Download Unit H: Diagnostic Skills

Unit H: Diagnostic Skills
Measure and Record Vital Signs
Medical Assisting and Laboratory
Skills
Temperature
• What is temperature?
Temperature
• What is temperature?
• The measurement of balance between
heat lost and produced by the body.
How does heat get lost from our
bodies?
How does heat get lost from our
bodies?
• Perspiration
• Respiration
• Excretion (urine and
feces)
How is heat produced in our
bodies?
How is heat produced in our
bodies?
• Metabolism of food
• Muscle and gland activity
What is homeostasis?
What is homeostasis?
• Equal balance in the body fluids
• Ideal state in the human body
• If body temperature is too high or
too low, homestasis is affected!
Measurement of Temperature
• F = Fahrenheit
• C = Celsius or Centigrade
• Normal range of temperature:
Oral = 97.6 - 99.6 F or 36.5 – 37.5 C
Rectal = 98.6 – 100.6 F or 37 – 38.1 C
Axillary = 96.6 – 98.6 F or 36 – 37 C
Tympanic or Aural = placed in ear or
auditory canal
Temperature is usually higher in the evening why?
What factors affect body
temperature?
What factors affect body
temperature?
• What increases body temperature?
What factors affect body
temperature?
• What increases body temperature?
Illness, infection, exercise,
excitement, and high temperatures
in the environment
What factors affect body
temperature?
• What decreases body temperature?
What factors affect body
temperature?
• What decreases body temperature?
Starvation or fasting, sleep, decreased
muscle activity, exposure to cold in
the environment, and certain diseases
Temperature Terms
• Hypothermia = prolonged exposure to cold
Temp. below 95 F; death below 93 F
• Hyperthermia = prolonged exposure to hot
temperatures, brain damage, or serious
infection Temp. above 104 F; death or
convulsions above 106 F
• Fever or pyrexia = elevated body
temperature usually above 101 F
• Afebrile = temperature within a normal
range
Febrile = referring to elevated temperature
Pyrogenic = producing fever
Calibration = standard measure (line on a
thermometer or ruler)
Clinical Thermometer Types
and where temperature taken
• Oral – in the mouth with either glass or
electronic thermometer
Most common method
Glass ones contain alcohol based
red dye; No longer use mercury
Long and slender bulb or blue
tip
If person eating, drinking, or smoking wait 15
minutes after they stop to take temperature.
• Rectal – temperature taken in the rectal
area
Most accurate way to measure
Has a red tip and bulb is short,
stubby, and rounded
Used when patients are less than 6 yrs. old,
mouth breathers, on O2, weakness,
difficulty breathing, and confused, unconscious
or senile.
• Aural or tympanic – taken in the ear
Accurate and easy to use
Can be used in place of oral temp.
Axillary – taken in the armpit
Least accurate and only used if
oral, rectal or aural temperatures
cannot be used.
Temperature Conversion between
Celsius and Fahrenheit
• To convert Celsius to Fahrenheit:
F = (C x 1.8) + 32
Example: 35 degree C to Fahrenheit
F = (35 x 1.8) + 32
F = (63) + 32
F = 95 degrees
Temperature Conversion between
Fahrenheit and Celsius
• To convert Fahrenheit to Celsius:
C = (F – 32) or (F - 32) divided by 1.8
1.8
Example: Convert 104 F to degrees Celsius
C = (104 – 32) divided by 1.8
C = (72) divided by 1.8
C = 40 degrees
Try your skill !!!!
• Convert the following temperatures:
A. 37.2 C to F
B. 101.6 F to C
C. 96 F to C
D. 41 C to F
Why is it important to double check your
results when you do conversions?
Pulse Measurements
• What causes a pulse?
• The pressure of the blood pushing against
the wall of an artery as the heart contracts
and relaxes.
• Important because indicates how well the
blood is circulating through the body.
Pulse Terminology
• Rate = number of pulse beats per minute
• Rhythm = regularity of beats
• Volume = strength or pressure felt with
each beat.
• Arrhythmia = an irregular pulse rate
• Bounding = leaping, strong, or forceful
pulse
• Thready = weak, barely felt pulse; thin, like
like a thread.
Tachycardia = pulse rate over 100 beats
per minute (for adults)
Bradycardia = pulse rate below 60 beats
per minute.
• Apex = pointed end of something; for
example the pointed end of the
heart is called the apex.
Stethoscope = instrument used to amplify
sound. Used to listen to the Apical
pulse; pulse counted at the apex
of the heart.
Pulse Points
•
•
•
•
•
•
•
Temporal – side of forehead
Carotid – neck
Brachial – crease of elbow
Radial – thumb side of wrist
Femoral – inner aspect of upper thigh
Popliteal – behind knee
Dorsalis pedis – top of foot arch
Normal pulse values
•
•
•
•
•
•
•
Before birth – 140 – 150 bpm
At birth - 90 – 160 bpm
Children 1-7yr – 80 – 130 bpm
Children over 7 – 70 – 115 bpm
Adult men - 60 - 90 bpm
Adult women - 65 – 80 bpm
bpm = beats per minute
Factors that affect Pulse
• Factors that increase pulse rate:
exercise, stimulant drugs, fever,
shock, excitement, nervous tension
Factors that decrease pulse rate:
sleep, depressent drugs, heart disease
coma, physical training
Counting the pulse
• The radial pulse is the most commonly
used pulse site.
• Count the beats for 30 seconds and
multiply by 2.
• If can not count radial pulse and must use
the apical pulse, count for one (1) full
minute to get beats per minute.
• ALERT! Report any abnormal pulse rate
Measuring Respirations
• What constitutes respiration?
• It is the process of taking in oxygen (O2)
into the body and expelling carbon dioxide
(CO2) from the body.
• One inspiration (breathing in) and one
expiration (breathing out) = one respiration
Normal Values of Respirations
• Newborn rates are 40 respirations per
minute
• Normal adult rates are 12 – 20 respirations
per minute
Respiratory Terms
•
•
•
•
•
•
•
Rate – number of respirations per minute
Rhythm – regularity or irregularity of
breathing
Quality – amount of air exchanged and the
effort it takes to breath
Dyspnea – shortness of breath
Tachypnea – abnormally fast respirations
• Apnea – absence of respirations, has
breathing stopped?
• Cheyne-Stokes – periods of labored
respirations followed by apnea;
usually noted in the dying pt.
• Rales – bubbling or rattling sounds cause
by mucus in the air passages
ALERT! Always report abnormal respirations
How to count respirations
• When counting a patients respirations:
•
Do not want them to be aware that
you are counting as he/she may not breath
normally.
•
Leave you hand on the pulse while
counting respirations and count for 30
seconds and multiply by 2
Measuring Blood Pressure
• What is blood pressure?
• It is the force of the blood pushing against
the walls of the blood vessels.
It is measured with an instrument known
as a sphygmomanometer (blood
pressure cuff) and read in millimeters (mm)
of mercury (Hg)
Blood Pressure Terms
• Systolic pressure – is the greatest force
exerted on the walls of the arteries
when the heart is contracting.
Normal range is 90 – 140 mm Hg
• Diastolic pressure – is the least force
exerted on the walls of the arteries
when the heart is at rest.
Normal range is 60 – 90 mm Hg
Blood Pressure Terms cont.
• Pulse pressure - difference between the
systolic and diastolic pressure.
Normal pulse pressure is 30-40 mm Hg
• Hypertension – high blood pressure
• Hypotension – low blood pressure
Types of equipment for BP
Two main blood pressure apparatus:
• Aneroid – have a round gauge with long and
short lines; long are 10 mm intervals and
the short are 2 mm intervals and used
with a stethoscope to hear beats.
Electronic/digital – push a button and are
battery powered or plugged in and
gives a reading on a screen.
Factors that affect BP
• Factors that increase BP:
stress, anxiety, obesity, high salt
intake, aging, kidney disease, thyroid
deficiency, eating, arteriosclerosis
Factors that decrease BP:
heart failure, hemorrhage, inactivity,
fasting, suppressants, depression, shock,
severe burns
Recording Vital Signs
• Now lets record what we have learned about.
• Always record the temperature, pulse and
respirations in the same order:
TPR
• Example: T 98.6 F P 72 R 16
• If temperature is rectal put an ® next to the
number; if axillary put an (AX) next to the
number; if aural put a (T) next to the number.
Recording BP
• Blood pressure is always recorded as a
fraction:
• Example 120/76 mm Hg =
120 systolic
76 diastolic
ALERT !!!! Always report any abnormal
findings in vital signs to your
supervisor.