1. MNA M osby ’ s Long Term Care Assistant Chapter 31 Vital Signs

2. Vital Signs Reflect function of body process needed for life: Temperature Pulse Respirations Blood Pressure. TPR and B/P

3. Amount of heat in the body Lower in amHigher in pm Effected by: Age Weather Exercise Emotions Stress illness Temperature

4. Sites: Oral Axillary Aural Rectal Temporal Temperature Mouth Arm pit Ear Rectum Forehead

5. Sites: Oral Normal 97.6 – 99.6 º F Leave in place 2-3 minutes No smoking, eating, drinking for 15 minutes Temperature

6. Sites: Axillary Normal 96.6 – 98.6 º F Leave in place 5-10minutes Dry the arm pit first Temperature

7. Sites: Aural (tympanic) Adult - Pull the ear up and back Child – pull the ear down and back Temperature Normal 97.6 – 99.6 º F Leave in place according to manufacturers instructions

8. Sites: Rectal Normal 98.6 – 100.6 º F Sims position Lubricate with KY Jelly Insert 1 inch Hold in place 2 minutes Temperature RED TIP

9. Sites: Temporal Artery in forehead Normal 97.6 – 99.6 º F Leave in place according to manufacturers instructions Temperature

10. So ….Normals Oral AX R Temperature 98.697.699.6 97.696.6 98.6 99.698.6100.6 Most accurate: Rectal

11. Reading a Glass Thermometer. 02 degrees 94.8 98.8 97 102.4 104.4 106.6

12. Using a Glass Thermometer Rinse in cool water Check for breaks, cracks, chips Shake down Use plastic covers Standard precautions

13. Types of Electric Thermometers

14. Pulse Beat of the felt at an artery Normal Adult Pulse: 60 - 100

15. Pulse Sites 1. Temporal 2 & 3. Carotid 4. Brachial 5. Radial 6. Femoral 7. Popliteal 8. Posterior tibial 9. Dorsalis pedis

16. Terms Taqchycardia Bradycardia Rate Rhythm Force Rate over 100 per minute Rate below 60 per minute Number ex 68 Regular or irregular Strong, weak, thready

17. Taking a Pulse Use radial Count for 30 seconds and X 2

18. Taking an Apical Pulse Use a stethoscope Listen at the apex Count for 1 full minute

19. Using a Stethoscope Instrument used to listen to sounds Clean earpieces with antiseptic Bend of tips point forward when placed in ears Tap diaphragm gently If no sound turn chest piece at tubing

20. Respirations Inhalation Exhalation Normal - 12 -20 per minute Breath in Breath out Count for 30 seconds X 2 Count when pt is at rest and unaware that you are counting

21. Blood Pressure Amount of force against walls of artery when beats and when relaxes Systolic - heart contraction Diastolic – heart relaxation 120/60

22. Blood Pressure Key terms: Stethoscope – used to listen Aneroid - dial Sphygmomanometer – B/P cuff

24. B/P Diaphragm – flat surface at end of stethoscope Brachial – arm Hypertension - ↑ B/P Hypotension – ↓ B/P Normal Adult Blood Pressure 100 - 140 60 - 90

25. Measuring B/P Pt is sitting or lying down Bare arm Cuff is snug Appropriate size cuff Listen for: 1 st sound - systolic last sound - diastolic

26. Factors effecting B/P AgeStress Gender female Pain ExerciseWeight RaceDrugs PositionSmoking Alcohol ↑ ↑ ↑ ↑ ↑ ↑

27. Review Amount of force exerted on walls of artery by blood is ? A.pulse B.respiration C.temperature D.Blood pressure

28. Review Heart rate less then 60 beats per minute? bradycardia TPR Temperature pulse respiration

29. Review The beat of the heart is felt at A.A vein B.An artery C.A capillary D.A joint

30. Review Used to measure B/P ? sphygmomanometer Used to listen to body sounds? stethoscope

31. Review Rectal thermometer is color coded? RED Most common site for taking a pulse? Radial

32. Review How long after smoking before taking an oral temp? 10 - 15 minutes

33. Review Normal respiration rate? 12 – 20 per minute

34. Review The diastolic pressure is the first sound heard TrueFalse

35. Review AX TID PRN PO STAT S QD axillary 3 x a day As needed By mouth immediately without Once a day _