1. Assessing Vitals and You By: Sean French Anna Morgan

2. What is Blood Pressure Measuring? The force of blood pushing against the arterial walls is known as blood pressure. The force of blood pushing against the arterial walls is known as blood pressure. Measuring blood pressure helps assess the overall health of the cardiovascular system and systemic circulation. Measuring blood pressure helps assess the overall health of the cardiovascular system and systemic circulation. There are 2 numbers recorded when measuring blood pressure. There are 2 numbers recorded when measuring blood pressure. Systolic and Diastolic pressures. Systolic and Diastolic pressures.

3. 120/80 Systolic pressure Diastolic pressure

4. What is Blood Pressure Measuring Cont. The Systolic pressure measures the amount of pressure that the blood exerts on arterial vessel walls as it passes through them (as the heart pumps it). The Systolic pressure measures the amount of pressure that the blood exerts on arterial vessel walls as it passes through them (as the heart pumps it). Diastolic pressure measures the amount of pressure that the blood exerts on arterial vessel walls while the heart is relaxed (in between beats). Diastolic pressure measures the amount of pressure that the blood exerts on arterial vessel walls while the heart is relaxed (in between beats).

5. What is Blood Pressure Measuring Cont. Blood pressure is measurements are in mmHg. Blood pressure is measurements are in mmHg. mmHg=millimeters of mercury mmHg=millimeters of mercury

6. What is ‘Normal’ Blood Pressure? No individual is the same. Therefore, not everyone’s ‘normal’ blood pressure will be the same. No individual is the same. Therefore, not everyone’s ‘normal’ blood pressure will be the same. The ‘normal’ agreed upon is 120/80 mmHg. The ‘normal’ agreed upon is 120/80 mmHg. Systolic pressure=120 mmHg Systolic pressure=120 mmHg Diastolic pressure=80 mmHg Diastolic pressure=80 mmHg

7. Blood Pressure Chart

8. Assessing Blood Pressure 1. Introduce yourself to the patient and inform them of what you are about to perform. 2. Palpate the patient’s brachial artery until you can feel the pulse 3. Place the cuff on the patient’s brachial artery as indicated 4. Place the stethoscope membrane against the anterior of the elbow.

9. Assessing Blood Pressure Cont. 5.Pump the cuff to about 200mmHg 6.Slowly release the pressure, listening carefully for the patient’s heartbeat. 7.Record the measurement for the first heartbeat you notice. This is the Systolic pressure. 8.Listen for the very last audible heartbeat, and record the measurement. This is the Diastolic pressure.

10. Abnormal Blood Pressures Hypertension Hypertension Also known as high blood pressure. Also known as high blood pressure. 140/90 mmHg is the average readings for hypertension 140/90 mmHg is the average readings for hypertension Anything above the patient’s ‘normal’ blood pressure can be diagnosed as hypertension. Anything above the patient’s ‘normal’ blood pressure can be diagnosed as hypertension. Hypotension Hypotension Also known as low blood pressure. Also known as low blood pressure. Anything significantly below the patient’s ‘normal’ blood pressure. Anything significantly below the patient’s ‘normal’ blood pressure.

11. What is a Pulse? Pulse is the tactile arterial palpation of the heartbeat. Pulse is the tactile arterial palpation of the heartbeat. The pulse may be palpated in any place that allows an artery to be compressed against a bone. The pulse may be palpated in any place that allows an artery to be compressed against a bone. Common places of arterial palpation: Common places of arterial palpation: Carotid artery Carotid artery Radial artery Radial artery Popliteal artery Popliteal artery Brachial artery Brachial artery Posterior tibeal artery Posterior tibeal artery Pulse is measured in bpm Pulse is measured in bpm Bpm=beats per minute Bpm=beats per minute

12. Assessing a Patient’s Pulse 1. Introduce yourself to the patient and inform them of what you are about to perform. 2. Gently place 2 fingers (usually index and middle finger) against the artery of your desire to palpate. Do NOT use your thumb, because it has a pulse of its own. 3. Feel around until you can feel their heartbeat, and count for 30 seconds. Then multiply by 2 and record on patient’s chart.

13. What is a ‘Normal’ Pulse? The ‘normal’ pulse rate for an adult is around 60-100 bpm. The ‘normal’ pulse rate for an adult is around 60-100 bpm.

14. Abnormal Pulse’s Pulsus alternans: an ominous medical sign that indicates progressive systolic heart failure. To trained fingertips, the examiner notes a pattern of a strong pulse followed by a weak pulse over and over again. This pulse signals a flagging effort of the heart to sustain itself in systole. Pulsus alternans: an ominous medical sign that indicates progressive systolic heart failure. To trained fingertips, the examiner notes a pattern of a strong pulse followed by a weak pulse over and over again. This pulse signals a flagging effort of the heart to sustain itself in systole. Pulsus bigeminus : indicates a pair of hoofbeats within each heartbeat. Concurrent auscultation of the heart may reveal a gallop rhythm of the native heartbeat. Pulsus bigeminus : indicates a pair of hoofbeats within each heartbeat. Concurrent auscultation of the heart may reveal a gallop rhythm of the native heartbeat. Pulsus bisferiens: an unusual physical finding typically seen in patients with aortic valve diseases. If the aortic valve does not normally open and close, trained fingertips will observe two pulses to each heartbeat instead of one. Pulsus bisferiens: an unusual physical finding typically seen in patients with aortic valve diseases. If the aortic valve does not normally open and close, trained fingertips will observe two pulses to each heartbeat instead of one.

15. Abnormal Pulse’s Cont. Pulsus paradoxus: a condition in which some heartbeats cannot be detected at the radial artery during the inspiration phase of respiration. It is caused by an exaggerated decrease in blood pressure during this phase, and is diagnostic of a variety of cardiac and respiratory conditions of varying urgency. Pulsus paradoxus: a condition in which some heartbeats cannot be detected at the radial artery during the inspiration phase of respiration. It is caused by an exaggerated decrease in blood pressure during this phase, and is diagnostic of a variety of cardiac and respiratory conditions of varying urgency. Pulsus tardus et parvus: a slower than normal rise in the tactile pulse caused by an increasingly stiff aortic valve. Loss of compliance in the aortic valve makes it progressively harder to open, thus requiring increased generation of blood pressure in the left ventricle. Pulsus tardus et parvus: a slower than normal rise in the tactile pulse caused by an increasingly stiff aortic valve. Loss of compliance in the aortic valve makes it progressively harder to open, thus requiring increased generation of blood pressure in the left ventricle.

16. What is a ‘Normal’ Temperature? The ‘normal’ oral temperature for an adult patient is roughly 98.6°F give or take 0.9°F The ‘normal’ oral temperature for an adult patient is roughly 98.6°F give or take 0.9°F Normal rectal temperature for an adult is roughly 99.6°F Normal rectal temperature for an adult is roughly 99.6°F Normal axillary or groin temperature for an adult is roughly 97.6°F Normal axillary or groin temperature for an adult is roughly 97.6°F

17. Assessing a Patient’s Temperature 1. Introduce yourself to the patient and inform them on what you are about to perform. 2. Take the thermometer out of its holder, and place a new throw-away plastic cover. 3. Place the covered tip under the patient’s mouth, and ask them to close their mouth keeping the thermometer under their tongue. 4. Remove once thermometer beeps, and record temperature onto patient’s chart.

18. Sites on a Patient That Gives the Most Accurate Temperature Reading. Rectal temperatures are said to be the most accurate site to obtain a temperature. Rectal temperatures are said to be the most accurate site to obtain a temperature. This is because it is inside the body itself (granted oral is too, but not within the viscera). This is because it is inside the body itself (granted oral is too, but not within the viscera).

19. What is ‘Normal’ Respirations? The normal rate for respirations in adults is 14 to 18 breaths per minute, although wider ranges may be observed (12 to 20 breaths per minute). The normal rate for respirations in adults is 14 to 18 breaths per minute, although wider ranges may be observed (12 to 20 breaths per minute). In children, respirations are slightly faster than those for adults and average 16 to 25 per minute. In children, respirations are slightly faster than those for adults and average 16 to 25 per minute. In infants, the rate may be 30 to 50 per minute. In infants, the rate may be 30 to 50 per minute.

20. How to Assess a Patient’s Respirations Do NOT inform the patient that you will be observing their respirations. This will affect how they breathe. Do NOT inform the patient that you will be observing their respirations. This will affect how they breathe. While taking the patient’s pulse, observe the patient’s chest and count how many breaths they take within the 30 seconds. Multiply by 2 and record on the patient’s chart. While taking the patient’s pulse, observe the patient’s chest and count how many breaths they take within the 30 seconds. Multiply by 2 and record on the patient’s chart.

21. Just a Little Extra Terms to Know Apnea-Absence of respirations, usually only temporary (acute). Apnea-Absence of respirations, usually only temporary (acute). Dyspnea-Difficult or labored breathing; Usually rather painful. Dyspnea-Difficult or labored breathing; Usually rather painful. Cheyne-stokes-Respirations—periods of dyspnea followed by periods of apnea; frequently noted in the dying patient. Cheyne-stokes-Respirations—periods of dyspnea followed by periods of apnea; frequently noted in the dying patient.

22. Just a Little Extra Terms to Know Cont. Wheezing-Difficult breathing with a high- pitched whistling or sighing sound during expiration; caused by a narrowing of bronchioles (as seen in asthma) and/or an obstruction or mucus accumulation in the bronchi. Wheezing-Difficult breathing with a high- pitched whistling or sighing sound during expiration; caused by a narrowing of bronchioles (as seen in asthma) and/or an obstruction or mucus accumulation in the bronchi. Orthopnea-Severe dyspnea in which breathing is very difficult in any position other than sitting erect or standing. Orthopnea-Severe dyspnea in which breathing is very difficult in any position other than sitting erect or standing.

23. Just a Little Extra Terms to Know Cont. Hyperthermia-An elevated body temperature due to failed thermoregulation; occurs when the body produces or absorbs more heat than it can dissipate. Hyperthermia-An elevated body temperature due to failed thermoregulation; occurs when the body produces or absorbs more heat than it can dissipate. When the elevated body temperatures are sufficiently high, hyperthermia is a medical emergency and requires immediate treatment to prevent disability or death. When the elevated body temperatures are sufficiently high, hyperthermia is a medical emergency and requires immediate treatment to prevent disability or death.

24. Just a Little Extra Terms to Know Cont. Tachycardia-A pulse rate over 100 beats per minute (except in children). Tachycardia-A pulse rate over 100 beats per minute (except in children). Bradycardia-A pulse rate under 60 beats per minute. Bradycardia-A pulse rate under 60 beats per minute. Afebrile-Literally means without a fever. Afebrile-Literally means without a fever.

25. Random Facts :] A red blood cell can circumnavigate your body in under 20 seconds. A red blood cell can circumnavigate your body in under 20 seconds. Nerve Impulses travel at over 400 km/hr (25 mi/hr). Nerve Impulses travel at over 400 km/hr (25 mi/hr). Our heart beats around 100,00 times every day. Our heart beats around 100,00 times every day. Our eyes can distinguish up to one million colour surfaces and take in more information than the largest telescope known to man. Our eyes can distinguish up to one million colour surfaces and take in more information than the largest telescope known to man. Our lungs inhale over two million litres of air every day, without even thinking. They are large enough to cover a tennis court. Our lungs inhale over two million litres of air every day, without even thinking. They are large enough to cover a tennis court.

26. Random Facts :] A person can expect to breathe in about 40 pounds of dust over his/her lifetime. A person can expect to breathe in about 40 pounds of dust over his/her lifetime. In one square inch of our hand we have nine feet of blood vessels, 600 pain sensors, 9000 nerve endings, 36 heat sensors and 75 pressure sensors. In one square inch of our hand we have nine feet of blood vessels, 600 pain sensors, 9000 nerve endings, 36 heat sensors and 75 pressure sensors.

27. Quiz Time! Muahahaha >:] 1. What is the very first thing you must do before assessing a patient’s vitals? a) Slap them in the face b) Introduce yourself and inform them of what you’re going to do c) Introduce yourself and inform them of what you’re going to do EXCEPT when taking respirations d) Tell them they make you want to vomit

28. 2.What is Hyperthermia? 2.What is Hyperthermia? An elevated body temperature due to failed thermoregulation; occurs when the body produces or absorbs more heat than it can dissipate. An elevated body temperature due to failed thermoregulation; occurs when the body produces or absorbs more heat than it can dissipate.

29. 3.I will give a dollar to the person who can tell me what acidosis is WITHOUT cheating or looking it up. 3.I will give a dollar to the person who can tell me what acidosis is WITHOUT cheating or looking it up. Acidosis is a pathological condition resulting from a disturbance in the acid-base balance in the blood and body tissues. Acidosis is a pathological condition resulting from a disturbance in the acid-base balance in the blood and body tissues.

30. 4.What is considered a healthy, normal blood pressure? 4.What is considered a healthy, normal blood pressure? a) 140/90 b) 7548/0.021548 c) 100/50 d) 120/80

31. I got extremely bored making the quiz, so here’s something to hopefully make you chuckle :]

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