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Urgent Care/Clinical Settings Teamwork between physician and technologist No call Low Stress Flextime More hands on with Patient Care No Heirarchy No problems with departmental communication
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PATIENT CARE PROCEDURES Laboratory Urine Collection Blood Draws Specimen Collection IV Therapy & Heparin Lock Medication Administration Eye Exams Sterile and Non-Sterile Physicals Orthostatic Vitals Universal Precautions Infection Control
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EVEN MORE COOL PROCEDURES Histofreeze Epistasis Cerumen Removal Nebulizer Treatment O2 Peak Flow Spirometry Burn Debridement Splinting/Casting Dressing Changes Suture Removal I & D & Laceration Trays
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VITALS Vital signs are measurable, concrete indicators that pertain to and are essential for life.
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GETTING VITALS Height/weight Temperature Pulse Respirations Blood Pressure Evaluation of pain
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Height/weight Provide information for diagnosing, treating, preventing, or evaluating a condition Growth pattern Dosage for certain drugs Weight determined for certain specialty exams.
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OVERWEIGHT PROBLEMS Hypertension Heart disease Diabetes mellitus Psychologic problems
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UNDERWEIGHT PROBLEMS Malnourishment Metabolic disorders Psychologic problems
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PROCEDURE Scales should be located in private area Patient stand with back to numbers
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TEMPERATURE Body temperature is a result of the balance maintained between heat produced and heat lost by the body. Regulated by hypothalamus 85% body heat lost through convection 15% lost through respiratory tract/mouth and feces/urine.
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TEMPERATURE Oral: 98.6 F (+/- 1F), 37 C Rectal: 99.6 F, 37.6 C Axillary: 97.6 F, 36.4 C Tympanic: read in oral or rectal
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PULSE The wave of blood that travels along the arteries with each contraction of the heart’s left ventricle. Best felt when a superficial artery is pressed against a firm structure.
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PULSE Rate Rhythm Volume Condition of arterial wall Infant: 100-180 bpm Child: 70-110 bpm Adult: 55-90 bpm
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Apical pulse Pulse deficit
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RESPIRATION The taking in of O2, its use in the tissues, and the giving off of CO2. Controlled by the medulla oblongata. Ratio of respiration to pulse is typically 1:4
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RESPIRATION Rate Rhythm Depth At birth: 30-60 R/min Infant: 30-38 R/min Child: 20-26 R/min Adult: 12-20 R/min
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BLOOD PRESSURE Pressure of the blood against the walls of the blood vessels. Systolic Pressure – ventricles of the heart in a state of contraction. Diastolic Pressure – ventricles of the heart in a state of relaxation. Pulse Pressure – difference of the two (30- 50 is normal)
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BLOOD PRESSURE Child: systolic100-120 mm/Hg diastolic60-80 Adult: systolic90-140 mm/Hg diastolic60-90 Elderly: systolic140-170 mm/Hg diastolic92-100
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BLOOD PRESSURE Hypertension – increase in blood pressure “Silent Killer” never based on one reading Hypotension – decrease in blood pressure
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INSTRUMENTS Sphygmo (pulse) mano (slight) meter (to measure) Mercury – column Aneroid – a, not neroid, liquid Manometer parts: Cuff, inflation bulb, control valve, pressure indicator Stethoscope
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Auscultation Method Brachial artery @ antecubital space Korotkoff sounds Phase I: faint tapping (systolic) Phase II: swishing; Phase III: crisp, loud Phase IV: Sound becomes dull/muffled (diastolic) Phase V: All sound disappears; 2 nd diast.
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