1. Copyright 2003 by Mosby, Inc. All rights reserved. CHAPTER 6 FOUNDATION SKILLS

2. Copyright 2003 by Mosby, Inc. All rights reserved. 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

3. Copyright 2003 by Mosby, Inc. All rights reserved. Vital Signs Values used to measure changes in body function, general health, and response to treatment Include blood pressure (BP) and temperature, pulse, and respiration (TPR) Affected by many factors: age, activity, nutrition, emotion, fitness, medication, and illness

4. Copyright 2003 by Mosby, Inc. All rights reserved. Assessing Vital Signs 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)

5. Copyright 2003 by Mosby, Inc. All rights reserved. Blood Pressure Measurement of the force of the blood against the walls of the arteries as it circulates through the body Maximum pressure at which the pulse can be heard is systolic Minimum pressure at which it is audible is diastolic

6. Copyright 2003 by Mosby, Inc. All rights reserved. Instruments for Taking Blood Pressure Stethoscope amplifies the sound Sphygmomanometer is an inflatable cuff that measures pressure using air (aneroid) or mercury

7. Copyright 2003 by Mosby, Inc. All rights reserved. Figure 6-1 Sphygmomanometer and Stethoscope

8. Copyright 2003 by Mosby, Inc. All rights reserved. Temperature The measurement of the balance between the heat produced and lost by the body Four methods commonly used to measure temperature –Mouth (oral) –Armpit (axillary) –Rectum (rectal) –Ear (temporal)

9. Copyright 2003 by Mosby, Inc. All rights reserved. Table 6-1 Temperature

10. Copyright 2003 by Mosby, Inc. All rights reserved. Types of Thermometers Glass with an expandable mercury filling –Expandable mercury filling –Oral –Rectal Electronic Disposable chemical thermometers

11. Copyright 2003 by Mosby, Inc. All rights reserved. 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

12. Copyright 2003 by Mosby, Inc. All rights reserved. Table 6-2 Pulse Ranges by Age Group

13. Copyright 2003 by Mosby, Inc. All rights reserved. Respiration One respiration includes the inspiration and expiration of a breath The rhythm and character of respiration are important observations

14. Copyright 2003 by Mosby, Inc. All rights reserved. Box 6-2 Respiration in Adults

15. Copyright 2003 by Mosby, Inc. All rights reserved. Height and Weight Insurance companies determine at which weight for a specific height an individual is predicted to live the longest American Heart Association recommends desired weight be considered in relation to other risk factors of heart disease such as blood pressure and cholesterol levels

16. Copyright 2003 by Mosby, Inc. All rights reserved. Physical Assessment Inspection is done by using visual and auditory 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

17. Copyright 2003 by Mosby, Inc. All rights reserved. Information Exchange Basic math –For medication dosages –Measure time –Temperature –Distance –Capacity (volume) –Mass

18. Copyright 2003 by Mosby, Inc. All rights reserved. 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

19. Copyright 2003 by Mosby, Inc. All rights reserved. Graphing Used to interpret data visually Commonly used to chart vital signs Four types of graphs include: –Bar graph –Pie graph –Pictograph –Line graph

20. Copyright 2003 by Mosby, Inc. All rights reserved. Figure 6-11 Types of Graphs

21. Copyright 2003 by Mosby, Inc. All rights reserved. Figure 6-11 Types of Graphs

22. Copyright 2003 by Mosby, Inc. All rights reserved. Figure 6-11 Types of Graphs

23. Copyright 2003 by Mosby, Inc. All rights reserved. Figure 6-11 Types of Graphs

24. Copyright 2003 by Mosby, Inc. All rights reserved. Computer Literacy Electronic equipment that stores, manipulates, and retrieves information according to a program Components of a computer system –Working space –Hardware –Keyboard –Central processing unit (CPU) –Viewing screen (monitor) –Disk drive –Disks

25. Copyright 2003 by Mosby, Inc. All rights reserved. Medical Terminology The vocabulary is based on Latin and Greek roots for common words Each word can be divided into parts that are reused to form new terms Abbreviations and symbols are used Physician’s orders

26. Copyright 2003 by Mosby, Inc. All rights reserved. Emergency First Aid Immediate care given to the victim of injury or sudden illness Certification in first aid is awarded by several accredited agencies –American Red Cross (ARC) –American Heart Association (AHA) Cardiopulmonary resuscitation (CPR)