1. CHAPTER 7 FOUNDATION SKILLS

2. CHAPTER 7 WORKBOOKS (25 points)
Know the values for the following (with units):
11. Normal BP
12. High BP
13. Normal Oral Temp
14. Normal adult pulse rate
15. Name & range for slow HR
16. Name & range for fast HR
17. Range for normal respiratory rate
18. Draw a clock in military time (one clock a.m., one p.m.)
Convert:
19. lbs to kg
20. inches & feet to cm
21. ounces to mL’s
Cover:
Chapter title, related picture, main objective
Define the following:
1. Apical
2. Auscultation
3. Blood pressure
4. BMI
5. Systolic
6. Diastolic
7. Cardiac arrest
8. Palpation
9. Percussion
10. Vital

3. Vital Signs
Values used to measure changes in body function, general health, and response to treatment
Include blood pressure (BP), temperature, pulse, respiration (TPR), and oxygen saturation, (SPO2) and Pain….
Affected by many factors: age, activity, nutrition, emotion, fitness, medication, and illness

4. Physical Assessment Inspection is done by using visual observation
Auscultation means listening to sounds, often with a stethoscope
Palpation is using the hands to observe structures by touch
Percussion is striking the body to assess the sound made

5. Taking vital signs

6. Blood Pressure

7. Blood Pressure
Measurement of the force of the blood against the walls of the arteries as it circulates through the body
Systolic (ventricles of heart are contracting)
Maximum pressure at which the pulse can be heard
Diastolic (ventricles of heart are relaxing)
Minimum pressure at which it is audible

8. Blood Pressure Normal blood pressure is 120/80
Range is acceptable with a systolic less than 119 and a diastolic less than 79
Blood pressures vary greatly among people
Affected by:
Diameter and flexibility of blood vessels
Force of heart contraction
Amount of blood in the vessels
Pressure on the area of the brain that controls blood pressure

9. MEAN ARTERIAL PRESSURE (MAP)
MAP is a term used in medicine to describe an average blood pressure in an individual. It is defined as the average arterial pressure during a single cardiac cycle...
Normal range =
Equation: (2 x diastolic) + systolic 3
Diastole counts twice as much as systole because 2/3 of cardiac cycle is spent in diastole (at rest).
How low is too low?
A MAP of 60 is necessary to profuse the coronary arteries, brain & kidneys.

11. Box 7-1 Recommended Blood Pressure Levels

12. Instruments Used for Taking Blood Pressure
Stethoscope
Amplifies the sound
Sphygmomanometer
Inflatable cuff that measures pressure using air (aneroid) or a liquid

14. How to take a Blood Pressure
Hyperlink to blood pressure practice
How to perform a BP

16. Temperature
The measurement of the balance between the heat produced and lost by the body
Five methods commonly used to measure temperature:
Mouth (oral)
Armpit (axillary)
Skin
Ear (temporal)
Rectum (rectal)

17. Table 7-1 Temperature

18. Types of Thermometers
Glass(liquid filled): can be used for oral/axillary or anal
Electronic: oral, anal or axillary
Tympanic: used in the ear
Temporal artery thermometer: scans the forehead

19. Pulse
Pulse is the heartbeat that can be felt, or palpated, on surface arteries as the artery walls expand
The pulse is usually assessed using the radial artery near the wrist
Normal adult pulse rate can range between 60 and 100 beats per minute
The pulse of an infant is significantly faster than that of an adult
A pulse is counted for 30 seconds, then the number is doubled to give a bpm count
If the beat is irregular, the pulse should be felt for a full minute

21. Table 7-2 Pulse Ranges by Age Group

22. Respiration
One respiration includes the inspiration and expiration of a breath
Normal rate of respiration is more rapid in infants than in adults
The rhythm and character of respiration are important observations

23. Box 7-2 Respiration in Adults

24. OXYGEN SATURATION – Sp02

25. SATURATION LEVELS 95 – 100% = Expected saturation
85 – 95% = Zone of minimal sensory impairment
75 – 85% = Zone of minimal mental impairment
65 – 75% = Zone of increasing sensory & mental impairment
55 – 65% = Zone of potential collapse

26. Oxygen Dissociation Curve

27. Pulse Oximetry/Hypoxia
Affects of hypoxia

28. HYPOXIA A condition in which the body or a region of the body is deprived of adequate oxygen supply…
Common causes:
Infection
COPD
Pulmonary HTN or Obstruction
Altitude..

29. PAIN – THE 5TH VITAL SIGN
Dcg&NR=1

30. THE PAIN SCALE

31. METHOD OF PAIN ASSESSMENT PQRST
P = Provokes
What causes pain?
What makes it better?
Worse?
Q = Quality
What does it feel like?
Is it sharp?
Dull?
Stabbing?
Burning?
Crushing? ( Try to let patient describe the pain, sometimes they say what they think you would like to hear. )

32. PQRST R = Radiates Where does the pain radiate? Is it in one place?
Does it go anywhere else?
Did it start elsewhere and now localized to one spot?
S = Severity
How severe is the pain on a scale of ?
T = Time
Time pain started?
How long did it last?

33. Common Orders for Assessing Vital Signs
Vital signs are ordered with different frequency depending on the type of service being provided.
Once a day (qd)
Twice a day (bid)
Three times a day (tid)
Four times a day (qid)
Every 4 hours (q4h)
Every 15 minutes (q15min)

34. Height and Weight Rapid changes in weight can
indicate underlying health issues
Insurance companies determine at which weight for a specific height an individual is predicted to live the longest
The National Heart, Lung, and Blood Institute defines an ideal weight as have a body mass between 18.7 and 24.9

37. Health Assessment • Interview and examination
Interview may include the medical history, nature of the current complaint, and medication record
Examination determines functional, cultural, spiritual, and physical characteristics

38. Table 7-3 Physical Assessment (Continued)

39. Military Time A 24-hour system used to measure time
Hours are numbered from 0 to 24, with noon being 1200
No need to use the morning (a.m.) and evening (p.m.) designation because there are no times with the same number

40. MILITARY TIME

41. Basic Math
• Many procedures performed by health care workers include mathematics:
Calculate medication dosages
Conversions of medication dosages
Measure time
Temperature
Distance
Capacity (volume)
Mass

42. Measurements Used in Health Care
Three systems of measurements used in health care:
Apothecary
SI (metric)
Household units

43. Table 7-4 Liquid and Solid Systems of Measurement

44. Graphing Used to interpret data visually
Commonly used to chart vital signs
Four types of graphs include:
Bar graph
Pie graph
Pictograph
Line graph

45. Figure 7-11 Types of Graphs

47. Survivor What does VS stand for?
Where would you auscultate an apical pulse?
Why would you need to take an apical pulse instead of a radial pulse?
VS includes what measurements?
Translate VS Q4h?
Why would VS be ordered Q15min?
Name 2 factors that affect VS.
What is the blood pressure?
Which tools are needed to take a BP

48. Which artery is normally used to palpate the pulse?
What is a the normal range for BP?
What is the Map of a BP of 140/50
What does palpation mean?
What does auscultation mean?
Name one assessment or VS that can be checked using palpation
Name one VS found using auscultation
Is an adult pulse of 110 normal?
Is an adult pulse of 59 normal?
What is the medical term for increased/above normal pulse?

49. What is the medical term for a low pulse rate?
What time is it right now in military time?
If a person weighs 120 lbs how many KG are they?
What is the temperature measuring?
Which part of the stethescope is placed on the chest to auscultate the BP or lung sounds:
Is 125/81 a normal BP for an adult?
What is hypertension?
What is the normal range for an adult BP?
Name 3 ways to take a temp?
What is the fifth VS?

50. What is the range for pre-hypertension in an adult?
What is the range for HTN in an adult?
A full respiration includes one_______and one_______.
What is the Spo2?
How does the pulse oximeter/Spo2 work?
What is hypoxia
What is the BMI?
How is BMI measured?
What do healthcare workers use math for?
What does TPR stand for?