2. VITAL SIGNS

3. Blood Pressure Definition: the pressure the blood exerts on the walls of the arteries. Hypertension = HIGH blood pressure Hypotension = LOW blood pressure

4. Blood Pressure Systole: the contraction phase, corresponds to the actual beat of the heart, and is the period of GREATEST pressure. Systole is the TOP number Diastole: the relaxation phase, corresponds to the filling action of the heart, and is the period of LEAST pressure. Diastole is the BOTTOM number.

5. Pulse Pressure Definition: the difference between the systolic and diastolic readings. Normal pulse pressure is 40 > 50 or < 30 is considered abnormal General rule of thumb is that pulse pressure should be about one third of the systolic pressure.

6. Blood Pressure Measured in millimeters of Mercury, or as it is written mm/Hg. Use a sphygmomanometer, and a stethoscope. Written as a fraction 120/80, where the systolic is 120 and diastolic is 80.

7. BLOOD PRESSURES..technique 1. Placement of cuff: brachial artery (just above the elbow 2. Close valve 3. Inflate bladder with bulb 4. SLOWLY release the valve 5. Listen…1 st sound, and last sound… REMEMBER… 100 - 140 60 - 90

8. Sounds 1 st sound : Systole= heart @ work (contracting) Last Sound: Diastole = heart @ rest ( relaxing)

9. Pulses Apical= stethoscope for 1 minute… Radial= wrist Carotid= neck REMEMBER 60-90=nml, Adults 90-160=nml, infants

10. Pulses Characteristics: Rhythm: refers to the regularity of the pulse (regular or irregular) Rate: the number of beats per minute Volume: refers to the force or strength of the pulse: normal, bounding, weak, thready (barely perceivable)

11. Pulses Tachycardia: > 100 beats per minute Bradycardia: < 60 beats per minute Exception: many athletes normally have heart rates < 60 because their heart is in better shape.

12. Pulses Pulse deficit: The difference between the apical pulse and the radial pulse. Pulse deficit can indicate certain heart conditions, that will be diagnosed by further testing.

13. Respirations Measurement of breathing This is tricky, you must “fool” the patient by letting them think you are continuing to count heartbeats and at the same time watch the chest rise and fall. Hyperventilation: excessively fast and deep respirations Dyspnea: difficult or labored breathing

14. Respirations..characteristics Apnea: no breathing.. Rales: noisy breathing Crackles: Heard in the bases of the lungs..sounds like …(demo) Respirations are: Normal, shallow or deep, regular or irregular Cheyne Stokes: slow shallow breaths that increse in depth and frequency to be followed by a few shallow breaths and then apnea for >10 seconds.. This usually precedes death.

15. RESPIRATIONS Stethoscope One inhalation, one exhalation=1 resp. Count by watching the chest rise and fall DON’T TELL THE PATIENT! REMEMBER NORMAL= 12-20 breaths per minute.

16. Temperatures Definition: the amount of heat the body generates under normal or stressed conditions. Oral – under the tongue Rectal – in the anus Axillary – under the armpit

17. TEMPERATURES RECTAL=99.6 AXILLIARY= 97.6 ORAL= 98.6 Shake down Thermometer Clean with alcohol. Place under tongue. For 3 minutes. Rectal & Axillary= 10 min. REMEMBER!

18. THE END