Vitals Competency

What is the normal range for the adult pulse?

60-100 bpm

What artery is used to assess the pulse rate?

Radial

Why isn't the thumb used to assess the pulse?

You will feel your own pulse and get an incorrect reading

What term describes a pulse rate of greater 100 BPM?

Tachycardia

What may cause an increased heart rate?

Stress/anxiety

What term describes a pulse rate of less than 60 BPM?

Bradycardia

What may cause a low heart rate?

High endurance athletes, sleep, hypothyroidism, heart conditions, beta blockers, calcium channel blockers

What is the normal range for adult respiration per minute?

12-20

Child respiration normal rate

20-25

What term describes uncontrolled rapid breathing?

Hyperventilation

What is a likely cause for hyperventilation in the dental setting?

Stress/anxiety

How should hyperventilation be managed?

Stop treatment - sit patient up

Reassure

Slow deep breaths

What is the most common emergency in the dental setting? What causes this emergency?

Syncope due to stress

How should syncope be managed?

Lay patient supine with feet elevated

Place cool wash cloth on head

Use ammonia inhalant

How do you know where to position the blood pressure cuff?

Lower edge of the cuff is placed approximately 1 inch above the antecubital fossa

If the cuff is too small how will it affect the reading?

Gives a falsely high reading due to more pressure than necessary

Why is it important that the cuff is not too loose on the arm prior to inflation?

If not tight enough it will not occlude the artery and will require too much inflation - the reading will be off

Where is the stethoscope placed?

Over the palpated brachial artery pulse point approximately 1 inch below the antecubital fossa and slightly toward the inner side of the arm

How do you know how much to inflate the blood pressure cuff?

Palpate the radial artery

Inflate until the radial artery is no longer detected during palpation (pulse obliteration)

20-30 mmHg above where the radial pulse was no longer felt

How quickly should you release the pressure from the cuff?

2-3 mmHg

What is the term for the sounds heard when assessing for blood pressure?

First Korotkoff Sound - Systolic pressure

Second Korotkoff Sound - Diastolic pressure

What are the two readings you are recording?

Systolic/diastolic

If they are in different categories - BP is classified as the higher category

If you have difficulty obtaining the BP, how long should you wait to reassess it?

1 minute

Systolic pressure

Peak or highest pressure, ventricular contraction

Diastolic pressure

Lowest pressure, ventricular relaxation

What is considered normal blood pressure?

less than 120/less than 80

Elevated Pressure

120-129/less than 80

Stage 1 Hypertension

130-139/80-89

Stage 2 Hypertension

140 or higher/90 or higher

Stage 3 Hypertensive Crisis

180 or higher/higher than 120

What are the risk factors associated with untreated hypertension?

Heart attack, CVA, kidney failure, angina attack

Why do we take the patient's vitals?

- establish a baseline

- retake if elevated during appointment

- consult with doctor if not within normal limits

- monitor during medical emergency