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TEMPERATURE, PULSE, RESPIRATIONS Abbreviated: TPR TEMPERATURE The measurement of core body heat ROUTES TO MEASURE TEMPERATURE Oral: By mouth Rectally: By rectum Axillary: Under the arm in the armpit Tympanic: In the ear TYPES OF THERMOMETERS Digital Electronic: To be used for oral, rectal, and axillary Thermoscan - Digital: To be used for tympanic Mercury or glass: To be used for oral, rectal, and axillary NORMS Orally: 97.6 - 99.6 degrees Fahrenheit Rectally: 99.6 - 100.6 degrees Fahrenheit Tympanic - manufacturers say to measure as for rectal Axillary: 96.6 - 98.6 degrees Fahrenheit Which of the following is a normal temperature? A) 98.9 axillary B) 101 .2 rectal C) 99.6 oral D) 98.6 rectal WHAT THERMOMETER SHOULD BE USED? Tympanic: Special device with plastic covers. Electronic: All routes. Probes that are red in color for rectal temperatures; blue in color for oral and axillary. Mercury: All routes. Red ends are rectal; blue ends oral and axillary. DURATION FOR TAKING TEMPERATURES Tympanic: As long as it takes to push a button Electronic: Until the thermometer beeps Mercury Oral: Three minutes Mercury Rectal: Three minutes Mercury Axillary: Ten minutes BE CAREFUL ON RECTAL AND AXILLARY TEMPS Always hold the thermometer in place while measuring both temperatures Always use lubricant with rectal temperatures Always remove clothing around axilla READING THE THERMOMETER Mercury Fahrenheit thermometers are read by degree and 0.2 of a degree Long lines indicate degrees Short lines indicate 0.2 of a degree Four short lines between each long line (0.2, 0.4, 0.6, 0.8) Factors affecting vital signs Sleep Activity Eating wait 15 minutes Weather Noise Exercise Meds Emotions Time of day Which of the following questions should you ask for an oral temperature? A) when did you eat or drink last? B) when did you last ambulate? C) when did you last smoke? D) Both a and c F to C F-32 divided by 1.8 equal C C to F C X 1.8 plus 32 =F Which of the following formulas is used to convert Fahrenheit to Celsius? A) Fahrenheit minus 32divided by 1.8 B) Celsius minus 32 divided by 1.8 C) Celsius plus 32 X 1.8 D) Celsius plus 1.8 x 32 PULSE The wave of blood created by the heart pumping, that travels along the arteries. FIND WHERE TO PULSES At points where the artery is between finger tips and a bony area Called pulse points Felt with 2-3 fingers, but never the thumb The pulse should be measured with which of the following? A) 2-3 fingers B) thumb C) whole hand D) index and baby finger PULSE POINTS AND THEIR LOCATIONS Temporal Radial Carotid Femoral Apical Popliteal Brachial Dorsal Pedalis Where is the popliteal pulse located? A) on top of the foot B) antecubital of the arm C) ulna D) behind the knee HOW TO MEASURE? Measured in beats per minute Count the waves for 60 seconds Or, count the waves for 30 seconds - multiply by 2 NORMS Pulse norms are 60 - 100 beats per minute Pulses between 90 - 100 are in a gray area - high normal Faster than 100 - tachycardia Slower than 60 - bradycardia Greater than 100 BPM indicates: A) tachycardia B) bradycardia C) tachypnea D) cheyne stokes QUALITY OF PULSE Rhythm: regular or irregular Rate: Within the normal limits Strength: Strong, bounding, thready WHAT AFFECTS PULSE RATES AND QUALITY Body Temperature Emotions Activity Level Health of the Heart RESPIRATION The mechanical act of breathing in air (inspiration) and expelling air (expiration) from the body Beats per minute equals: A) rate B) rhythym C) strength D) none of the above RESPIRATION Measured in breaths per minute Normal range is 12 - 24 breaths per minute Greater than 24 is tachypnea Less than 12 is bradypnea Watch for rate, depth, quality of breath, and difficulty in breathing METHOD OF MEASURING TPR If using a mercury thermometer, measure the pulse and respiration while waiting for the temperature If using another method of measuring the temperature, complete the temperature then measure the pulse and respiration Keep you fingers on the pulse while measuring the respiration CHARTING Chart in order temperature - pulse - respiration. Do not write T =, etc. Write (Ax) after axillary temperatures Write (R) after rectal temperatures ABBREVIATIONS SOB - Short of breath QID - Four times a day pulse, and respiration QS - Every shift Within normal limits QD - Every day P.O. - By mouth PRN - As needed BID -Twice a day Ad Lib - At liberty TID -Three times a B/P - Blood Pressure day VS - Vital Signs TPR - Temperature, ABBREVIATIONS SOB QID TPR QS WNL QD PO PRN BID Ad Lib TID B/P VS ABBREVIATIONS Short of breath Four times a day Temperature, pulse, Every shift and respiration Within normal limits By mouth Twice a day Three times a day Every day As needed At liberty Blood Pressure Vital Signs TERMS Eupnea - Normal Bradypnea - Slow breathing Orthopnea - Sitting upright to breath more easily Apnea - No breath Hyperpnea - Fast, deep breathing Tachypnea - Fast, shallow breathing breathing Dyspnea - Painful or difficult breathing Tachycardia - Pulse rate in excess of 100 bpm Bradycardia - pulse rate less than 60 bpm TERMS Eupnea Bradypnea Orthopnea Dyspnea Apnea Tachycardia Hyperpnea Bradycardia Tachypnea TERMS Normal Breathing Slow breathing Sitting upright to breath more easily Fast, deep breathing Fast, shallow breathing Painful or difficult breathing Pulse rate in excess of 100 beats per minute Pulse rate less that 60 beats per minute TERMS Bounding pulse - excessively strong pulse Thready pulse - Pulse rate difficult to palpate because the heart is not beating hard enough to produce a strong wave of blood. Feels as though there is a piece of thread running under the fingertips. TERMS Bounding pulse Thready pulse TERMS Excessively strong pulse Pulse difficult to palpate because heart not beating heard enough NORM Norm:120/80 Report: 100/60 hypotension 140/90 hypertension Factors that affect blood pressure Age Gender Pain Emotions Weight Blood volume Exercise meds Which of the following bp is hypotension? A) 140/80 B) 110/59 C) 120/60 D) 120/66 Types of sphygmomanometer Aneroid Mercury electrical What causes high blood pressure? The arteries constrict and the blood can’t easily pass causing the heart to pump harder. Primary causes: hereditary, obesity, sedentary lifestyle, diet, and race Secondary: hypertension Kidney disease Brain disorders PIH Which of the following are secondary reasons for hypertension? A) kidney disease B) smoking C) race D) diet Treatment medication DIET smoking Low salt diet Complications of hypertension Arteriosclerosis Atherosclerosis Retinal detachment Aneurysms Enlarged hearts Left ventricular hypertrophy CVA(stroke) Blood clots 90% of heart attacks are due to blood clots Renal artery stenosis leads to kidney deterioration Which of the following are possible complications of hypertension? A) enlarged heart B) blood clots C)aneurysm D)all of the above
