating or drinking hot/cold liquids.


Temperature ConditionsTemperature Conditions

•• HyperthermiaHyperthermia– Increased body temp– Body temp >104ºF– >106 ºF will cause

convulsions and death

•• FeverFever- temp over 101 ºF R- Due to illness or

injury4.01 Nursing Fundamentals 7243 44

Temperature ConditionsTemperature Conditions

•• HypothermiaHypothermia– Body temp below– 96 ºF– due to exposure to

cold temperatures – Depends on core

temperature, age and length of exposure


SKILLSKILL 4.01A4.01A

Training Lab AssignmentTraining Lab AssignmentEngage in the Skill Acquisition Process for:Engage in the Skill Acquisition Process for:


SKILLSKILL 4.01A4.01AOral temperature using a nonOral temperature using a non --mercury mercury

glass thermometerglass thermometer

SKILLSKILL 4.01B4.01B



SKILLSKILL 4.01B4.01BAxillary temperature using a Axillary temperature using a

nonnon --mercury glass thermometermercury glass thermometer

SKILLSKILL 4.01C4.01C



SKILLSKILL 4.01C4.01CRectal Temperature using a Rectal Temperature using a

nonnon --mercury glass thermometermercury glass thermometer

SKILLSKILL 4.01Dto4.01Dto

Measure Temperature with Measure Temperature with




Electronic ThermometerElectronic Thermometer

SKILLSKILL 4.01E4.01E





Tympanic ThermometerTympanic Thermometer

TTPPR+BP = Vital SignsR+BP = Vital Signs

PULSEPULSEPULSEPULSE


PULSEPULSEMeasuring the pulse is one way of

checking on the circulatory system


Circulatory SystemCirculatory System


Circulatory SystemCirculatory System

Circulatory System

• Circulation is continuous movement of blood

Nursing Fundamentals 7243 54

movement of blood throughout body

4.01

Circulatory System(continued)

• Functions of circulatory system–Arteries carry blood with

oxygen and nutrients away from heart and to cells


from heart and to cells–Veins carry waste products

away from cells and to heart

4.01

Blood

• Adult has 5 to 6 quarts (liters)• Consists of

–water - 90% (plasma)–blood cells


–blood cells–carbon dioxide and oxygen–nutrients, hormones and

enzymes–waste products

4.01

Blood(continued)

• Types of blood cells–Red blood cells - erythrocytes

• carry oxygen from blood to cells–White blood cells - leukocytes


–White blood cells - leukocytes• fight infection

–Platelets - thrombocytes• required for clotting to stop bleeding

4.01

Blood Vessels

• Arteries - carry blood away from heart• Veins – carry blood to heart

Nursing Fundamentals 7243 584.01

Heart

• Tissue (three layers)–endocardium - smooth,

inner layer–myocardium – thick,


–myocardium – thick, muscular middle layer

–pericardium – double-walled membrane that covers outside of heart

4.01

Heart Chambers

• Heart divided into right and left side

• Atria – upper chambers –


receive blood• Ventricles –

lower chambers – pump blood to lungs and body

4.01

Heart Chambers

• Four chambers–right atrium (1) - receives

blood from two large veins:• superior vena cava


• superior vena cava• inferior vena cava

–right ventricle (2) - receives blood from right atrium and pumps it to lungs through pulmonary artery

4.01

Heart Chambers(continued)

• Four chambers–left atrium (3) - receives

oxygenated blood from left and right pulmonary veins


and right pulmonary veins–left ventricle (4) - pumps

blood to aorta, which delivers blood to all body parts (except lungs)

4.01

Heart Valves

• Located at entrance and exit of each ventricle

• Four heart valves

Nursing Fundamentals 7243 634.01

Heartbeat

• Systole - contraction of heart muscle• Diastole - relaxation of heart muscle• Blood pressure – highest and lowest


• Blood pressure – highest and lowest pressure against walls of blood vessels as heart contracts and relaxes

• Pulse - expansion and contraction of artery

4.01

Common Disorders of the Circulatory System

• Arteriosclerosis - walls of arteries become thick and harden

• Hypertension - high blood pressure


• Hypertension - high blood pressure• Peripheral vascular disease -

decrease in flow of blood to extremities and brain

• Angina pectoris - chest pain4.01


(continued)

• Varicose veins - enlarged, twisted veins usually in legs

• Congestive heart failure -


• Congestive heart failure -circulatory congestion caused by weak pumping of heart muscle

• Myocardial infarction (MI) - heart attack due to blockage in coronary arteries

4.01


(continued)

• Anemia – low red blood cell counts• Thrombus – blood clot• Phlebitis – inflammation of vein


• Phlebitis – inflammation of vein• Atherosclerosis - fatty deposits on

walls of arteries that reduce blood flow

4.01

Changes of the Circulatory System Due To Aging

• Heart muscle less efficient• Blood pumped with less force• Arteries lose elasticity and


• Arteries lose elasticity and become narrow

• Blood pressure increases• Blood chemistry less efficient• Capillaries become more fragile4.01

Observations of the Circulatory System

• Changes in pulse rate and blood pressure

• Changes in skin color


• Changes in skin color• Changes in skin

temperature – coldness

4.01


(continued)

• Complaint of dizziness and headaches

• Complaint of pain in chest


• Complaint of pain in chest and/or indigestion

• Edema in feet and legs• Shortness of breath

4.01


(continued)• Sweating• Blue color to lips and/or nail beds• Complaint of tingling sensations• Memory lapses


• Memory lapses• Lack of energy• Irregular respirations• Anxiety• Staring and lack of responsiveness4.01

TTPPR+BP = Vital SignsR+BP = Vital SignsPULSEPULSE

• Pulse is pressure of blood pushing against wall of artery as heart beats and restsbeats and rests

• Pulse easier to locate in arteries close to skin that can be pressed against bone


Sites For Taking Pulse

• Radial – base of thumb• Temporal – side of

forehead• Carotid – side of neck• Carotid – side of neck• Brachial – inner aspect

of elbow• Femoral – inner aspect

of upper thigh


Sites For Taking Pulse(continued)

• Popliteal - behind knee• Dorsalis pedis – top of

foot • Apical pulse – over apex • Apical pulse – over apex

of heart–taken with stethoscope–left side of chest


Factors Affecting Pulse

• Age• Sex• Position• Drugs• Illness• Illness• Emotions• Activity level • Temperature• Physical training


Measurement of Pulse

• Normal pulse range/characteristics: 60 -100 beats per minute and regular

• Documenting pulse rate–Noted as number of beats per –Noted as number of beats per

minute–Rhythm - regular or irregular–Volume - strong, weak, thready,

bounding


SKILLSKILL 4.01F4.01FCount and Record Count and Record



Count and Record Count and Record Radial PulseRadial Pulse

SKILLSKILL 4.01G4.01G

Measure and Record Measure and Record



Measure and Record Measure and Record

Apical PulseApical Pulse

TPTPRR+BP = Vital Signs+BP = Vital Signs

RESPIRATIONSRESPIRATIONS


RESPIRATIONSRESPIRATIONSMeasuring respirations is one way of Measuring respirations is one way of checking on the checking on the respiratory systemrespiratory system


Respiratory SystemRespiratory System


Respiratory SystemRespiratory System

The Respiratory System

• Respiration means to breathe in oxygen and breathe out carbon dioxide

• Exchange of oxygen and carbon


• Exchange of oxygen and carbon dioxide necessary for life

4.01

The Respiratory System(continued)

• Process–External respiration - oxygen and

carbon dioxide exchanged between lungs and blood


lungs and blood–Internal respiration - oxygen and

carbon dioxide exchanged between blood stream and cells

4.01

The Respiratory SystemStructure

• Oral cavity – mouth• Pharynx – throat• Larynx - voice box• Trachea – windpipe


• Trachea – windpipe• Bronchi - right and left• Bronchioles - smallest branches of

bronchi• Alveoli - air sacs covered with

capillaries4.01

The Respiratory SystemStructure(continued)

• Nose - lined with mucous membrane–air filtered by cilia


–air filtered by cilia–mucous membrane

warms and moistens air

4.01


• Lungs–right - 3 lobes


–right - 3 lobes–left - 2 lobes

4.01


• Pleura – membrane that encloses lungs

• Diaphragm - muscle that separates


• Diaphragm - muscle that separates the chest and abdomen–contraction - draws air into lungs–relaxation - forces air out of lungs

4.01

Common Disorders of Respiratory System

• URI – Upper R espiratory I nfection -infection of nose, throat, larynx, trachea

• Pneumonia - inflammation or


• Pneumonia - inflammation or infection of the lungs

4.01


(continued)

• Emphysema (Chronic Obstructive Pulmonary Disease – COPD) –alveoli become stretched and stiff


alveoli become stretched and stiff preventing adequate exchange of oxygen and carbon dioxide

• Asthma – spasms of bronchial tube walls causing narrowing of air passages usually due to allergies

4.01


(continued)

• Allergy – reaction to substances that leads to slight or severe response by body.


body.• Influenza – highly contagious URI• Pleurisy – inflammation of the pleura

surrounding the lungs

4.01


(continued)

• Bronchitis - inflammation of the bronchi

• Lung cancer - malignant tumors in


• Lung cancer - malignant tumors in the lungs that destroy tissue

4.01

Changes in Respiratory System Due To Aging

• Lung tissue becomes less elastic• Respiratory muscles weaken• Number of alveoli decrease


• Respirations increase• Voice pitched higher and weaker due

to changes in larynx• Chest wall and structures become

more rigid4.01

Observations Of Respiratory System

• Rate and rhythm of respirations• Respiratory secretions – character• Character of cough• Changes in skin color - pale or bluish


• Changes in skin color - pale or bluish gray

• Temperature changes• Difficulty breathing

4.01

Observations Of Respiratory System(continued)

• Color of sputum• Complaint of pain in

chest, back, sides• Shortness of breath


• Shortness of breath• Noisy respirations• Sneezing• Gasping for breath• Anxiety

4.01

Measuring Respirations

• Respiration – process of taking in oxygen and expelling carbon dioxide from lungs dioxide from lungs and respiratory tract


Measuring Respirations(continued)

• Age• Activity

• Sex• Illness

Factors Affecting Rate

• Activity level

• Position• Drugs

• Illness• Emotions• Temperature



• Qualities of normal respirations–12-20 respirations per minute–Quiet–Effortless–Effortless–Regular



• Documenting respiratory rate–Noted as number of inhalations

and exhalations per minute (one inhalation and one exhalation inhalation and one exhalation equals one respiration)

–Rhythm – regular or irregular–Character: shallow, deep, labored


SKILLSKILL 4.01H4.01HCount and Record Count and Record



Count and Record Count and Record RespirationRespiration

TPR+TPR+BPBP = Vital Signs= Vital Signs

BLOOD PRESSUREBLOOD PRESSURE


Blood PressureBlood PressureMeasuring the pulse is one way of

checking on the circulatory system


Measuring Blood Pressure

• Blood pressure is the force of blood pushing against walls of arteries–Systolic pressure: greatest force

exerted when heart contractingexerted when heart contracting–Diastolic pressure: least force

exerted as heart relaxes


Factors Influencing Blood Pressure

• Weight• Sleep• Age• Emotions• Emotions• Sex• Heredity• Viscosity of blood• Illness/Disease


Blood Pressure: Equipment

• Sphygmomanometer (manual)–cuff - different sizes–pressure control bulb–pressure gauge – marked

with numbers• aneroid• mercury


Blood Pressure: Equipment(continued)

• Stethoscope–magnifies sound–has diaphragm–has diaphragm


Measuring Blood Pressure

Blood Pressure Systolic(top#)

Diastolic (bottom #)

NormalNormal ≤ 120≤ 120 <80<80

Pre HypertensionPre Hypertension 120120--139139 8080--8989

Hypertension StageHypertension Stage (1)(1) 140140--159159 9090--9999

Hypertension Stage (2)Hypertension Stage (2) ≥160≥160 ≥100≥100


Guidelines for Blood Pressure Measurements

• Measure on upper arm

• Have correct size cuff cuff

• Identify brachial artery for correct placement of stethoscope


=

Positioning of stethoscope Positioning of stethoscope diaphragm diaphragm directly over the brachial artery directly over the brachial artery increases ability to increases ability to hear the systolic and diastolic soundshear the systolic and diastolic sounds


=

Positioning of Positioning of stethoscope stethoscope diaphragm diaphragm directly directly over the brachial over the brachial artery artery increases increases


artery artery increases increases ability to hear the ability to hear the systolic and systolic and diastolicdiastolic


(continued)

• First sound heard –systolic pressure

• Last sound heard or • Last sound heard or change - diastolic pressure


SystolicSystolic –– SStart hearing a tart hearing a SSound ound –– Heart Muscle is Heart Muscle is SSqueezingqueezing

1201208080


DiastolicDiastolic –– DDon’t hear sound anymore on’t hear sound anymore –– Heart muscle Heart muscle ddoes not oes not work during work during ddiastolic. This number is written iastolic. This number is written ddown under the own under the systolic number.systolic number.


(continued)

• Record - systolic/diastolic• Resident in relaxed

position, sitting or lying down

• Blood pressure usually taken in left arm



(continued)

Do not measure blood Do not measure blood pressure in arm with IV, pressure in arm with IV, pressure in arm with IV, pressure in arm with IV, AA--V shunt (dialysis), V shunt (dialysis), cast, wound, or sorecast, wound, or sore



(continued)

• Apply cuff to bare upper arm, not over clothingclothing

• Room quiet so blood pressure can be heard

• Sphygmomanometer must be clearly visible


Blood Pressure: Reading Gauge

• Large lines are at increments of 10 mmHg

• Shorter lines at • Shorter lines at 2 mm intervals

• Take reading at closest line


SKILLSKILL 4.01I4.01IMeasure Blood Pressure Measure Blood Pressure



Measure Blood Pressure Measure Blood Pressure ManualManual

SKILLSKILL 4.01J4.01J



SKILLSKILL 4.01J4.01JCombined Vital SignsCombined Vital Signs

Measuring Measuring

Height and WeightHeight and Weight


Height and WeightHeight and Weight

The resident’s The resident’s weightweight , , compared with the compared with the heightheight , , gives information about gives information about his/her his/her nutritional status nutritional status his/her his/her nutritional status nutritional status and changes in the and changes in the medical medical condition. condition.


Measuring Height And Weight

• Baseline measurement obtained on admission and must be accurate.

• Other measurements obtained as ordered.


Measuring Height And Weight(continued)

• Height measurements–Feet–Inches –Centimeters–Centimeters

• Weight measurements–Pounds–Ounces–Kilograms


Measuring Height and Weight(continued)

• Reasons for obtaining height and weight–Indicator of nutritional status–Indicator of nutritional status–Indicator of change in medical

condition–Used by doctor to order medications


Special Case for Height Measurement

• Residents who are contractured or • Residents who cannot stand• Must be measured using a tape • Must be measured using a tape

measure



–Use same scale each time

–Have resident void,

• Guidelines for weighing residents

–Have resident void, remove shoes and outer clothing

–Weigh at same time each day



• Scales–Remain more accurate if moved as

little as possible.–Various types of scales

• bathroom scale• bathroom scale• standing scale• scales attached to hydraulic lifts• wheelchair scales• bed scales


SKILLSKILL 4.01K4.01KMeasure HeightMeasure Height



Measure HeightMeasure Height& Weight& Weight

�� ENDEND ��

4.014.01Understand Understand vital signsvital signs , , heightheight , and , and weightweight measurement skills. measurement skills.

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4.014.01

4.01 Nursing Fundamentals 7243

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Understanding vital signs, height, and weight · PDF fileUnderstanding vital signs, height, and Unit B ... Understand vital signs, height, ... Training Lab Assignment