Download VS 3- pulse and respiration

Pearson's Comprehensive
Medical Assisting
Administrative and Clinical Competencies
Second Edition
CHAPTER
CHAPTER
35
Vital Signs
Lesson 3:
Pulse and Respirations
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Lesson Objectives
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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.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
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
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Factors that Influence Pulse Rate
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Exercise
Age
Gender
Size
Physical condition
Disease states
Medications
Depression
Fear, anxiety, anger
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
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
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Characteristics of Pulse
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Rate
Volume
Rhythm
Compliance of the arterial wall
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
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
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
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
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
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
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Common Pulse Sites
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Radial
Brachial
Carotid
Temporal
Femoral
Popliteal
Posterior tibial
Dorsalis pedis
Apical
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Brachial
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Radial
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Carotid
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Femoral
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Popliteal
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Posterior Tibial
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
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Pedal (Dorsalis Pedis)
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Steps in Measuring a Radial
Pulse Rate
Step 5: Check quality of pulse.
Step 4: Place finger tips on radial artery on
thumb side of wrist.
Step 3: Ask patient to sit down and place arm in
a comfortable, supported position.
Step 2: Explain procedure to the patient and ask the
patient about any recent physical activity or smoking.
Step 1: Perform hand hygiene. Identify the patient.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Steps in Measuring a Radial
Pulse Rate
Step 9: Perform hand hygiene and record the
pulse beats per minute in the patient’s record.
Step 8: Immediately write the pulse beats per
minute on a piece of paper.
Step 7: Count the pulse for 1 full minute.
Step 6: Start counting pulse beats when second had on
watch is at 3, 6, 9, or 12.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
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
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Characteristics of Respiration
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Rate
Rhythm
Depth
Quality
Breath sounds
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Respiratory Rate Ranges
by Age Group
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Newborn: 30-50
1 year old: 20-40
2-10 years: 20-30
11-18 years: 18-24
Adult: 14-20
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Situations that Alter Respirations
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Allergic reactions
Medications
Disease
Exercise
Emotions
Fever
Hemorrhage
• High altitudes
• Obstruction of air
passage
• Pain and shock
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.