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U10 Pt Procedures & Vital Signs Patient Procedures ALWAYS BEGIN TESTS/PROCDURES WITH THE 6 Rules of PATIENT PROCEDURES Patient Procedures 6 rules Introduce yourself Patient Procedures Introduce yourself Identify the pt.-Make sure you are with the correct pt Patient Procedures Introduce yourself Identify the pt.--Make sure you are with the correct pt Explain the procedure to the pt Patient Procedures Introduce yourself Identify the pt.--Make sure you are with the correct pt Explain the procedure to the pt Explain to the pt that if they feel uncomfortable/pain at any time, they are to tell you and that you will stop the procedure. Patient Procedures Introduce yourself Make sure you are with the correct pt Explain the procedure to the pt Explain to the pt that if they feel uncomfortable/pain at any time, they are to tell you and that you will stop the procedure. Ask the pt if they understand or if they have any questions Patient Procedures Introduce yourself Make sure you are with the correct pt Explain the procedure to the pt Explain to the pt that if they feel uncomfortable/pain at any time, they are to tell you and that you will stop the procedure Ask the pt if they understand or if they have any questions Record Results Vital Signs Tests/procedures that are indicators of internal homeostasis (homeostasis is the maintaining of a constant internal environment—breathing, heart rate, body temperature, internal functions). Vital Signs Represents the general health of the pt at that point in time Important factors of Vital Signs Understand how to do the procedure/test Important factors of Vital Signs Understand how to do the procedure/test Know how to perform the procedure or test with confidence Important factors of Vital Signs Understand how to do the procedure/test Know how to perform the procedure or test with confidence Must be accurate Important factors of Vital Signs Understand how to do the procedure/test Know how to perform the procedure or test with confidence Must be accurate Must be able to keep the pt comfortable. Factors that may influence VS Physical Walking, running, illness, stairs etc…. Factors that may influence VS Physical Emotional-afraid, stress etc….. bad day, Factors that may influence VS Physical Emotional-afraid, bad day, stress etc….. Equipment Failures To big or small Low batteries Vital Signs Temperature Pulse/Heart rate Respiratory Rate Blood pressure Ht Wt Temperature Physiology: The body maintains a constant temperature, this helps to maintain homeostasis (the internal environment of the body), this is controlled by the brain. Temperature Physiology: The body moves blood to the core of the body to increase the temperature of the blood, which in turns increases the body temperature----fever. Factors that influence Temperature Liquids Factors that influence Temperature Liquids Weather Factors that influence Temperature Liquids Weather Exercise Factors that influence Temperature Liquids Weather Exercise Infections Factors that influence Temperature Liquids Weather Exercise Infections Stress Is a Fever a good thing? Yes—the increase in temperature helps the body destroy any pathogens. Pathogens are temperature sensitive. Is a Fever a good thing? Yes—the increase in temperature helps the body destroy any pathogens. Pathogens are temperature sensitive. Sometimes not--- a prolonged fever (having a fever for a long period of time), can cause brain injuries. Temperature Sites Oral--mouth Temperature Sites Oral—mouth Rectal- ummmmm Temperature Sites Oral—mouth Rectal- ummmmm Tympanic--ear Temperature Sites Oral—mouth Rectal- ummmmm Tympanic—ear Axillary- arm pit Temperature Sites Oral—mouth Rectal- ummmmm Tympanic—ear Axillary- arm pit Temporal Scanforehead/behind the ear Temperature Value/Readings Normal- 98.6 degrees F Temperature Value/Readings Normal- Rectal 98.6 degrees F temperature: subtract 1 degree Temperature Value/Readings Normal- 98.6 degrees F Rectal temperature: subtract 1 degree Axillary degree temperature- add 1 Types of thermometers Glass Types of thermometers Glass digital Types of thermometers Glass Digital Digital Probe Types of thermometers Glass Digital Digital Probe Tympanic Types of thermometers Glass Digital Digital Probe Tympanic Temporal Scan Pulse/Heart Rate The number of times the heart beats per minute. Pulse/Heart Rate The number of times the heart beats per minute. Documented as ___B/M ( beats per minute) Pulse/Heart Rate Factors the affect the HR. Exercise Pulse/Heart Rate Factors the affect the HR. Exercise Food Pulse/Heart Rate Factors the affect the HR. Exercise Food Illness Pulse/Heart Rate Factors the affect the HR. Exercise Food Illness Stress Pulse/Heart Rate Factors the affect the HR. Exercise Food Illness Stress Medications—OTC, Rx, illegal 3. Carotid 4. Brachial 5. Radial ***** 7. Popliteal Taking a pulse Never use your thumb. Your thumb has a small pulse that can be felt. Pulse is taken on the thumb (radial) side of the pts wrist. Pulse Characteristics Rate: how fast the heart is beating Pulse Characteristics Rate: how fast the heart is beating Average Range 70 bpm for Adults 60-90 bpm Range for children/infants 115-125 bpm Range for Athletes 40-60 bpm Pulse Characteristics Rhythm – time between the beats. Pulse Characteristics Volume- pulse. the force of the Pulse Characteristics Elasticity- the feel of the vessel through the skin. Respiration ( breaths)/RR Documented as the # of breaths per minute Respiration / RR Documented as the # of breaths per minute It is automatically assumed that the recorded # is the number of breaths per minute. Respiration / RR Documented as the # of breaths per minute It is automatically assumed that the recorded # is the number of breaths per minute. INHALE + EXHALE = 1 breath Respiration Rate: 12-20 breaths per minute Respiration ( breaths) Rate: 12-20 breaths per minute Children and infants have a higher rate Athletes have a slower rate. Respiration Rhythm- the time between each breath. Respiration Depth- how deep the breath is—deep, shallow, or normal Respiration Counting- watch the shoulders rise and fall Respiration Counting- watch the shoulders rise and fall DO NOT tell the pt your are counting their breathing Respiration Counting- watch the shoulders rise and fall DO NOT tell the pt you are counting their breathing Pt modesty—do not stare at the pts chest. Blood Pressure The amount of pressure in the arteries when the heart contracts and relaxes. Blood Pressure The amount of pressure in the arteries when the heart contracts and relaxes. The pressure is measured in mm hg= millimeters of mercury Blood Pressure Blood pressure measurement. Blood Pressure Blood pressure measurement. 110/70 mm hg Blood Pressure Blood pressure measurement. 110/70 mm hg 110 (the first/top number) Systolic-the pressure in the artery when the heart contracts. Blood Pressure Blood pressure measurement. 110/70 mm hg 110 (the first/top number) Systolic-the pressure in the artery when the heart contracts. 70 (the second/bottom number) Diastolic- the pressure in the artery when the heart is relaxed Factors that affect Blood Pressure Food, fat, salt Factors that affect Blood Pressure Food, fat, salt Family Factors that affect Blood Pressure Food, fat, salt Family White coat syndrome-fear of doctors Factors that affect Blood Pressure Food, fat, salt Family White coat syndrome-fear of doctors Exercise Factors that affect Blood Pressure Food, fat, salt Family White coat syndrome-fear of doctors Exercise Stress Factors that affect Blood Pressure Food, fat, salt Family White coat syndrome-fear of doctors Exercise Stress Smoking Blood Pressure Measurements Normal Values 110/70--- 128/90 High blood pressure=130/90 or higher High blood pressure increases the risk of stroke, kidney damage, and heart attacks. Blood Pressure Equipment Stethoscope Ear Piece Blood Pressure Equipment Blood pressure cuff Height and Weight Measuring the ht and wt of pt can help determine the condition of the pts body. Height and Weight Measuring the ht and wt of pt can help determine the condition of the pts body. Help measure long term fluctuations with in the body. Height and Weight Examples: Height and Weight Examples: Sudden wt loss may indicate cancer, diabetes, or other metabolic conditions Height and Weight Examples: Sudden wt loss may indicate cancer, diabetes, or other metabolic conditions Quick weight gain can also indicate the onset of medical conditions such as cancer. Height and Weight Examples: Sudden wt loss may indicate cancer, diabetes, or other metabolic conditions Quick weight gain can also indicate the onset of medical conditions A decrease in ht can be a sign of conditions such as osteoporosis Height and Weight Ht and wt are measured using a certified scale, you should not guess, but at times the pt may refuse to get on the scale, just document the pts refusal.