Download Age Temp Pulse Resp BP Newborn 36.8 axilary 130 (80

Age
Newborn
6-8 yrs
Temp
36.8
axilary
37.7
rectal
37 oral
10 yrs
37
Teens
37
adults
37
Older
adults
(>70)
36
1-3 yrs
Pulse
130
(80-180)
120
(80-140)
100
(75-120)
70
(50-90)
70
(50-90)
80
(60-100)
80
(60-100)
Resp
35
(30-80)
30
(20-40)
20
(15-25)
19
(15-25)
18
(15-20)
16
(12-20)
16
(15-20)
BP
73/55
90/55
95/57
102/62
120/80
120/80
Possible
incr.
diastolic
Respiratory
-Dry, irratative couch is characteristic of an upper resp tract infection of viral
origin or may be a side effect of ACE inhibitors
-Laryngotracheitis causes an irratative, high pitched couch
-Trachial lesions produce a brassy cough
-Severe or changing cough may indicate bronchosgenic carcinoma
-Pleuritic chest pain accompanying coughing may indicate pleural or chest
wall involvement
Coughing at night possible on set of left-sided HF or bronchial asthma
Cough in morning with sputum may indicate bronchitis
Cough worsening when in supine may ne postnasal drip (sinusitis)
Calcium Channel blockers
-used to manage angina pectoris, dysrythmias, and hypertension
Mechanism of Action
-contraction of muscle is regulated by the amount of calcium ion inside of the
cell, and when calcium enters the cell through channels in the plasma membrane,
muscular contraction is initiated.
-relax arterioles and reduce peripheral resistance to decrease BP
-acts large and fast. (decreases BP fast). Good in crisis!
-not for stable theory
-Amiodipine (norvasc), Diltiazem (Cardizem, Dilecor XR),
Nifedipine (Adalat, Procardia), Verapamil (Calan, Isoptin, Verelan, Covera)
Angiotension Converting Enzyme Inhibitor (ACE Inhibitors)
PRIL
-ACE Inhibitors are used to manage hypertension, heart failure, and
myocardial infarctions
Mechanism of Action
-Block the conversion of angiotension I and angiotension II, which decreases BP
by lowering resistance (through vasodilatation) and decreases blood volume
(by preventing the secretion on aldosterone by the adrenal cortex). * (Helps with fluid).
-Enalapril (Vasotec), Lisinopril
-after load reduction
-reduces sodium and water retention (causes diuretic effect)
-does not have effect of rate
Beta Blockers OLOL
-used to manage hypertension and myocardial ischemia (angina). There
is a cardioprotective effect to prevent MI
Mechanism of Action
-action is the decrease of HR, and through reduction of myocardial conduction
rate and contractility. Shrinks cardiac hypertrophy. Drops cardiac workload.
-Can cause fluid retention. Can cause fatigue
-Atenolol(tenormin), bisoprolol(zebeta), metoprolol(toprol, lopressor),
Propanolo(Inderal), timolol(Betimol)
-Decrease preload (cardiac), decrease after load (peripheral), decrease
HR and cardiac workload, decrease BP, shrinks large hearts. Causes fluid retention
Digoxin (Cardiac Glycosides)
-Used in management of CHF, tachyarrythmias: atrial fibrillation and atrial flutter
(slows ventricular rate)
Mechanism of Action
-Increases cardiac output (positive inotropic effect), and slowing of the HR
(negative chronotropic effect)
-increases the force of myocardial contraction
-Digoxin, Digitoxin (more prolonged half-life)
-PO- onset 30-120 min, peak 2-8 hr, duration 2-4 days
-IM- onset 30 min, peak 4-6 hr, duration 2-4 days
-IV- onset 5-30 min, 1-4 he, 2-4 days
-SE: fatique, bradycardia, anorexia, nausea, vomiting
Nitroglycerine (antianginals)
-used in the management of angina, and useful in the management of HF
-Relax both arterial and venous smooth muscle.
- Increases cardiac output. Reduction of BP
-dilation of the coronary arteries to improve perfusion of myocardial tissue
(particularly helpful when angina is due to coronary artery spasm).
-Produces vasodilatation. Helpful with angina
- SL- onset 1-3 min, peak unknown, duration 30-60 min
-PO-ER- onset 40-60 min, unknown, duration 8-12hr
-TD-onset Patch 40-60 min, peak unknown, duration 8-24hr
-SE: dizziness, headache, hypotension, tachycardia
P = Provokes
What causes pain?
What makes it better? Worse?
Q = Quality
What does it feel like?
Is it sharp? Dull? Stabbing? Burning?
Crushing?
R = Radiates
Where does the pain radiate?
Is it in one place? Does it go anywhere
else?
Did it start elsewhere and now localised to
one spot?
S = Severity
How severe is the pain on a scale of 1 - 10?
T = Time
Time pain started? How long did it last?
Other questions to ask and look for....
Does it hurt on deep inspiration?
Activity @ onset?
Any history of pain?
Is it the same? Different?
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Any family history of heart
disease lung problems, stroke or
hypertension?
Check LOC.
Pupils?
JVD?
Midline trachea?
Any recent trauma?
Post Anesthetic
Activity – able to move four extremities
voluntarily or on command
- Able to move two
extremities voluntarily or on
command
Unable to move extremities
voluntarily or on command
Respiratory- able to deep breath and cough
Dyspnea or limited breathing
Apneic
BP
Consciousness- fully awake
Arousal on calling
Not responding
O2 sats- >90% on room air
Needs 02 for > 90%
<90% even with o2
Wound Exudate
Serous- clear, watery plasma. Serum does
not contain blood cells or platelets. Ex. Fluid
from a blister
Serosanguineous- Thin, water drainage
that is blood-tinged. Commonly seen in
surgical incisions
Sanguineous- blood drainage. Larger
amounts may indicate hemorrhage; this type
frequently seen in open wounds.
Purulent- Thick drainage that contains pus.
Purulent drainage caries in color depending
partly on the organism in the pus and may
be green, yellow or brown.
Dressing – dry and clean
Wet but marked and not
increasing
Growing area of wetness
Pain- pain free
Mild pain handled by oral meds
Severe pain requiring
parenteral meds
Ambulation – able to stand up and walk
*straight
Vertigo when erect
Dizziness when supine
Pasting-feeding- able to drink fluids
Nauseated
Nausea and vomiting
Urine output- has voided
Unable to void but comfortable
Unable to void and
uncomfortable