U10 Pt Procedures & Vital U10 Pt Procedures & Vital SignsSigns
Patient ProceduresPatient ProceduresALWAYS BEGIN ALWAYS BEGIN
TESTS/PROCDURES TESTS/PROCDURES WITH THE WITH THE
6 Rules of PATIENT 6 Rules of PATIENT PROCEDURESPROCEDURES
Patient ProceduresPatient Procedures6 rules6 rules
Introduce Introduce yourselfyourself
Patient ProceduresPatient Procedures
Introduce yourselfIntroduce yourself
Identify the pt.--Identify the pt.--Make sure you are Make sure you are with the correct ptwith the correct pt
Patient ProceduresPatient Procedures
Introduce yourselfIntroduce yourself Identify the pt.--Make sure you are with Identify the pt.--Make sure you are with
the correct ptthe correct pt
Explain the Explain the procedure to the ptprocedure to the pt
Patient ProceduresPatient Procedures Introduce yourselfIntroduce yourself Identify the pt.--Make sure you are with the correct ptIdentify the pt.--Make sure you are with the correct pt Explain the procedure to the ptExplain the procedure to the pt
Explain to the pt that if they Explain to the pt that if they feel uncomfortable/pain at feel uncomfortable/pain at any time, they are to tell you any time, they are to tell you and that you will stop the and that you will stop the procedure.procedure.
Patient ProceduresPatient Procedures Introduce yourselfIntroduce yourself Make sure you are with the correct ptMake sure you are with the correct pt Explain the procedure to the ptExplain the procedure to the pt Explain to the pt that if they feel Explain to the pt that if they feel
uncomfortable/pain at any time, they are uncomfortable/pain at any time, they are to tell you and that you will stop the to tell you and that you will stop the procedure.procedure.
Ask the pt if they Ask the pt if they understand or if they understand or if they have any questionshave any questions
Patient ProceduresPatient Procedures Introduce yourselfIntroduce yourself Make sure you are with the correct ptMake sure you are with the correct pt Explain the procedure to the ptExplain the procedure to the pt Explain to the pt that if they feel Explain to the pt that if they feel
uncomfortable/pain at any time, they are uncomfortable/pain at any time, they are to tell you and that you will stop the to tell you and that you will stop the procedureprocedure
Ask the pt if they understand or if they Ask the pt if they understand or if they have any questionshave any questions
Record ResultsRecord Results
Vital SignsVital Signs Tests/procedures that are Tests/procedures that are
indicators of internal indicators of internal homeostasis (homeostasis (homeostasis homeostasis is the maintaining of a is the maintaining of a constant internal constant internal environment—breathing, environment—breathing, heart rate, body heart rate, body temperature, internal temperature, internal functionsfunctions).).
Vital SignsVital Signs
Represents the Represents the general health of general health of the pt at that the pt at that point in timepoint in time
Important factors of Vital SignsImportant factors of Vital Signs Understand how to do the Understand how to do the
procedure/testprocedure/test
Important factors of Vital SignsImportant factors of Vital Signs Understand how to do the Understand how to do the
procedure/testprocedure/test Know how to perform the Know how to perform the
procedure or test with procedure or test with confidenceconfidence
Important factors of Vital SignsImportant factors of Vital Signs Understand how to do the Understand how to do the
procedure/testprocedure/test Know how to perform the Know how to perform the
procedure or test with procedure or test with confidenceconfidence
Must be accurateMust be accurate
Important factors of Vital SignsImportant factors of Vital Signs Understand how to do the Understand how to do the
procedure/testprocedure/test Know how to perform the Know how to perform the
procedure or test with procedure or test with confidenceconfidence
Must be accurateMust be accurate Must be able to keep the pt Must be able to keep the pt
comfortable.comfortable.
Factors that may influence Factors that may influence VSVS
PhysicalPhysicalWalking, running, illness, Walking, running, illness, stairs etc….stairs etc….
Factors that may influence Factors that may influence VSVS
PhysicalPhysical
Emotional-afraid, bad day, Emotional-afraid, bad day, stress etc….. stress etc…..
Factors that may influence Factors that may influence VSVS
PhysicalPhysical Emotional-afraid, bad day, stress etc…..Emotional-afraid, bad day, stress etc….. EquipmentEquipment
FailuresFailuresTo big or smallTo big or smallLow batteriesLow batteries
Vital SignsVital Signs
TemperatureTemperature Pulse/Heart ratePulse/Heart rate Respiratory RateRespiratory Rate Blood pressureBlood pressure HtHt WtWt
TemperatureTemperature
Physiology: The body Physiology: The body maintains a constant maintains a constant temperature, this helps to temperature, this helps to maintain maintain homeostasis (the homeostasis (the internal environment of the internal environment of the body)body), this is controlled by the , this is controlled by the brain.brain.
TemperatureTemperature
Physiology: The body moves Physiology: The body moves blood to the core of the blood to the core of the body to increase the body to increase the temperature of the blood, temperature of the blood, which in turns increases the which in turns increases the body temperature----fever.body temperature----fever.
Factors that influence Factors that influence TemperatureTemperature
LiquidsLiquids
Factors that influence Factors that influence TemperatureTemperature
LiquidsLiquids WeatherWeather
Factors that influence Factors that influence TemperatureTemperature
LiquidsLiquids WeatherWeather ExerciseExercise
Factors that influence Factors that influence TemperatureTemperature
LiquidsLiquids WeatherWeather ExerciseExercise InfectionsInfections
Factors that influence Factors that influence TemperatureTemperature
LiquidsLiquids WeatherWeather ExerciseExercise InfectionsInfections StressStress
Is a Fever a good Is a Fever a good thing?thing?
Yes—the increase in Yes—the increase in temperature helps temperature helps the body destroy any the body destroy any pathogens. Pathogens pathogens. Pathogens are temperature are temperature sensitive.sensitive.
Is a Fever a good thing?Is a Fever a good thing?
Yes—the increase in temperature helps Yes—the increase in temperature helps the body destroy any pathogens. the body destroy any pathogens. Pathogens are temperature sensitive.Pathogens are temperature sensitive.
Sometimes not--- a prolonged Sometimes not--- a prolonged fever (having a fever for a fever (having a fever for a long period of time), can long period of time), can cause brain injuriescause brain injuries..
Temperature SitesTemperature Sites
Oral--mouthOral--mouth
Temperature SitesTemperature Sites
Oral—mouthOral—mouth
Rectal- ummmmmRectal- ummmmm
Temperature SitesTemperature Sites
Oral—mouthOral—mouth Rectal- ummmmmRectal- ummmmm
Tympanic--earTympanic--ear
Temperature SitesTemperature Sites
Oral—mouthOral—mouth Rectal- ummmmmRectal- ummmmm Tympanic—earTympanic—ear
Axillary- arm pitAxillary- arm pit
Temperature SitesTemperature Sites
Oral—mouthOral—mouth Rectal- ummmmmRectal- ummmmm Tympanic—earTympanic—ear
Axillary- arm pitAxillary- arm pit Temporal Temporal
Scan-forehead/behind the earScan-forehead/behind the ear
Temperature Temperature Value/ReadingsValue/Readings
Normal- 98.6 degrees FNormal- 98.6 degrees F
Temperature Temperature Value/ReadingsValue/Readings
Normal- 98.6 degrees FNormal- 98.6 degrees F
Rectal temperature: Rectal temperature: subtract 1 degreesubtract 1 degree
Temperature Temperature Value/ReadingsValue/Readings
Normal- 98.6 degrees FNormal- 98.6 degrees F
Rectal temperature: subtract 1 Rectal temperature: subtract 1 degreedegree
Axillary temperature- add 1 Axillary temperature- add 1 degreedegree
Types of thermometersTypes of thermometers
GlassGlass
Types of thermometersTypes of thermometers
GlassGlass
digitaldigital
Types of thermometersTypes of thermometers
GlassGlass DigitalDigital
Digital ProbeDigital Probe
Types of thermometersTypes of thermometers
GlassGlass DigitalDigital Digital ProbeDigital Probe
TympanicTympanic
Types of thermometersTypes of thermometers
GlassGlass DigitalDigital Digital ProbeDigital Probe TympanicTympanic Temporal ScanTemporal Scan
Pulse/Heart RatePulse/Heart Rate
The number of times the The number of times the heart beats per minute.heart beats per minute.
Pulse/Heart RatePulse/Heart Rate
The number of times the The number of times the heart beats per minute.heart beats per minute.
Documented as ___B/M Documented as ___B/M ( beats per minute)( beats per minute)
Pulse/Heart RatePulse/Heart RateFactors the affect the Factors the affect the HR.HR.ExerciseExercise
Pulse/Heart RatePulse/Heart RateFactors the affect the Factors the affect the HR.HR.ExerciseExerciseFoodFood
Pulse/Heart RatePulse/Heart RateFactors the affect the Factors the affect the HR.HR.ExerciseExerciseFoodFoodIllnessIllness
Pulse/Heart RatePulse/Heart RateFactors the affect the HR.Factors the affect the HR.
ExerciseExerciseFoodFoodIllnessIllnessStressStress
Pulse/Heart RatePulse/Heart RateFactors the affect the HR.Factors the affect the HR.
ExerciseExerciseFoodFoodIllnessIllnessStressStressMedications—OTC, Rx, illegalMedications—OTC, Rx, illegal
3. Carotid3. Carotid 4. Brachial4. Brachial 5. Radial 5. Radial
********** 7. Popliteal7. Popliteal
Taking a pulseTaking a pulse
Never use your thumb.Never use your thumb.
Your thumb has a smallYour thumb has a small
pulse that can be felt.pulse that can be felt.
Pulse is taken on the Pulse is taken on the
thumb (radial) sidethumb (radial) side
of the pts wrist.of the pts wrist.
Pulse CharacteristicsPulse Characteristics
Rate: how fast the heart is Rate: how fast the heart is beatingbeating
Pulse CharacteristicsPulse Characteristics
Rate: how fast the heart is Rate: how fast the heart is beatingbeating Average 70 bpmAverage 70 bpm
Range for Adults 60-90 bpmRange for Adults 60-90 bpmRange for children/infants 115-Range for children/infants 115-125 bpm125 bpm
Range for Athletes 40-60 bpm Range for Athletes 40-60 bpm
Pulse CharacteristicsPulse Characteristics
Rhythm – time Rhythm – time between the beats.between the beats.
Pulse CharacteristicsPulse Characteristics
Volume- the force of Volume- the force of the pulse.the pulse.
Pulse CharacteristicsPulse Characteristics
Elasticity- the feel of Elasticity- the feel of the vessel through the vessel through the skin.the skin.
Respiration ( breaths)/RRRespiration ( breaths)/RR
Documented as the # of Documented as the # of breaths per minutebreaths per minute
Respiration / RRRespiration / RR
Documented as the # of Documented as the # of breaths per minutebreaths per minute
It is automatically It is automatically assumed that the recorded assumed that the recorded # is the number of breaths # is the number of breaths per minute.per minute.
Respiration / RRRespiration / RR
Documented as the # of Documented as the # of breaths per minutebreaths per minute
It is automatically assumed It is automatically assumed that the recorded # is the that the recorded # is the number of breaths per minute.number of breaths per minute.
INHALE + EXHALE = 1 breathINHALE + EXHALE = 1 breath
Respiration Respiration
Rate: 12-20 breaths Rate: 12-20 breaths per minuteper minute
Respiration ( breaths)Respiration ( breaths)
Rate: 12-20 breaths per Rate: 12-20 breaths per minuteminuteChildren and infants have a Children and infants have a higher ratehigher rate
Athletes have a slower rate.Athletes have a slower rate.
RespirationRespiration
Rhythm- the time Rhythm- the time between each breath.between each breath.
RespirationRespiration
Depth- how deep the Depth- how deep the breath is—deep, shallow, breath is—deep, shallow, or normalor normal
RespirationRespiration
Counting- watch the Counting- watch the shoulders rise and fallshoulders rise and fall
RespirationRespiration
Counting- watch the Counting- watch the shoulders rise and fallshoulders rise and fall
DO NOT tell the pt your are DO NOT tell the pt your are counting their breathingcounting their breathing
RespirationRespiration
Counting- watch the Counting- watch the shoulders rise and fallshoulders rise and fall
DO NOT tell the pt you are DO NOT tell the pt you are counting their breathingcounting their breathing
Pt modesty—do not stare Pt modesty—do not stare at the pts chest.at the pts chest.
Blood PressureBlood PressureThe amount of The amount of pressure in the pressure in the arteries when the arteries when the heart contracts and heart contracts and relaxes.relaxes.
Blood PressureBlood PressureThe amount of The amount of pressure in the arteries pressure in the arteries when the heart when the heart contracts and relaxes.contracts and relaxes.
The pressure is The pressure is measured in measured in mm hgmm hg= = millimeters of mercurymillimeters of mercury
Blood PressureBlood Pressure
Blood pressure Blood pressure measurement.measurement.
Blood PressureBlood Pressure
Blood pressure measurement.Blood pressure measurement.110/70110/70 mm hg mm hg
Blood PressureBlood Pressure Blood pressure measurement.Blood pressure measurement. 110/70110/70 mm hg mm hg 110110 (the first/top (the first/top number) number) SystolicSystolic-the -the pressure in the artery pressure in the artery when the heart when the heart contracts.contracts.
Blood PressureBlood Pressure Blood pressure measurement.Blood pressure measurement. 110/70110/70 mm hg mm hg 110110 (the first/top number) (the first/top number) SystolicSystolic-the -the
pressure in the artery when the heart pressure in the artery when the heart contracts.contracts.
7070 (the second/bottom (the second/bottom number) number) DiastolicDiastolic- the - the pressure in the artery pressure in the artery when the heart is relaxedwhen the heart is relaxed
Factors that affect Blood Factors that affect Blood PressurePressure
Food, fat, saltFood, fat, salt
Factors that affect Blood Factors that affect Blood PressurePressure
Food, fat, saltFood, fat, salt
FamilyFamily
Factors that affect Blood Factors that affect Blood PressurePressure
Food, fat, saltFood, fat, salt FamilyFamily
White coat syndrome-fear of White coat syndrome-fear of doctorsdoctors
Factors that affect Blood Factors that affect Blood PressurePressure
Food, fat, saltFood, fat, salt FamilyFamily White coat syndrome-fear of doctorsWhite coat syndrome-fear of doctors
ExerciseExercise
Factors that affect Blood Factors that affect Blood PressurePressure
Food, fat, saltFood, fat, salt FamilyFamily White coat syndrome-fear of doctorsWhite coat syndrome-fear of doctors ExerciseExercise
StressStress
Factors that affect Blood Factors that affect Blood PressurePressure Food, fat, saltFood, fat, salt
FamilyFamily White coat syndrome-fear of doctorsWhite coat syndrome-fear of doctors ExerciseExercise StressStress
SmokingSmoking
Blood Pressure Blood Pressure MeasurementsMeasurements
Normal Values 110/70---Normal Values 110/70---128/90128/90
High blood pressure=130/90 High blood pressure=130/90 or higheror higherHigh blood pressure High blood pressure increases the risk of stroke, increases the risk of stroke, kidney damage, and heart kidney damage, and heart attacks.attacks.
Blood Pressure EquipmentBlood Pressure Equipment
StethoscopeStethoscope
Ear Piece
Bell
Diaphragm
Sound sensitive
tube
Blood Pressure EquipmentBlood Pressure Equipment
Blood pressure cuffBlood pressure cuff Cuff
Bulb
Sphygmomanometer
Height and Weight Height and Weight Measuring the ht and wt of Measuring the ht and wt of
pt can help determine the pt can help determine the conditioncondition of the pts body. of the pts body.
Height and Weight Height and Weight Measuring the ht and wt of Measuring the ht and wt of
pt can help determine the pt can help determine the conditioncondition of the pts body. of the pts body.
Help measure long term Help measure long term fluctuations with in the fluctuations with in the body.body.
Height and Weight Height and Weight Examples:Examples:
Height and Weight Height and Weight Examples:Examples: Sudden wt loss may indicate Sudden wt loss may indicate
cancer, diabetes, or other cancer, diabetes, or other metabolic conditionsmetabolic conditions
Height and Weight Height and Weight Examples:Examples: Sudden wt loss may indicate Sudden wt loss may indicate
cancer, diabetes, or other cancer, diabetes, or other metabolic conditionsmetabolic conditions
Quick weight gain can also Quick weight gain can also indicate the onset of medical indicate the onset of medical conditions such as cancer.conditions such as cancer.
Height and Weight Height and Weight Examples:Examples: Sudden wt loss may indicate Sudden wt loss may indicate
cancer, diabetes, or other cancer, diabetes, or other metabolic conditionsmetabolic conditions
Quick weight gain can also Quick weight gain can also indicate the onset of medical indicate the onset of medical conditionsconditions
A decrease in ht can be a sign of A decrease in ht can be a sign of conditions such as osteoporosis conditions such as osteoporosis
Height and Weight Height and Weight
Ht and wt are measured Ht and wt are measured using a certified scale, you using a certified scale, you should not guess, but at should not guess, but at times the pt may refuse to times the pt may refuse to get on the scale, just get on the scale, just document the pts refusal.document the pts refusal.