2Measuring and Recording Temperature Measurement of balance between heat lost and produced by the body.Lost through:PerspirationRespirationExcretion
3If body temperature too high or too low, homeostasis is affected Produced by:Metabolism of foodMuscle and gland activityHomeostasis = balanceIf body temperature too high or too low, homeostasis is affected
4Normal – 97 – 100 F or 36.1 – 37.8 CF = FahrenheitC = Celsius or CentigradeTemperature is usually higher in the evening.
5Parts of the body where temperature is taken: OralIn the mouthGlass or electronicMost commonNormal 98.6 F ( – 99.6)RectalMost accurate
6Axillary Aural In the armpit Also, can measure in the groin In the ear or auditory canalAlso called “Tympanic”Uses different modesUsually in less than 2 seconds
7Factors that body temperature Factors that body temperature Starvation or fastingSleepDecreased muscle activityExposure to cold in the environmentCertain diseasesFactors that body temperatureIllnessInfectionExerciseExcitementHigh temperatures in the environment
8Hypothermia Fever Hyperthermia Below 95 F Caused by prolonged exposure to coldDeath when temp below 93 FFeverElevated temperature, above 101 FHyperthermiaElevated temperature, above 104 FCaused by prolonged exposure to hot temperatures, brain damage, or serious infectionTemperatures above 106 F can lead to convulsions and death
9Taking Temperatures Clinical (glass) thermometer contains mercury Comes in oral, security, and rectalElectronic can be used for oral, rectal, axillary or groinMost have disposable probe coverTympanic placed in auditory canalTaker pushes the scan button
10Paper or plastic are used in some hospitals Contain special chemicals or dots that change colorsTo record temperature:986 is an oral reading996 (R) is a rectal reading976 (Ax) is an axillary reading986 (T) is an aural reading
11Eating, drinking hot or cold liquids, or smoking can alter oral temperature. Be sure it has been 15 minutes since the patient did any of those things before taking the temperature.
12Measuring and Recording Pulse The pressure of blood pushing against the wall of an artery as the heart beats and rests.
14Pulse Terminology Bradycardia – Under 60 beats per minute Tachycardia – Over 100 beats per minuteRhythm – Regularity of the pulse (regular or irregular)Volume – Strength or intensity (strong, weak, thready, or bounding)
15Pulse can be increased by: Pulse can be decreased by: ExerciseStimulant drugsExcitementFeverShockNervous tensionPulse can be decreased by:SleepDepressant drugsHeart diseaseComa
16Measuring and Recording Respiration Process of taking in Oxygen (O2) and expelling Carbon Dioxide (CO2)1 inspiration + 1 expiration = 1 respirationNormal rate = 14 – 18/min
17Character – depth and quality of respirations DeepShallowLaboredDifficultStertorousMoist
18Dyspnea – difficult or labored breathing Apnea – absence of respirationsCheyne-Stokes – periods of dyspnea followed by periods of apnea; noted in the dying patientRales – bubbling or noisy sounds caused by fluids or mucus in the air passages
19Leave your hand on the pulse while counting respirations and be sure the patient doesn’t know you are counting the respirations.
20Apical Pulse Taken with a stethoscope at the apex of the heart Actual heartbeat heard and countedTips of earpieces and diaphragm of stethoscope should be cleaned with alcohol before useHeart sounds heard resemble “lubb-dupp”
21Measuring and Recording Blood Pressure Measure of the pressure blood exerts on the walls of arteriesBlood pressure read in millimeters (mm) of mercury (Hg) on an instrument known as a sphygmomanometer
22Diastolic: Constant pressure when heart is at rest Systolic: Pressure on the walls of arteries when the heart is contracting.Normal range – 100 to 140 mm HgDiastolic: Constant pressure when heart is at restNormal range – 60 to 90 mm Hg
23Factors that blood pressure Factors that body temperature Excitement, anxiety, nervous tensionStimulant drugsExercise and eatingFactors that body temperatureRest or sleepDepressant drugsShockExcessive loss of blood
24Blood pressure recorded as a fraction Sphygmomanometers: Usually aneroid or mercury
25Measuring/Recording Height and Weight Used to determine if pt underweight or overweightHeight/weight chart used as averages+ or - 20% considered normalWhen are height-weight measurements routinely done in a health care setting?
26Daily Weights Be sure to: Ordered for patients with edema due to heart, kidney, or other diseases.Be sure to:Use the same scale every dayMake sure the scale is balanced before weighing the patientWeigh the patient at the same time each dayMake sure the patient is wearing the same amount of clothing each dayOBSERVE SAFETY PRECAUTIONS! Prevent injury from falls and the protruding height lever.
27Some people are weight conscious. Make only positive commentswhen weighing a patient.
28Types of ScalesClinical scales contain a balance beam and measuring rodSome institutions have bed scales or chair scalesInfant scales come in balanced, aneroid, or digital
29When weighing an infant…keep one hand slightly over but not touching the infant A tape measure is used to measure infant height. One way to accomplish this is to:Make a mark on the exam table paper at the top of the headStretch out the infant's leg and make a mark the paper at the heelUse a tape measure to measure from mark to mark
30Positioning a PatientMedical exam tableSurgical tableBedBe sure you know how to operate the table!
31Paper covers are usually used on exam tables After use, tables are often cleaned with disinfectantDuring any procedure, reassure the patientObserve safety factors to prevent falls and injuryUse correct body mechanicsObserve the patient for signs of distressProtect the patient's privacy
32Learn the purpose and procedure for the following positions: Horizontal recumbent (Supine)ProneSims' (Left lateral)Knee-chest*Fowler'sLow-Fowler'sSemi-Fowler'sHigh-Fowler'sLithotomyDorsal recumbent*TrendelenburgJackknife** Learn the position of these positions. You will not be required to demonstrate them.
33Did you save me a specimen? Testing UrineDid you save me a specimen?
34Physical = color, odor, transparency and specific gravity Urinalysis: Usually consists of physical, chemical and microscopic testsPhysical = color, odor, transparency and specific gravityBe sure the specimen is freshChemical = to check pH, protein, glucose, ketone, bilirubin, urobilinogen, and bloodReagent strips used for chemical testing
35Microscopic = to look for casts, cells, crystals, and amorphous deposits To do microscopic, urine is centrifuged and sediment is examined.
36OBSERVE STANDARD PRECAUTIONS when collecting and handling urine!!!