2. U10 Pt Procedures & Vital Signs

3. Patient Procedures ALWAYS BEGIN TESTS/PROCDURES WITH THE ALWAYS BEGIN TESTS/PROCDURES WITH THE 6 Rules of PATIENT PROCEDURES 6 Rules of PATIENT PROCEDURES

4. Patient Procedures 6 rules Introduce yourself Introduce yourself

5. Patient Procedures Introduce yourself Introduce yourself Identify the pt.-- Make sure you are with the correct pt Identify the pt.-- Make sure you are with the correct pt

6. Patient Procedures Introduce yourself Introduce yourself Identify the pt.--Make sure you are with the correct pt Identify the pt.--Make sure you are with the correct pt Explain the procedure to the pt Explain the procedure to the pt

7. Patient Procedures Introduce yourself Introduce yourself Identify the pt.--Make sure you are with the correct pt Identify the pt.--Make sure you are with the correct pt Explain the procedure to the pt Explain the procedure to the pt Explain to the pt that if they feel uncomfortable/pain at any time, they are to tell you and that you will stop the procedure. Explain to the pt that if they feel uncomfortable/pain at any time, they are to tell you and that you will stop the procedure.

8. Patient Procedures Introduce yourself Introduce yourself Make sure you are with the correct pt Make sure you are with the correct pt Explain the procedure to the pt Explain the procedure to the pt Explain to the pt that if they feel uncomfortable/pain at any time, they are to tell you and that you will stop the procedure. Explain to the pt that if they feel uncomfortable/pain at any time, they are to tell you and that you will stop the procedure. Ask the pt if they understand or if they have any questions Ask the pt if they understand or if they have any questions

9. Patient Procedures Introduce yourself Introduce yourself Make sure you are with the correct pt Make sure you are with the correct pt Explain the procedure to the pt Explain the procedure to the pt Explain to the pt that if they feel uncomfortable/pain at any time, they are to tell you and that you will stop the procedure Explain to the pt that if they feel uncomfortable/pain at any time, they are to tell you and that you will stop the procedure Ask the pt if they understand or if they have any questions Ask the pt if they understand or if they have any questions Record Results Record Results

10. Vital Signs Tests/procedures that are indicators of internal homeostasis (homeostasis is the maintaining of a constant internal environment—breathing, heart rate, body temperature, internal functions). Tests/procedures that are indicators of internal homeostasis (homeostasis is the maintaining of a constant internal environment—breathing, heart rate, body temperature, internal functions).

11. Vital Signs Represents the general health of the pt at that point in time Represents the general health of the pt at that point in time

12. Important factors of Vital Signs Understand how to do the procedure/test Understand how to do the procedure/test

13. Important factors of Vital Signs Understand how to do the procedure/test Understand how to do the procedure/test Know how to perform the procedure or test with confidence Know how to perform the procedure or test with confidence

14. Important factors of Vital Signs Understand how to do the procedure/test Understand how to do the procedure/test Know how to perform the procedure or test with confidence Know how to perform the procedure or test with confidence Must be accurate Must be accurate

15. Important factors of Vital Signs Understand how to do the procedure/test Understand how to do the procedure/test Know how to perform the procedure or test with confidence Know how to perform the procedure or test with confidence Must be accurate Must be accurate Must be able to keep the pt comfortable. Must be able to keep the pt comfortable.

16. Factors that may influence VS Physical Physical Walking, running, illness, stairs etc…. Walking, running, illness, stairs etc….

17. Factors that may influence VS Physical Physical Emotional-afraid, bad day, stress etc….. Emotional-afraid, bad day, stress etc…..

18. Factors that may influence VS Physical Physical Emotional-afraid, bad day, stress etc….. Emotional-afraid, bad day, stress etc….. Equipment Equipment Failures Failures To big or small To big or small Low batteries Low batteries

19. Vital Signs Temperature Temperature Pulse/Heart rate Pulse/Heart rate Respiratory Rate Respiratory Rate Blood pressure Blood pressure Ht Ht Wt Wt

20. Temperature Physiology: The body maintains a constant temperature, this helps to maintain homeostasis (the internal environment of the body), this is controlled by the brain. Physiology: The body maintains a constant temperature, this helps to maintain homeostasis (the internal environment of the body), this is controlled by the brain.

21. Temperature Physiology: The body moves blood to the core of the body to increase the temperature of the blood, which in turns increases the body temperature----fever. Physiology: The body moves blood to the core of the body to increase the temperature of the blood, which in turns increases the body temperature----fever.

22. Factors that influence Temperature Liquids Liquids

23. Factors that influence Temperature Liquids Liquids Weather Weather

24. Factors that influence Temperature Liquids Liquids Weather Weather Exercise Exercise

25. Factors that influence Temperature Liquids Liquids Weather Weather Exercise Exercise Infections Infections

26. Factors that influence Temperature Liquids Liquids Weather Weather Exercise Exercise Infections Infections Stress Stress

27. Is a Fever a good thing? Yes—the increase in temperature helps the body destroy any pathogens. Pathogens are temperature sensitive. Yes—the increase in temperature helps the body destroy any pathogens. Pathogens are temperature sensitive.

28. Is a Fever a good thing? Yes—the increase in temperature helps the body destroy any pathogens. Pathogens are temperature sensitive. Yes—the increase in temperature helps the body destroy any pathogens. Pathogens are temperature sensitive. Sometimes not--- a prolonged fever (having a fever for a long period of time), can cause brain injuries. Sometimes not--- a prolonged fever (having a fever for a long period of time), can cause brain injuries.

29. Temperature Sites Oral--mouth Oral--mouth

30. Temperature Sites Oral—mouth Oral—mouth Rectal- ummmmm Rectal- ummmmm

31. Temperature Sites Oral—mouth Oral—mouth Rectal- ummmmm Rectal- ummmmm Tympanic--ear Tympanic--ear

32. Temperature Sites Oral—mouth Oral—mouth Rectal- ummmmm Rectal- ummmmm Tympanic—ear Tympanic—ear Axillary- arm pit Axillary- arm pit

33. Temperature Sites Oral—mouth Oral—mouth Rectal- ummmmm Rectal- ummmmm Tympanic—ear Tympanic—ear Axillary- arm pit Axillary- arm pit Temporal Scan- forehead/behind the ear Temporal Scan- forehead/behind the ear

34. Temperature Value/Readings Normal- 98.6 degrees F Normal- 98.6 degrees F

35. Temperature Value/Readings Normal- 98.6 degrees F Normal- 98.6 degrees F Rectal temperature: subtract 1 degree Rectal temperature: subtract 1 degree

36. Temperature Value/Readings Normal- 98.6 degrees F Normal- 98.6 degrees F Rectal temperature: subtract 1 degree Rectal temperature: subtract 1 degree Axillary temperature- add 1 degree Axillary temperature- add 1 degree

37. Types of thermometers Glass Glass

38. Types of thermometers Glass Glass digital digital

39. Types of thermometers Glass Glass Digital Digital Digital Probe Digital Probe

40. Types of thermometers Glass Glass Digital Digital Digital Probe Digital Probe Tympanic Tympanic

41. Types of thermometers Glass Glass Digital Digital Digital Probe Digital Probe Tympanic Tympanic Temporal Scan Temporal Scan

42. Pulse/Heart Rate The number of times the heart beats per minute. The number of times the heart beats per minute.

43. Pulse/Heart Rate The number of times the heart beats per minute. The number of times the heart beats per minute. Documented as ___B/M ( beats per minute) Documented as ___B/M ( beats per minute)

44. Pulse/Heart Rate Factors the affect the HR. Factors the affect the HR. Exercise Exercise

45. Pulse/Heart Rate Factors the affect the HR. Factors the affect the HR. Exercise Exercise Food Food

46. Pulse/Heart Rate Factors the affect the HR. Factors the affect the HR. Exercise Exercise Food Food Illness Illness

47. Pulse/Heart Rate Factors the affect the HR. Factors the affect the HR. Exercise Exercise Food Food Illness Illness Stress Stress

48. Pulse/Heart Rate Factors the affect the HR. Factors the affect the HR. Exercise Exercise Food Food Illness Illness Stress Stress Medications—OTC, Rx, illegal Medications—OTC, Rx, illegal

49. 3. Carotid 3. Carotid 4. Brachial 4. Brachial 5. Radial ***** 5. Radial ***** 7. Popliteal 7. Popliteal

50. Taking a pulse Never use your thumb. Your thumb has a small pulse that can be felt. Pulse is taken on the thumb (radial) side of the pts wrist.

51. Pulse Characteristics Rate: how fast the heart is beating Rate: how fast the heart is beating

52. Pulse Characteristics Rate: how fast the heart is beating Rate: how fast the heart is beating Average 70 bpm Average 70 bpm Range for Adults 60-90 bpm Range for Adults 60-90 bpm Range for children/infants 115-125 bpm Range for children/infants 115-125 bpm Range for Athletes 40-60 bpm Range for Athletes 40-60 bpm

53. Pulse Characteristics Rhythm – time between the beats. Rhythm – time between the beats.

54. Pulse Characteristics Volume- the force of the pulse. Volume- the force of the pulse.

55. Pulse Characteristics Elasticity- the feel of the vessel through the skin. Elasticity- the feel of the vessel through the skin.

56. Respiration ( breaths)/RR Documented as the # of breaths per minute Documented as the # of breaths per minute

57. Respiration / RR Documented as the # of breaths per minute Documented as the # of breaths per minute It is automatically assumed that the recorded # is the number of breaths per minute. It is automatically assumed that the recorded # is the number of breaths per minute.

58. Respiration / RR Documented as the # of breaths per minute Documented as the # of breaths per minute It is automatically assumed that the recorded # is the number of breaths per minute. It is automatically assumed that the recorded # is the number of breaths per minute. INHALE + EXHALE = 1 breath INHALE + EXHALE = 1 breath

59. Respiration Rate: 12-20 breaths per minute Rate: 12-20 breaths per minute

60. Respiration ( breaths) Rate: 12-20 breaths per minute Rate: 12-20 breaths per minute Children and infants have a higher rate Children and infants have a higher rate Athletes have a slower rate. Athletes have a slower rate.

61. Respiration Rhythm- the time between each breath. Rhythm- the time between each breath.

62. Respiration Depth- how deep the breath is—deep, shallow, or normal Depth- how deep the breath is—deep, shallow, or normal

63. Respiration Counting- watch the shoulders rise and fall Counting- watch the shoulders rise and fall

64. Respiration DO NOT tell the pt your are counting their breathing DO NOT tell the pt your are counting their breathing

65. Respiration Counting- watch the shoulders rise and fall Counting- watch the shoulders rise and fall DO NOT tell the pt you are counting their breathing DO NOT tell the pt you are counting their breathing Pt modesty—do not stare at the pts chest. Pt modesty—do not stare at the pts chest.

66. Blood Pressure The amount of pressure in the arteries when the heart contracts and relaxes. The amount of pressure in the arteries when the heart contracts and relaxes.

67. Blood Pressure The amount of pressure in the arteries when the heart contracts and relaxes. The amount of pressure in the arteries when the heart contracts and relaxes. The pressure is measured in mm hg= millimeters of mercury The pressure is measured in mm hg= millimeters of mercury

68. Blood Pressure Blood pressure measurement. Blood pressure measurement.

69. Blood Pressure Blood pressure measurement. Blood pressure measurement. 110/70 mm hg 110/70 mm hg

70. Blood Pressure Blood pressure measurement. Blood pressure measurement. 110/70 mm hg 110/70 mm hg 110 (the first/top number) Systolic-the pressure in the artery when the heart contracts. 110 (the first/top number) Systolic-the pressure in the artery when the heart contracts.

71. Blood Pressure Blood pressure measurement. Blood pressure measurement. 110/70 mm hg 110/70 mm hg 110 (the first/top number) Systolic-the pressure in the artery when the heart contracts. 110 (the first/top number) Systolic-the pressure in the artery when the heart contracts. 70 (the second/bottom number) Diastolic- the pressure in the artery when the heart is relaxed 70 (the second/bottom number) Diastolic- the pressure in the artery when the heart is relaxed

72. Factors that affect Blood Pressure Food, fat, salt Food, fat, salt

73. Factors that affect Blood Pressure Food, fat, salt Food, fat, salt Family Family

74. Factors that affect Blood Pressure Food, fat, salt Food, fat, salt Family Family White coat syndrome-fear of doctors White coat syndrome-fear of doctors

75. Factors that affect Blood Pressure Food, fat, salt Food, fat, salt Family Family White coat syndrome-fear of doctors White coat syndrome-fear of doctors Exercise Exercise

76. Factors that affect Blood Pressure Food, fat, salt Food, fat, salt Family Family White coat syndrome-fear of doctors White coat syndrome-fear of doctors Exercise Exercise Stress Stress

77. Factors that affect Blood Pressure Food, fat, salt Food, fat, salt Family Family White coat syndrome-fear of doctors White coat syndrome-fear of doctors Exercise Exercise Stress Stress Smoking Smoking

78. Blood Pressure Measurements Normal Values 110/70--- 128/90 Normal Values 110/70--- 128/90 High blood pressure=130/90 or higher High blood pressure=130/90 or higher High blood pressure increases the risk of stroke, kidney damage, and heart attacks. High blood pressure increases the risk of stroke, kidney damage, and heart attacks.

79. Blood Pressure Equipment Stethoscope Stethoscope Ear Piece Bell Diaphragm Sound sensitive tube

80. Blood Pressure Equipment Blood pressure cuff Blood pressure cuff Cuff Bulb Sphygmomanometer

81. Height and Weight Measuring the ht and wt of pt can help determine the condition of the pts body. Measuring the ht and wt of pt can help determine the condition of the pts body.

82. Height and Weight Measuring the ht and wt of pt can help determine the condition of the pts body. Measuring the ht and wt of pt can help determine the condition of the pts body. Help measure long term fluctuations with in the body. Help measure long term fluctuations with in the body.

83. Height and Weight Examples: Examples:

84. Height and Weight Examples: Examples: Sudden wt loss may indicate cancer, diabetes, or other metabolic conditions Sudden wt loss may indicate cancer, diabetes, or other metabolic conditions

85. Height and Weight Examples: Examples: Sudden wt loss may indicate cancer, diabetes, or other metabolic conditions Sudden wt loss may indicate cancer, diabetes, or other metabolic conditions Quick weight gain can also indicate the onset of medical conditions such as cancer. Quick weight gain can also indicate the onset of medical conditions such as cancer.

86. Height and Weight Examples: Examples: Sudden wt loss may indicate cancer, diabetes, or other metabolic conditions Sudden wt loss may indicate cancer, diabetes, or other metabolic conditions Quick weight gain can also indicate the onset of medical conditions Quick weight gain can also indicate the onset of medical conditions A decrease in ht can be a sign of conditions such as osteoporosis A decrease in ht can be a sign of conditions such as osteoporosis

87. Height and Weight Ht and wt are measured using a certified scale, you should not guess, but at times the pt may refuse to get on the scale, just document the pts refusal. Ht and wt are measured using a certified scale, you should not guess, but at times the pt may refuse to get on the scale, just document the pts refusal.