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Signs
are objective findings seen by the examiner
(can be measured, felt , or heard)
Symptoms
are objective findings seen by the patient
Signs are usually accompanied by symptoms
Homeostasis
consistency in the internal environment of the body (normal)
What are the primary mechanisms that function to help maintain homeostasis?
1. heart beat
2. temperature
3. blood pressure
4. respiratory rate
5. electrolyte balance
What is use to measure the primary mechanisms?
vital signs
Vital signs measure what?
1. temperature
2. blood pressure
3. pulse rate
4. respiratory rate
What does abnormal vital signs in the body indicate?
that the body is not in homeostasis
What is normal body temperature?
98.6F with a one to two degree variation
Body temperature is regulated by what?
the hypothalamus
Body temperature is regulated or kept constant by what?
produced heat
sweat (diaphoresis)
breathe heavier
can be measure in the body in C or F
5 common places to measure body temperature are?
1. oral
2. axillary
3. tympanic
4. rectal
5. temporal artery
oral
by placing the thermometer underneath the tongue (sublingual) normal oral temp is 98.6F
axillary
by placing the thermometer between upper arm and the torso or the armpit (use covering) 97.6F
tympanic
placing the thermometer into the ear 97.6F Normal temp
rectal
placing the thermometer into the rectum 99.6F normal temp
temporal artery
placing the thermometer on the side of the forehead normal temp 100F
hyperthermia
body temperature higher than normal (fever)
(confusion, dizziness, and coma)
hypothermia
body temperature below average
Respiratory System
delivers oxygen and release carbon dioxide (has to have a constant supply of oxygen)
How does the diaphragm controls inspiration and expiration?
by its upward and downward movement
A single respiration consists of what?
one inspiration and one expiration
How should a normal respiration be?
it should be silent and effortless
Normal breath rate
12 to 20 breaths per minute
Children 10 and less breath rate
20 to 30 breaths per minute
Newborns
30 to 60 breaths per minute
Respiration can also be measured by what?
measured in 1 by depths and patterns
tachypnea
rapid respiratory rate and is higher than 20 breaths per minute
bradypnea
slower than normal respiratory rate
dyspnea
difficult breathing
apnea
absent of breathing
any abnormal respiratory rate can be dangerous
3 common sites to measure pulse are
1. Radial artery
2. Brachial artery
3. Carotid artery
Radial artery
at the wrist
Brachial artery
at the elbow
Carotid artery
at the neck
Optical pulse
stethoscope over the apex of the heart
Normal Rates
recorded as beats per minute
What is the normal rest rate for an adult?
60-100 beats per minute
Normal rest rate for children 10 or younger?
70-120 beats per minute
To obtain a pulse by an EKG you do what?
a series of electrodes place across the chest and heart activity is recorded
Arteriole Line
has the ability to measure pulse rate
types of arteriole lines
swan gaze catheter
pulse oximeter
Pulse oximeter
measure oxygen concentration in blood, also use to measure the pulse as well
Tachycardia
pulse rate over 20 beats per minute above the resting pulse rate
Bradycardia
when the pulse rate is below the normal rate
irregular heart beat is life threatening
Cardiac output
product of the heart rate and stroke volume
Cardiac cycle
refers to the events that occur from one ventricular contraction to another
SA node
sinode atrial node
AV node
aventricular node
Bundles of his (left and right)
Purkinje fibers
Any abnormalities in the conduction system that adversely affect the cardiac output is called what?
arrhythmia or dysrhythmia
P wave
represents contraction of the atrial muscle
Depolarization
same as contraction
QRS complex
contraction of the ventricles
T wave
follows the relaxation of the ventricles
U wave
repolarization of the rest of the heart muscles (not always going to see)
5 steps to evaluate an EKG
1. is the rhythm regular or irregular
2. are QRS complexes similar and narrow and should not exceed 3 small squares .12 seconds
3. are the P waves similar; are the PR intervals normal and need to be from 3 to 5 small squares.
4. is the rate normal? count the number of large squares in between each QRS complex /300 75 beats per minute pulse rate. If irregular, calculate count the QRS complexes in a 6 second interval and multiply by 10
5. is the sequence normal? P QRS T
atrial fibrillation
atrial quiver instead of contracting and relaxing
ventricular fibrillation
ventricles quiver not contracting or relaxing
asystole
patient dead-no evidence of activity
What does blood pressure do?
force blood on the arteriole walls during contraction and relaxation of the heart
diastole
pressure during the relaxation of the heart
Systolic Pressure
is the peak pressure during the contraction of the heart
is recorded as systolic pressure over diastolic pressure
What do they use to take blood pressure with manually?
sphygmomanometer and a stethoscope
inflate the cuff to more than the normal systolic
Systolic number
1st time you hear the heart beat in the patient
diastolic number
2nd time when you stop hearing the heart beat in the patient
Blood pressure is recorded in what?
mm/Hg
Normal Blood pressure in adult
less than 120 for systolic
less than 80 for diastolic
How should a person be seated for a blood pressure check?
should be in a seated position with bp cuff at the same level as the heart
Multiple BP readings
140/90 or more in hypertension
120-139
80-89
prehypertension
140-149
90-99
stage 1 hypertension
160+
100+
stage 2 hypertension
more common in men than women
twice as common in blacks than whites
hypotension
is below the limits
each one of the vital signs has an affect on the other
be aware if something is wrong with the patient know how to take care of them
Normal Saturation (O2)
is 95% to 100%
Hypoxemia
less than 90% of O2 (sat) in the blood
can be characterized by cyanosis
around lips, finger nails, and gums
Hypoxia
insufficient oxygen in the tissue
oxygen is considered to be a drug and have to have a doctor's order to be on it
don't administrated oxygen just because someone is having a difficult time breathing
when oxygen is ordered it is ordered in L/min
the most common device to deliver oxygen
nasal cannula
nasal cannula
normal rate is usually one to four L/min
Don't go beyond 4 L/min but never go beyond 6 L/min because it will dry out the patient's nasal
Simple O2 mask
used to cover nose and mouth not used very much and it is hooked up to the oxygen
Nonrebreathing mask
provide high concentration of oxygen and they prevent exhale oxygen from being rebreathe back into the patient's body
aerosol mask
used to prevent drying out of the nasal passage
air entertainment mask
helps keep oxygen
patient breathes in oxygen from the mas, an from outside the mask as well
when a patient is on oxygen we do not remove the oxygen for the sake of an xray
if it's green then its related to oxygen
babies can be placed in oxygen tents
ventillator
is used for a pt that cannot breathe on their own
endotracheal tube (ET)
placed into the trachea for purpose of respiration
intubation
process of placing an ET tube
tip of ET tube should be placed 1-2 inches superior to the burifaction of the trachea
urinals
used for males