1. Vital Signs Temperature, Pulse, Respirations Mr. Hilton Health Science & Principles of Health Science

2. TEMPERATURE, PULSE, RESPIRATIONS Abbreviated: TPR

3. TEMPERATURE The measurement of core body heat

4. ROUTES TO MEASURE TEMPERATURE 4 Oral: By mouth 4 Rectally: By rectum 4 Axillary: Under the arm in the armpit 4 Tympanic: In the ear

5. TYPES OF THERMOMETERS 4 Digital Electronic: To be used for oral, rectal, and axillary 4 Thermoscan - Digital: To be used for tympanic 4 Mercury or glass: To be used for oral, rectal, and axillary

6. Thermometers

7. NORMS 4 Orally: 97.6 - 99.6 degrees Fahrenheit 4 Rectally: 99.6 - 100.6 degrees Fahrenheit 4 Tympanic - manufacturers say to measure as for rectal 4 Axillary: 96.6 - 98.6 degrees Fahrenheit

8. WHAT THERMOMETER SHOULD BE USED? 4 Tympanic: Special device with plastic covers. 4 Electronic: All routes. Probes that are red in color for rectal temperatures; blue in color for oral and axillary. 4 Mercury: All routes. Red ends are rectal; blue ends oral and axillary.

9. DURATION FOR TAKING TEMPERATURES 4 Tympanic: As long as it takes to push a button 4 Electronic: Until the thermometer beeps 4 Mercury Oral: Three minutes 4 Mercury Rectal: Three minutes 4 Mercury Axillary: Ten minutes

10. BE CAREFUL ON RECTAL AND AXILLARY TEMPS 4 Always hold the thermometer in place while measuring both temperatures 4 Always use lubricant with rectal temperatures 4 Always remove clothing around axilla

11. READING THE THERMOMETER 4 Mercury Fahrenheit thermometers are read by degree and 0.2 of a degree 4 Long lines indicate degrees 4 Short lines indicate 0.2 of a degree 4 Four short lines between each long line (0.2, 0.4, 0.6, 0.8)

12. PULSE The wave of blood created by the heart pumping, that travels along the arteries.

13. PULSE LOCATIONS 4 At points where the artery is between finger tips and a bony area 4 Called pulse points 4 Felt with 2-3 fingers, but never the thumb

14. PULSE POINTS AND THEIR LOCATIONS 4 Temporal 4 Carotid 4 Apical 4 Brachial 4 Radial 4 Femoral 4 Popliteal 4 Dorsal Pedalis

15. MAJOR PULSE LOCATIONS

16. HOW TO MEASURE? 4 Measured in beats per minute 4 Count the waves for 60 seconds 4 Or, count the waves for 30 seconds - multiply by 2

17. NORMS 4 Pulse norms are 60 - 100 beats per minute 4 Pulses between 90 - 100 are in a gray area - high normal 4 Faster than 100 - tachycardia 4 Slower than 60 - bradycardia

18. QUALITY OF PULSE 4 Rhythm: regular or irregular 4 Rate: Within the normal limits 4 Strength: Strong, bounding, thready

19. WHAT AFFECTS PULSE RATES AND QUALITY 4 Body Temperature 4 Emotions 4 Activity Level 4 Health of the Heart

20. RESPIRATION The mechanical act of breathing in air (inspiration) and expelling air (expiration) from the body

21. RESPIRATION 4 Measured in breaths per minute 4 Normal range is 12 - 24 breaths per minute 4 Greater than 24 is tachypnea 4 Less than 12 is bradypnea 4 Watch for rate, depth, quality of breath, and difficulty in breathing

22. METHOD OF MEASURING TPR (temp, pulse, respirations) 4 If using a mercury thermometer, measure the pulse and respiration while waiting for the temperature 4 If using another method of measuring the temperature, complete the temperature - then measure the pulse and respiration 4 Keep you fingers on the pulse while measuring the respiration

23. CHARTING 4 Chart in order temperature - pulse - respiration. 4 Do not write T =, etc. 4 Write (Ax) after axillary temperatures 4 Write (R) after rectal temperatures

24. ABBREVIATIONS 4 SOB - Short of breath 4 TPR - Temperature, pulse, and respiration Within normal limits 4 P.O. - By mouth 4 BID -Twice a day 4 TID -Three times a day 4 QID - Four times a day 4 QS - Every shift 4 QD - Every day 4 PRN - As needed 4 Ad Lib - At liberty 4 B/P - Blood Pressure 4 VS - Vital Signs

25. ABBREVIATIONS 4 SOB 4 TPR 4 WNL 4 PO 4 BID 4 TID 4 QID 4 QS 4 QD 4 PRN 4 Ad Lib 4 B/P 4 VS

26. ABBREVIATIONS 4 Short of breath 4 Temperature, pulse, and respiration Within normal limits 4 By mouth 4 Twice a day 4 Three times a day 4 Four times a day 4 Every shift 4 Every day 4 As needed 4 At liberty 4 Blood Pressure 4 Vital Signs

27. TERMS 4 Eupnea - Normal breathing 4 Orthopnea - Sitting upright to breath more easily 4 Apnea - No breath 4 Hyperpnea - Fast, deep breathing 4 Tachypnea - Fast, shallow breathing 4 Bradypnea - Slow breathing 4 Dyspnea - Painful or difficult breathing 4 Tachycardia - Pulse rate in excess of 100 bpm 4 Bradycardia - pulse rate less than 60 bpm

28. TERMS 4 Eupnea 4 Orthopnea 4 Apnea 4 Hyperpnea 4 Tachypnea 4 Bradypnea 4 Dyspnea 4 Tachycardia 4 Bradycardia

29. TERMS 4 Normal Breathing 4 Sitting upright to breath more easily 4 Fast, deep breathing 4 Fast, shallow breathing 4 Slow breathing 4 Painful or difficult breathing 4 Pulse rate in excess of 100 beats per minute 4 Pulse rate less that 60 beats per minute

30. TERMS 4 Bounding pulse - excessively strong pulse 4 Thready pulse - Pulse rate difficult to palpate because the heart is not beating hard enough to produce a strong wave of blood. Feels as though there is a piece of thread running under the fingertips.

31. TERMS 4 Bounding pulse 4 Thready pulse

32. TERMS 4 Excessively strong pulse 4 Pulse difficult to palpate because heart not beating heard enough