Monday, June 9, 2014

 Let’s review the 4 vital signs!  Heart rate  Respiratory rate  Blood pressure  Temperature

 What does heart rate tell you?  Tells you part of the patient’s story – how your body is being supplied by oxygenated blood  Where can you measure heart rate?  11 sites, 8 discussed last class  How do you describe (document) heart rate?  Site, rate, rhythm, depth

 Describe the process of breathing  Inhalation and expiration: exchange of gases in the body  What does respiratory rate tell you?  Tells you how much oxygen you may need, and how much carbon dioxide to expel  How does respiratory rate relate to heart rate?  Hold your breath  Your body needs oxygen, but needs to also get rid of gas wastes: CO2

 What is blood pressure?  A ratio of the pressure in your arteries when your heart contracts & relaxes  Systolic vs diastolic  What is hypotension vs hypertension?  Hypo – below normal, ie. shock  Hyper – above normal, ie. cardiovascular disease  What does blood pressure tell you?  Tells you whether oxygenated blood is getting delivered properly

 What does temperature tell you?  The body self-regulates its temperature to ensure cellular reactions work best  What is hypothermia vs hyperthermia?  Temperature below or above normal can seriously affect body function  What is the difference between core and peripheral temperature?  Core: taken by ear (T) & rectum (PR)  Peripheral: taken by armpit (Ax), mouth (PO)

 Manual blood pressure  1) Make sure patient has not been doing any strenuous activity for about 5 minutes.  2) Take cuff and secure it around patient’s arm, placing the tubing centre to the patients brachial artery site  3) Locate the radial pulse, and inflate the cuff until you cannot feel the pulse anymore (obliteration), making note of the mmHg

 Manual blood pressure continued  4) Now place your stethoscope on this site and listen for a pulse. Inflate cuff above the obliteration point by 30-40mmHg.  5) Slowly deflate cuff at 2-3mmHg per second, and make note when you begin to hear the pulse again. That’s your systolic!  6) Continue to deflate and make note when you no longer hear the pulse. That’s your diastolic!

Heart Rate Respiratory Rate Temperature Blood pressure Critical thinking

 What is the normal heart range for an adult?  Back to the Board

 What is the normal heart rate range for an infant?  BPM Back to the Board

 What is tachycardia?  Increased heart rate over the normal range Back to the Board

 There are 11 sites to palpate pulse. 8 were in the last presentation: name 3 of these sites.  Apical  Radial  Femoral  Popliteal  Brachial  Carotid  Dorsalis pedis  Temporal Back to the Board

 What are the 4 components of documenting of heart rate?  1) Site  2) Rate  3) Rhythm  4) Depth Back to the Board

 How is respiratory rate measured?  Respirations per minute Back to the Board

 What is the normal range for a child?  respirations per minute Back to the Board

 Name 2 of the 3 components of documenting respiratory rate.  1) Rate  2) Rhythm  3) Depth Back to the Board

 What is the process in which your diaphragm flattens and chest expands allowing exchange of oxygen in your lungs?  Inhalation Back to the Board

 Name 2 things that can affect your ability to breath: Bonus points if you can explain how.  Airway is obstructed  Lung tissue is poor (ie. inflammation, thickened)  Lung cannot inflate properly (ie. collapsed, pressure against lung space) Back to the Board

 What is the normal range for temperature?  *C Back to the Board

 What site is denoted by the letter “O”?  Oral temperature site Back to the Board

 Name the 4 sites to take temperature.  Oral  Rectal  Axillary  Tympanic Back to the Board

WWhat is the difference between core and peripheral temperatures? CCore refers to temperatures closest to internal organs PPeripheral refers to temperatures away from internal organs Back to the Board

 Which type of temperature sites is the most accurate? Bonus points if you can explain why.  Core temperature sites such as tympanic & rectal  Because they are a better at measuring the temperature of your internal organs and less influenced by fluctuations of your environment Back to the Board

 What is the normal blood pressure of an adult?  120/80 Back to the Board

 What is the unit of measure for blood pressure?  mmHg or “millimetres of mercury” Back to the Board

 What is the difference between systolic & diastolic pressures?  Systolic is a measures of the pressure in the arteries when the heart contracts  Diastolic is a measure of the pressure when the arteries relax Back to the Board

 What is the normal blood pressure of an infant?  90/55 Back to the Board

 Give 3 symptoms of hypotension.  Dizziness, light-headedness, syncope (fainting), cold/clammy skin, fatigue, shallow breathing, blurred vision, lack of concentration, nausea Back to the Board

 BEFORE taking vital signs, what are some observations you can make that may affect how you interpret your findings? Back to the Board

 A 20 year old man comes into the ER with a stab wound to the stomach. His vitals are T- 37.2*C (PO), BP-88/60, HR-121, RR-24. Explain the relationship between his blood pressure and his heart rate. Back to the Board

 A 77 year old lady becomes increasingly confused so her family takes her to see the doctor. Her vitals are T-37.7*C (PO), BP- 109/68, HR-108 and RR-18. The nurse takes a rectal temperature and it’s T-38.2*C (PR). What does this finding mean? Back to the Board