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

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Presentation on theme: "Measuring: -Temperature -Pulse -Blood Pressure -Body mass index."— Presentation transcript:

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

2 Pulse

3 Definition of Pulse  The pressure of the blood pushing against the wall of an artery as the heart beats and rests

4 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

5 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)

6 Blood Pressure

7 The 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

8 Equipment  Sphygmomanometer 1. Inflatable cuff 2. Pressure bulb or other device for inflating cuff 3. Manometer  Stethoscope

9 Types of sphygmomanometers 1. Aneroid  Circular gauge for registering pressure  Must be checked, and calibrated every 3 to 6 months

10 Types of sphygmomanometers 2. Electronic  Provides a digital readout of the blood pressure  No stethoscope is needed  Easy to use

11 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

12 Measuring the BP 1. Before measuring the BP  Instruct your patients to avoid coffee, smoking or any other unprescribed drug with sympathomimetic activity on the day of the measurement  Make sure the patient has rested and settled after entering the room

13 Measuring the BP 2. Position of the Patient  Sitting position  Arm and back are supported  Feet should be resting firmly on the floor  Feet not dangling

14 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 arm  Raise 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.

15 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 it  Inflate the cuff to a pressure 20-30mmHg above the estimated value.  Deflate slowly and listen for pulsation from artery (Korotkoff’s sounds)

16  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

17 Interpretation 1. Normal blood pressure  Normal SBP<120, DBP<80 2. Hypotension  SBP < 90, DBP< 60, or a pressure 25 mmHg lower than usual 3. Hypertension (Adults) ClassificationSBP mmHgDBP mmHg Prehypertension 120–139or 80–89 Stage 1 Hypertension 140–159or 90–99 Stage 2 Hypertension 160-179or 100-109 Hypertensive crisis ≥180≥ 110

18 Temperature

19 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

20 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

21 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 temp  Make sure the patient has had nothing to eat, drink or smoke for at least 15 minutes prior to taking temp FoFo CoCo

22 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

23 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

24 Types of Thermometers 2. Heat-sensitive patches  Patch placed on the skin  color changes on the patch indicate temperature readings

25 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

26 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

27 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

28 Areas to measure from 2. Rectal  Most accurate because it is an internal measurement  Clinical thermometer left in place for 3 to 5 minutes

29 Areas to measure from 3. 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

30 Areas to measure from 4. 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

31 Causes of high Body Temperature  Illness and infection  Exercise and/or excitement  High temperatures in the environment Causes of low Body Temperature  Starvation or fasting  Sleep  Decrease in muscle activity  Mouth breathing  Cold temperatures in the environment

32 Interpretation 1. Normal body temperature: 2. Fever (Hyperthermia): temp above the normal range 3. Hypothermia : Core body temperature less than 35 o C (below 95° F). 4. Hyperpyrexia : Body temp exceeds 40-41 o C (104-106°F) rectally

33 Body weight

34 Indications  Monitor treatment response and disease progression in:  Heart disease  Renal disease  Liver disease  Assess the nutritional status of the patient

35  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)

36 Procedure  Explain procedure to the patient and take permission  Remove shoes, heavy objects and jacket  Balance the scale at zero( 0)level  Allow patient to climb the scale  On the weighing scale, balance scale while patient is on it  Read the patient’s weight from the weighing scale and record reading  Tell the patient their reading and thank him

37 Height

38 Indication  To assess the growth in children  To assess the nutritional state of patient (calculate the BMI)

39 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

40 Body Mass Index

41 How to calculate

42 BMI (Sedentary adults)  Underweight < 20  Healthy Weight20 - 24.9  Overweight25 – 29.9  Obese ( Class 1 )30 – 34.9  Obese ( Class 2 )35 – 40  Morbid Obesity> 40  Careful in athlete, elderly, and children (Why)

43 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

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