1. temperature/pulse/respiration
TPR
temperature/pulse/respiration

2. TPR Pulse sites are: Temples Carotid Brachial Radial Femoral Popliteal
Dorsalis pedis
Apical when all else fails

3. TPR You take a radial on a walkin talkin
You take a carotid/femoral on a bluebloater
You take a popliteal/dorsalis pedis for circulation below the pulse site

4. TPR Correct pulse range is 60-100 beats per minute
If the pulse is above 100- it is considered tachycardia
If the pulse is below 60 it is considered bradycardia

5. TPR to determine pulse, palpate the appropriate artery
On a watch with a second hand, time out 10 seconds as you count number of beats you feel. Multiply this number by 6.
Example: I feel 10 beats in 10 seconds
10x6=60 normal
Example I feel 12 beats in 10 seconds
12x6=72 normal

6. TPR Note the quality of the pulse….. Is it thready, weak, irregular?
Is it strong, bounding, racing
Note the skin temp as well….
Is it warm, hot
Is it cool, clammy

7. TPR Temperature can be taken: sublingually-children and adults
Tempanic- in the ear, children and adults
Forehead via infrared, children and adults
Axillary- babies and adults who have had something to eat or drink in last 5 minutes or who can’t receive it orally
Rectally- babies, children adults who need a more accurate temp
Foley cath temp- monitors core temp of the body and can be read on the box continuously

8. TPR
Normal range for temperature would be 98.6 degrees, but may vary by 1 degree either direction throughout the day
Add 1 degree to an axillary temp to determine if it is normal
Subtract a degree from rectal temp to see if it is normal range

9. TPR Temperature above 100.4 F is considered hyperthermia or febrile
Temperature is 95 degrees F and below
Is considered hypothermia, brain and body function slows to a minimum at 85 degrees and body functions cease at 65 degrees F core temp

10. TPR
Respirations- normal respirations will be between breaths/min
Anything below 12 would be considered bradypnea
Anything above 24 would be considered tachypnea

11. TPR Note the quality of breathing
Is the patient gasping- this is not breathing! Nasal flaring in infants and guttural sounds is not breathing! Start CPR
Is the patient cyanotic? Indicates a lack of O2. Get a Pulse Oximeter on the patient ASAP. Normal reading needs to 95%-100% O2 and notify nearest supervisor

12. TPR
Pain is always noted on vital sign assessments. It is considered the 5th VS.
Remember, pain is relative, ALWAYS BELIEVE YOUR PATIENT!
Instruct bp---
What is bp---
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