2. TEMPERATURE, PULSE, RESPIRATIONS Abbreviated: TPR

3. TEMPERATURE The measurement of core body heat

4. ROUTES TO MEASURE TEMPERATURE 4 Oral: By mouth 4 Rectally: By rectum 4 Axillary: Under the arm in the armpit 4 Tympanic: In the ear

5. TYPES OF THERMOMETERS 4 Digital Electronic: To be used for oral, rectal, and axillary 4 Thermoscan - Digital: To be used for tympanic

6. NORMS 4 Orally: 97.6 - 99.6 degrees Fahrenheit 4 Rectally: 99.6 - 100.6 degrees Fahrenheit 4 Axillary: 96.6 - 98.6 degrees Fahrenheit

7. 4 Which of the following is a normal temperature? 4 A) 98.9 axillary 4 B) 101.2 rectal 4 C) 99.6 oral 4 D) 98.6 rectal

8. WHAT THERMOMETER SHOULD BE USED? 4 Tympanic: Special device with plastic covers. 4 Electronic: All routes. Probes that are red in color for rectal temperatures; blue in color for oral and axillary.

9. DURATION FOR TAKING TEMPERATURES 4 Tympanic: As long as it takes to push a button 4 Electronic: Until the thermometer beeps

10. BE CAREFUL ON RECTAL AND AXILLARY TEMPS 4 Always hold the thermometer in place while measuring both temperatures 4 Always use lubricant with rectal temperatures 4 Always remove clothing around axilla

11. Factors affecting vital signs 4 Sleep 4 Activity 4 Eating wait 15 minutes 4 Weather 4 Noise 4 Exercise 4 Meds 4 Emotions 4 Time of day

12. 4 Which of the following questions should you ask for an oral temperature? 4 A) when did you eat or drink last? 4 B) when did you last ambulate? 4 C) when did you last smoke? 4 D) Both a and c

13. 4 F to C 4 F-32 divided by 1.8 equal C 4 C to F 4 C X 1.8 plus 32 =F

14. 4 Which of the following formulas is used to convert Fahrenheit to Celsius? 4 A) Fahrenheit minus 32divided by 1.8 4 B) Celsius minus 32 divided by 1.8 4 C) Celsius plus 32 X 1.8 4 D) Celsius plus 1.8 x 32

15. PULSE The wave of blood created by the heart pumping, that travels along the arteries.

16. FIND WHERE TO PULSES 4 At points where the artery is between finger tips and a bony area 4 Called pulse points 4 Felt with 2-3 fingers, but never the thumb

17. 4 The pulse should be measured with which of the following? 4 A) 2-3 fingers 4 B) thumb 4 C) whole hand 4 D) index and baby finger

18. PULSE POINTS AND THEIR LOCATIONS 4 Temporal 4 Carotid 4 Apical 4 Brachial 4 Radial 4 Femoral 4 Popliteal 4 Dorsal Pedalis

19. 4 Where is the popliteal pulse located? 4 A) on top of the foot 4 B) antecubital of the arm 4 C) ulna 4 D) behind the knee

20. HOW TO MEASURE? 4 Measured in beats per minute 4 Count the waves for 60 seconds 4 Or, count the waves for 30 seconds - multiply by 2

21. NORMS 4 Pulse norms are 60 - 100 beats per minute 4 Pulses between 90 - 100 are in a gray area - high normal 4 Faster than 100 - tachycardia 4 Slower than 60 - bradycardia

22. 4 Greater than 100 BPM indicates: 4 A) tachycardia 4 B) bradycardia 4 C) tachypnea 4 D) cheyne stokes

23. QUALITY OF PULSE 4 Rhythm: regular or irregular 4 Rate: Within the normal limits 4 Strength: Strong, bounding, thready

24. WHAT AFFECTS PULSE RATES AND QUALITY 4 Body Temperature 4 Emotions 4 Activity Level 4 Health of the Heart

25. RESPIRATION The mechanical act of breathing in air (inspiration) and expelling air (expiration) from the body

26. 4 Beats per minute equals: 4 A) rate 4 B) rhythym 4 C) strength 4 D) none of the above

27. RESPIRATION 4 Measured in breaths per minute 4 Normal range is 12 - 24 breaths per minute 4 Greater than 24 is tachypnea 4 Less than 12 is bradypnea 4 Watch for rate, depth, quality of breath, and difficulty in breathing

28. METHOD OF MEASURING TPR 4 If using a mercury thermometer, measure the pulse and respiration while waiting for the temperature 4 If using another method of measuring the temperature, complete the temperature - then measure the pulse and respiration 4 Keep you fingers on the pulse while measuring the respiration

29. CHARTING 4 Chart in order temperature - pulse - respiration. 4 Do not write T =, etc. 4 Write (Ax) after axillary temperatures 4 Write (R) after rectal temperatures

30. ABBREVIATIONS 4 SOB - Short of breath 4 TPR - Temperature, pulse, and respiration Within normal limits 4 P.O. - By mouth 4 BID -Twice a day 4 TID -Three times a day 4 QID - Four times a day 4 QS - Every shift 4 QD - Every day 4 PRN - As needed 4 Ad Lib - At liberty 4 B/P - Blood Pressure 4 VS - Vital Signs

31. ABBREVIATIONS 4 SOB 4 TPR 4 WNL 4 PO 4 BID 4 TID 4 QID 4 QS 4 QD 4 PRN 4 Ad Lib 4 B/P 4 VS

32. ABBREVIATIONS 4 Short of breath 4 Temperature, pulse, and respiration Within normal limits 4 By mouth 4 Twice a day 4 Three times a day 4 Four times a day 4 Every shift 4 Every day 4 As needed 4 At liberty 4 Blood Pressure 4 Vital Signs

33. TERMS 4 Eupnea - Normal breathing 4 Orthopnea - Sitting upright to breath more easily 4 Apnea - No breath 4 Hyperpnea - Fast, deep breathing 4 Tachypnea - Fast, shallow breathing 4 Bradypnea - Slow breathing 4 Dyspnea - Painful or difficult breathing 4 Tachycardia - Pulse rate in excess of 100 bpm 4 Bradycardia - pulse rate less than 60 bpm

34. TERMS 4 Eupnea 4 Orthopnea 4 Apnea 4 Hyperpnea 4 Tachypnea 4 Bradypnea 4 Dyspnea 4 Tachycardia 4 Bradycardia

35. TERMS 4 Normal Breathing 4 Sitting upright to breath more easily 4 Fast, deep breathing 4 Fast, shallow breathing 4 Slow breathing 4 Painful or difficult breathing 4 Pulse rate in excess of 100 beats per minute 4 Pulse rate less that 60 beats per minute

36. TERMS 4 Bounding pulse - excessively strong pulse 4 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.

37. TERMS 4 Bounding pulse 4 Thready pulse

38. TERMS 4 Excessively strong pulse 4 Pulse difficult to palpate because heart not beating heard enough

40. NORM 4 Norm:120/80 (new norm: 115/75) 4 Report: 100/60 hypotension 4 140/90 hypertension

41. Factors that affect blood pressure 4 Age 4 Gender 4 Pain 4 Emotions 4 Weight 4 Blood volume 4 Exercise 4 meds

42. 4 Which of the following bp is hypotension? 4 A) 140/80 4 B) 110/59 4 C) 120/60 4 D) 120/66

43. Types of sphygmomanometer 4 Aneroid 4 Mercury 4 electrical

44. What causes high blood pressure? 4 The arteries constrict and the blood can’t easily pass causing the heart to pump harder. 4 Primary causes: hereditary, obesity, sedentary lifestyle, diet, and race

45. Secondary: hypertension 4 Kidney disease 4 Brain disorders 4 PIH

46. 4 Which of the following are secondary reasons for hypertension? 4 A) kidney disease 4 B) smoking 4 C) race 4 D) diet

47. Treatment 4 medication

48. DIET

49. smoking

50. Low salt diet

51. Complications of hypertension 4 Arteriosclerosis 4 Atherosclerosis 4 Retinal detachment 4 Aneurysms 4 Enlarged hearts

52. 4 Left ventricular hypertrophy 4 CVA(stroke) 4 Blood clots 4 90% of heart attacks are due to blood clots 4 Renal artery stenosis leads to kidney deterioration

53. 4 Which of the following are possible complications of hypertension? 4 A) enlarged heart 4 B) blood clots 4 C)aneurysm 4 D)all of the above