vital signs lesson 3: pulse and respirations

Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e

Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan

Pearson's ComprehensiveMedical AssistingAdministrative and Clinical Competencies

Second Edition

CHAPTERCHAPTER CHAPTERCHAPTER CHAPTERCHAPTER 3535

Vital SignsLesson 3:Pulse and Respirations

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.

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

Factors that Influence Pulse Rate

• Exercise• Age• Gender• Size• Physical condition• Disease states• Medications• Depression• Fear, anxiety, anger

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

Characteristics of Pulse

• Rate• Volume• Rhythm• Compliance of the arterial wall

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

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

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

Common Pulse Sites

• Radial• Brachial• Carotid• Temporal• Femoral• Popliteal• Posterior tibial• Dorsalis pedis• Apical

Brachial

Radial

Carotid

Femoral

Popliteal

Posterior Tibial

Pedal (Dorsalis Pedis)

Step 1:Step 1: Perform hand hygiene. Identify the patient. Perform hand hygiene. Identify the patient.

Step 2:Step 2: Explain procedure to the patient and ask the Explain procedure to the patient and ask thepatient about any recent physical activity or smoking. patient about any recent physical activity or smoking.

Step 3:Step 3: Ask patient to sit down and place arm in Ask patient to sit down and place arm ina comfortable, supported position. a comfortable, supported position.

Step 4:Step 4: Place finger tips on radial artery on Place finger tips on radial artery on thumb side of wrist. thumb side of wrist.

Step 5:Step 5: Check quality of pulse. Check quality of pulse.

Steps in Measuring a Radial Pulse Rate

Step 6:Step 6: Start counting pulse beats when second had on Start counting pulse beats when second had on watch is at 3, 6, 9, or 12. watch is at 3, 6, 9, or 12.

Step 7:Step 7: Count the pulse for 1 full minute. Count the pulse for 1 full minute.

Step 8:Step 8: Immediately write the pulse beats per Immediately write the pulse beats per minute on a piece of paper.minute on a piece of paper.

Step 9:Step 9: Perform hand hygiene and record the Perform hand hygiene and record the pulse beats per minute in the patient’s record. pulse beats per minute in the patient’s record.

Steps in Measuring a Radial Pulse Rate

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

Characteristics of Respiration

• Rate• Rhythm• Depth• Quality• Breath sounds

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

Situations that Alter Respirations

• Allergic reactions• Medications• Disease• Exercise• Emotions• Fever• Hemorrhage

• High altitudes• Obstruction of air

passage• Pain and shock

vital signs lesson 3: pulse and respirations

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