1. TEMPERATURE, PULSE, RESPIRATIONS Abbreviated: TPR

2. TEMPERATURE The measurement of core body heat, balance between heat lost & heat produced

3. ROUTES TO MEASURE TEMPERATURE 4 Oral: By mouth 4 Rectally: By rectum 4 Axillary: Under the arm in the armpit 4 Tympanic: In the ear

4. TYPES OF THERMOMETERS 4 Digital Electronic: To be used for oral, rectal, and axillary 4 Thermoscan - Digital: To be used for tympanic 4 Mercury or glass: To be used for oral, rectal, and axillary

5. NORMS 4 Orally: 97.6 - 99.6 degrees Fahrenheit 4 Rectally: 99.6 - 100.6 degrees Fahrenheit 4 Tympanic - manufacturers say to measure as for rectal 4 Axillary: 96.6 - 98.6 degrees Fahrenheit

6. WHAT THERMOMETER SHOULD BE USED? 4 Tympanic: Special device with plastic covers. 4 Electronic: All routes. Clean Probes with each use 4 Mercury: All routes. Rounded ends are rectal; Straight ends oral and axillary.

7. DURATION FOR TAKING TEMPERATURES 4 Tympanic: As long as it takes to push a button 4 Electronic: Until the thermometer beeps 4 Mercury Oral: Three minutes 4 Mercury Rectal: Three minutes 4 Mercury Axillary: Ten minutes

8. BE CAREFUL ON RECTAL AND AXILLARY TEMPS 4 Always hold the thermometer in place while measuring both temperatures 4 Always use lubricant with rectal temperatures 4 Always remove clothing around axilla

9. READING THE THERMOMETER 4 Mercury Fahrenheit thermometers are read by degree and 0.2 of a degree 4 Long lines indicate degrees 4 Short lines indicate 0.2 of a degree 4 Four short lines between each long line (0.2, 0.4, 0.6, 0.8)

10. PULSE The wave of blood created by the heart pumping, that travels along the arteries.

11. FIND WHERE TO PULSES 4 At points where the artery is between finger tips and a bony area 4 Called pulse points 4 Felt with 2-3 fingers, but never the thumb

12. PULSE POINTS AND THEIR LOCATIONS 4 Temporal 4 Carotid 4 Apical 4 Brachial 4 Radial 4 Femoral 4 Popliteal 4 Dorsal Pedalis

13. HOW TO MEASURE? 4 Measured in beats per minute 4 Count the waves for 60 seconds 4 Or, count the waves for 30 seconds - multiply by 2

14. NORMS 4 Pulse norms are 60 - 100 beats per minute 4 Pulses between 90 - 100 are in a gray area - high normal 4 Faster than 100 - tachycardia 4 Slower than 60 - bradycardia

15. QUALITY OF PULSE 4 Rhythm: regular or irregular 4 Rate: Within the normal limits 4 Strength: Strong, bounding, thready

16. WHAT AFFECTS PULSE RATES AND QUALITY 4 Body Temperature 4 Emotions 4 Activity Level 4 Health of the Heart

17. RESPIRATION The mechanical act of breathing in air (inspiration) and expelling air (expiration) from the body

18. RESPIRATION 4 Measured in breaths per minute 4 Normal range is 12 - 20 breaths per minute 4 Greater than 20 is tachypnea 4 Less than 12 is bradypnea 4 Watch for rate, depth, quality of breath, and difficulty in breathing

19. METHOD OF MEASURING TPR 4 If using a mercury thermometer, measure the pulse and respiration while waiting for the temperature 4 If using another method of measuring the temperature, complete the temperature - then measure the pulse and respiration 4 Keep you fingers on the pulse while measuring the respiration

20. CHARTING 4 Chart in order temperature - pulse - respiration. 4 Write (Ax) after axillary temperatures 4 Write (R) after rectal temperatures

21. ABBREVIATIONS 4 SOB - Short of breath 4 TPR - Temperature, pulse, and respiration 4 Within normal limits 4 P.O. - By mouth 4 BID -Twice a day 4 TID -Three times a day 4 QID - Four times a day 4 PRN - As needed 4 Ad Lib - At liberty 4 B/P - Blood Pressure 4 VS - Vital Signs

22. ABBREVIATIONS 4 SOB 4 TPR 4 WNL 4 PO 4 BID 4 TID 4 QID 4 PRN 4 Ad Lib 4 B/P 4 VS

23. ABBREVIATIONS 4 Short of breath 4 Temperature, pulse, and respiration 4 Within normal limits 4 By mouth 4 Twice a day 4 Three times a day 4 Four times a day 4 As needed 4 At liberty 4 Blood Pressure 4 Vital Signs

24. TERMS 4 Eupnea - Normal breathing 4 Orthopnea - Sitting upright to breath more easily 4 Apnea - No breath 4 Hyperpnea - Fast, deep breathing 4 Tachypnea - Fast, shallow breathing 4 Bradypnea - Slow breathing 4 Dyspnea - Painful or difficult breathing 4 Tachycardia - Pulse rate in excess of 100 bpm 4 Bradycardia - pulse rate less than 60 bpm

25. TERMS 4 Eupnea 4 Orthopnea 4 Apnea 4 Hyperpnea 4 Tachypnea 4 Bradypnea 4 Dyspnea 4 Tachycardia 4 Bradycardia

26. TERMS 4 Normal Breathing 4 Sitting upright to breath more easily 4 Fast, deep breathing 4 Fast, shallow breathing 4 Slow breathing 4 Painful or difficult breathing 4 Pulse rate in excess of 100 beats per minute 4 Pulse rate less that 60 beats per minute

27. TERMS 4 Bounding pulse - excessively strong pulse 4 Thready pulse - Pulse rate difficult to palpate because the heart is not beating hard enough to produce a strong wave of blood. Feels as though there is a piece of thread running under the fingertips.

28. TERMS 4 Bounding pulse 4 Thready pulse

29. TERMS 4 Excessively strong pulse 4 Pulse difficult to palpate because heart not beating heard enough

30. The normal range for an oral temperature is A.) 99.6-100.6 B.) 95.6-99.6 C.) 97.6-99.6 D.) 100.6-101.6

31. The wave of blood created by the heart pumping, that travels along the arteries is a A.) emboli B.) pulse C.) respiration D.) hypertension

32. Normal range for pulse is A.) 80-100 bpm B.) 70-90 bpm C.) 60-80 bpm D.) 60-100 bpm

33. The two most common sites to take a pulse are A.) Apical & Radial B.) temporal & carotid C.) brachial & popliteal D.) Radial & bcarotid

34. The average respiratory rates for an adult is A.) 12-15 B.) 12-20 C.) 20-30 D.) 30-40

35. Painful or difficult breathing is A.) Eupnea B.) Orthopnea C.) dyspnea D.) apnea

36. A heart Rate of 55 is A.) Bradycardia B.) tachycardia C.) Normal D.) eupnea

37. A Pulse rate difficult to palpate because the heart is not beating hard enough to produce a strong wave of blood is often described as A.) Bounding B.) Thready C.) Not so good D.) Normal

38. When taking a pt's respiratory rate you should make sure they do not know when you are counting their rate A.) True B.) False

39. You use your thumb when pressing an artey against a bone to get a pulse A.) True B.) False