1. V ITAL S IGNS AND O THER A SSESSMENT S URVEYS P RACTICAL S ESSION

2. O BJECTIVES At the end of this session, each student should be able to: Identify common pulse sites.  Measure the pulse rate at carotid, brachial, and radial pulse sites. Identify sites of temperature assessment, and the differences among them.  Change the temperature readings from Celsius to Fahrenheit and vice-versa. Measure brachial blood pressure using mercury sphygmomanometer.

3. P ULSE S ITES Peripheral pulses can be assessed by palpation. How To Assess The Peripheral Pulses With moderate pressure, apply (place) pads of the most distal aspects of the middle three fingers on the peripheral site location. Note: Apical pulse is usually evaluated by auscultation.

4. صدغي سباتي عضدي فخذي شعاعي ( كعبري ) Note: Apical pulse is usually evaluated by auscultation.

5. M EASURING A LERT A DULT C LIENT ’ S O RAL T EMPERATURE USING M ERCURY T HERMOMETER See Accompanying Sheets.

6. S ITES OF T EMPERATURE A SSESSMENT SiteDescriptionTime to attain Oral Posterior sublingual pocket (under tongue) No hot or cold drinks or smoking 20 minutes before to assess for the temperature. The client must be awake and alert. Not for small children (bite down) (Mercury) Leave in place 2-3 minutes. (Electronic) Leave in place until a sound is heard.

7. S ITES OF TEMPERATURE ASSESSMENT SiteDescriptionTime to attain Axillary Bulb in center of axilla Lower arm position across chest Not-invasive Good for children. Less accurate (no major blood vessels nearby) (Mercury) Leave in place 5-10 minutes. (Electronic) Leave in place until a sound is heard. Measures 0.5 C lower than oral temperature.

8. S ITES OF TEMPERATURE ASSESSMENT SiteDescriptionTime to attain Rectal Left-side lying with right leg flexed, insert lubricated bulb Adult: 1 to 1.5 inch Infant: 0.5 inch Note: 1 inch = 2.54 cm When unsafe or inaccurate by mouth (unconscious, disoriented or irrational) Left side lying position – right leg flexed Left leg straight (Mercury) Leave in place 2-3 minutes. (Electronic) Leave in place until a sound is heard. Measures 0.5 C higher than oral temperature

9. S ITES OF TEMPERATURE ASSESSMENT SiteDescriptionTime to attain Ear Close to hypothalamus – sensitive to core temperature changes. Adult - Pull pinna up and back Child – Pull pinna down and back Rapid measurement Easy to assess Cerumen إفرازات الأذن الصمغية impaction distorts reading Otitis media التهاب الأذن المتوسطة can distort reading (Electronic) 2-3 seconds

10. C HANGING T EMPERATURE R EADING How to change Temperature Reading from Celsius to Fahrenheit: How to change Temperature Reading from Fahrenheit to Celsius:

11. M EASURING (B RACHIAL ) B LOOD P RESSURE (BP) USING M ERCURY S PHYGMOMANOMETER See Accompanying Sheets.