VITAL SIGNS AND OXYGEN ADMINISTRATION

CHAPTER 6

MEASURING VITAL SIGNS

VITAL SIGNS ARE ALSO CALLED CARDINAL SIGNS.

1. BODY TEMPERATURE2. PULSE3. RESPIRATION4. BLOOD PRESSURE

CHANGES IN VITALS INDICATE A POTENTIAL PROBLEM!

VITALS

OXYGEN IS VITAL TO SURVIVE. THE HUMAN BRAIN CAN NOT

FUNCTION FOR LONGER THAN 4 TO 5 MINUTES WITHOUT OXYGEN!

IT IS YOUR RESPONSIBILITY TO KNOW WHAT ARE NORMAL VITAL SIGNS.

VITAL SIGNS

A PHYSICIANS ORDER IS NOT REQUIRED FOR VITAL SIGNS TO BE MEASURED. UNLESS A NURSE IS PRESENT IT IS YOUR JOB TO TAKE VITAL SIGNS ON A PATIENT.

BODY TEMPERATURE

DEFINED BY THE HEAT PRODUCED IN THE BODY TISSUES TO THE HEAT LOST TO THE ENVIRONMENT.

CAN VARY 2 TO 3 DEGREES. BODY TEMPERATURE IS CONTROLLED

BY THE BASAL REGION OF THE BRAIN CALLED THE HYPOTHALAMUS (BODY THERMOSTAT)

FACTS THE ENVIRONMENT, TIME OF DAY,

WEIGHT, EMOTION, EXERCISE, DISEASE, DIGESTION OF FOOD AND INJURY ALL HAVE AN EFFECT ON TEMPERATURE.

FEVER OR PYREXIA IS ELEVATED TEMP.

AS BODY TEMP. INCREASES THE BODIES DEMAND FOR OXYGEN INCREASES.

TEMPERATURE RANGES 3 MONTHS TO 3 YEARS IS 99

DEGREES 5 TO 13 YEARS IS 97.8-98.6

SYMPTOMS OF A FEVER ARE INCREASED PULSE AND INCREASED RESPIRATIONS, ACHINESS ,FLUSHED DRY SKIN, CHILLS AND LOSS OF APPETITE.

LOW BODY TEMPERATURE IS CALLED HYPOTHERMIA.

HYPOTHERMIA CAN BE AN INDICATION OF A PATHOLOGICAL PROCESS AND CAN REDUCE A PATIENTS NEED FOR OXYGEN.

MEASURING TEMPERATURE

THERE ARE FOUR WAYS TO MEASURE TEMPERATURE.

1. ORAL2. TYMPANIC3. RECTAL4. AXILLARY

MEASURING TEMPERATURE

AVERAGE ORAL READING IS 98.6 AVERAGE RECTAL READING IS 99.6 AVERAGE AXILLARY READING IS

97.6-98 DEGREES. AVERAGE TYMPANIC READING IS

97.6

THE SITE SELECTED FOR MEASURING TEMPERATURE MUST BE CHOSEN CAREFULLY DEPENDING ON STATE OF MIND, AGE AND THE ABILITY TO COOPERATE.

ALERT!

PATIENTS WHO ARE DISORIENTED, DELUSIONAL, DELIRIOUS OR WHO HAVE FACIAL INJURIES OR A HISTORY OF CONVULSIONS SHOULD NEVER USE AN ORAL THERMOMETER.

TYMPANIC THERMOMETER

THIS IS PLACED IN THE EAR AND IS CALLED AN AURAL THERMOMETER

MEASURES THE BLOOD VESSELS IN THE TYMPANIC MEMBRANE OF THE EAR.

AXILLARY SAFEST METHOD OF MEASURING

BODY TEMPERATURE. USEFUL FOR INFANTS.

RECTAL MOST RELIABLE MEASURE OF

TEMPERATURE. CLOSE PROXIMITY TO THE CORE OF

THE BODY.

PULSE AS THE HEART

BEATS, BLOOD IS PUMPED IN A PULSATING FASHION INTO THE ARTERIES. THIS RESULTS IN A THROB SOUND!

PULSE

1. APICAL: OVER THE APEX OF THE HEART (HEARD WITH STETHOSCOPE)

2. RADIAL: RADIAL ARTERY OF WRIST3. CAROTID: FRONT OF NECK4. FEMORAL: GROIN5. POPLITEAL: BACK OF KNEE6. TEMPORAL: FRONT OF THE EAR7. DORSALIS PEDIS: TOP OF FOOT8. POSTERIOR TIBIAL: INNER SIDE OF

ANKLES.

PULSE

THE NORMAL AVERAGE PULSE RATE IN AN ADULT IS BETWEEN 60 AND 90 BEATS PER MINUTE.THE NORMAL PULSE FOR INFANTS IS 120 BEATS PER MINUTE.A CHILD 4 TO 10 YEARS OLD 90-100 BEATS PER MINUTE.

ASSESSMENT OF THE PULSE PULSE ASSESSES CARDIOVASCULAR FUNCTION. TACHYCARDIA IS A RAPID HEART BEAT (OVER

100 BEATS) BRADYCARDIA IS AN ABNORMALLY SLOW

HEART BEAT (BELOW 60).PULSE RATE SHOULD BE COUNTED FOR A FULL MINUTE.FOR INFANTS AND CHILDREN THE APICAL PULSE IS MOST ACCURATE.TO ASSESS THE PULSE YOU NEED A WATCH WITH A SECOND HAND.

RESPIRATION THE AVERAGE RATE OF

RESPIRATION FOR AN ADULT IS 15 TO 20 BREATHS PER MINUTE AND 30-60 BREATHS FOR AN INFANT.

RESPIRATION LESS THAN 10 BREATHS PER MINUTE MAY RESULT IN CYANOSIS, APPREHENSION AND A CHANGE IN CONSCIOUSNESS BECAUSE OF INADEQUATE OXYGEN.

ASSESSMENT OF RESPIRATION

1. KEEP PATIENT IN PRESENT POSITION.

2. OBSERVE CHEST WALL FOR SYMMETRY OF MOVEMENT.

3. OBSERVE SKIN COLOR.4. COUNT THE NUMBER OF TIMES

THE CHEST RISES AND FALLS FOR ONE MINUTE.

BLOOD PRESSURE IN GENERAL TERMS, IS DEFINED AS THE

PRODUCT OF FLOW TIMES RESISTANCE. BLOOD PRESSURE IS THE AMOUNT OF

BLOOD FLOW EJECTED FROM THE LEFT VENTRICLE OF THE HEART DURING SYSTOLE AND THE AMOUNT OF RESISTANCE THE BLOOD MEETS DUE TO SYSTEMIC VASCULAR RESISTANCE.

BLOOD PRESSURE FACTS

BLOOD PRESSURE VARIES WITH AGE, GENDER, BODY POSITION, TIME OF DAY AND HEALTH STATUS.

BLOOD PRESSURE IS USUALLY LOWER IN THE MORNING AFTER A NIGHT OF SLEEP THAN LATER IN THE DAY.

BLOOD PRESSURE FACTS

MEN USUALLY HAVE HIGHER BLOOD PRESSURE.

INFANTS HAVE HIGHER BLOOD PRESSURE.

SPHYGMOMANOMETER IS THE INSTRUMENT TO MEASURE BLOOD PRESSURE.

FACTS CONTINUED BLOOD PRESSURE REQUIRES TWO

READINGS AND IS MEASURED IN MILLIMETERS OF MERCURY.

THE TWO READINGS ARE CALLED SYSTOLIC AND DIASTOLIC.

SYSTOLIC IS THE TOP NUMBER DIASTOLIC IS THE BOTTOM NUMBER.

SYSTOLIC THIS READING IS THE HIGHEST POINT

REACHED DURING CONTRACTION OF THE LEFT VENTRICLE OF THE HEART AS IT PUMPS INTO THE AORTA.

THE NORMAL SYSTOLIC PRESSURE IS 110-140.

CHILDREN RANGE FROM 90-120. ADOLESCENT RANGES FROM 85-130.

DIASTOLIC THIS IS THE LOWEST POINT TO WHICH

THE PRESSURE DROPS DURING RELAXATION OF THE VENTRICLES AND INDICATES THE MINIMUM PRESSURE EXERTED ON THE ARTERIAL WALLS.

THE NORMAL RANGE IS 60-80 IN ADULTS.

CHILDRENS DIASTOLIC IS 50-70. ADOLESCENT PRESSURE 45-85.

HYPERTENSION

A PATIENT IS CONSIDERED HYPERTENSIVE IF THE SYSTOLIC PRESSURE IS GREATER THEN 140 AND THE DIASTOLIC PRESSURE IS GREATER THAN 90.

BLOOD PRESSURE CUFFS

THE BLOOD PRESSURE CUFF SHOULD BE SELECTED ACCORDING TO THE PATIENTS SIZE.

A CUFF TO LARGE OR SMALL WILL GIVE AN IMPROPER READING.

OXYGEN THERAPY OXYGEN IS ESSENTIAL TO LIFE. OXYGEN CAN NOT BE STORED AND IS DEPENDANT ON

THE ENVIRONMENT. IT IS YOUR RESPONSIBILITY AS A RADIOGRAPHER THAT

EQUIPMENT TO ADMINISTER OXYGEN IS AVAILABLE AND WORKING.

IT IS YOUR RESPONSIBILITY TO ASSIST WITH ADMINISTRATION OF OXYGEN IN EMERGENCY SITUATIONS.

THE AMOUNT OF OXYGEN IN EITHER AIR OR BLOOD IS CALLED OXYGEN TENSION.

INADEQUATE OXYGEN IS CALLED HYPOXEMIA. WHEN TO MUCH CARBON DIOXIDE IS RETAINED IN THE

ARTERIAL BLOOD IT IS CALLED HYPERCAPNEA.

PULSE OXIMETRY A DEVICE PLACED AT THE END OF

A PATIENTS FINGERTIP OR EARLOBE AND MEASURES OXYGEN SATURATION OF HEMOGLOBIN.

NORMAL OXYGEN SATURATION IS 90-100 PERCENT .

BELOW 85% INDICATES THE TISSUES ARE NOT GETTING ENOUGH OXYGEN.

HAZARDS OF OXYGEN ADMINISTRATION1. OXYGEN IS CONSIDERED A MEDICATION AND

MUST BE PRESCRIBED.2. SPECIAL CARE IS NECESSARY WHEN

ADMINISTERING OXYGEN TO COPD PATIENTS.

3. INFECTIONS AND BACTERIA THRIVE IN OXYGEN ENVIRONMENTS.

4. BE CERTAIN THAT TUBING, CANNULAS AND MASKS ARE USED ONE TIME AND FOR ONE PATIENT ONLY.

5. NO SMOKING AROUND OXYGEN!!!!!!!!!!!!!!!

OXYGEN DELIVERY SYSTEMS

HIGH FLOW RATES REQUIRE HUMIDIFICATION TO PREVENT DRY MUCOUS MEMBRANES.

OXYGEN IS PIPED TO ROOMS IN A HOSPITAL TO A WALL OUTLET.

A FLOWMETER IS ATTACHED TO EACH WALL OUTLET.

TYPES OF OXYGEN DELIVERY SYSTEMS

NASAL CANNULA NASAL CATHETER FACE MASK OXYGEN TENT

EQUIPMENT NEEDED FOR THE IMAGING DEPARTMENT

1. OXYGEN SOURCE ( TANK, PIPED IN )2. A STERILE CANNULA OR MASK IN A

SEALED PACKING.3. CONNECTING TUBING4. A HUMIDIFIER , IF NEEDED.5. A FLOW METER.6. A “NO SMOKING” SIGN.

CHEST RADIOGRAPHY

PLACEMENT OF TUBES CRITICAL THINKING PATHOLOGIES AND TECHNIQUE PORTABLES

THE END

OXYGEN DELIVERY WILL BE TAUGHT MORE EXTENSIVELY IN TOPGRAPHIC ANATOMY 2.