1. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Pearson's Comprehensive Medical Assisting Administrative and Clinical Competencies Second Edition CHAPTERCHAPTER CHAPTER 35 Vital Signs Lesson 3: Pulse and Respirations

2. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Lesson Objectives Upon completion of this lesson, students should be able to … Define and spell the terms to learn for this chapter. State the normal values of temperature, pulse, respiratory rates, and blood pressure. List and describe the nine pulse sites. Describe the respiratory rate range for the various age groups.

3. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan The Pulse The amount of times the heart beats per minute (bpm) Wave of blood created each time the left ventricle of the heart contracts Each pulse beat is one cardiac cycle or one heartbeat Normal heartbeat is about 70 times per minute Increased oxygen results in a faster pulse rate Tachycardia = pulse rate above 100 bpm Bradycardia = pulse rate below 60 bpm

4. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Factors that Influence Pulse Rate Exercise Age Gender Size Physical condition Disease states Medications Depression Fear, anxiety, anger

5. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Average Pulse Rates by Age Less than 1 year: 120-160 bpm 2-6 years: 80-120 bpm 6-10 years: 80-100 bpm 11-16 years: 70-90 bpm Adult: 60-80 bpm Older adult: 50-65 bpm

6. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Characteristics of Pulse Rate Volume Rhythm Compliance of the arterial wall

7. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Rate and Volume of Pulse Rate – describes the number of pulse beats per minute Volume – refers to the strength of the pulse Volume is noted as: –Full or bounding pulse, indicating an increase in blood volume –A strong or normal amount of force or blood volume –A weak or thready pulse (barely perceptible) force or blood volume

8. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Rate and Volume of Pulse Volume is influenced by the forcefulness of the heartbeat, the condition of the arterial walls, and dehydration A variance in intensity of the pulse may indicate heart disease

9. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Rhythm Refers to the regularity, or equal spacing, of all the beats of the pulse Various aspects of rhythm are as follows: –Normally, the intervals between each heartbeat are of the same duration –A pulse with an irregular rhythm is known as a dysrhythmia or arrhythmia –The irregular rhythm may be random irregular beats or a predictable pattern of irregular beats –It is not considered abnormal if the heart occasionally skips a beat – This is referred to as an intermittent pulse

10. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Common Pulse Sites Radial Brachial Carotid Temporal Femoral Popliteal Posterior tibial Dorsalis pedis Apical

11. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Brachial

12. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Radial

13. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Carotid

14. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Femoral

15. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Popliteal

16. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Posterior Tibial

17. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Pedal (Dorsalis Pedis)

18. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Step 1: Perform hand hygiene. Identify the patient. Step 2: Explain procedure to the patient and ask the patient about any recent physical activity or smoking. Step 3: Ask patient to sit down and place arm in a comfortable, supported position. Step 4: Place finger tips on radial artery on thumb side of wrist. Step 5: Check quality of pulse. Steps in Measuring a Radial Pulse Rate

19. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Step 6: Start counting pulse beats when second had on watch is at 3, 6, 9, or 12. Step 7: Count the pulse for 1 full minute. Step 8: Immediately write the pulse beats per minute on a piece of paper. Step 9: Perform hand hygiene and record the pulse beats per minute in the patient’s record. Steps in Measuring a Radial Pulse Rate

20. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Respiration The act of breathing The exchange of oxygen and carbon dioxide Consists of one expiration and one inspiration Each rise and fall of a patient’s chest equals one respiration Taken typically at the same time as a pulse

21. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Characteristics of Respiration Rate Rhythm Depth Quality Breath sounds

22. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Respiratory Rate Ranges by Age Group Newborn: 30-50 1 year old: 20-40 2-10 years: 20-30 11-18 years: 18-24 Adult: 14-20

23. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman Fleming-McPhillips Routh Gohsman Reagan Situations that Alter Respirations Allergic reactions Medications Disease Exercise Emotions Fever Hemorrhage High altitudes Obstruction of air passage Pain and shock