Week 2 Chairside 1- Vital signs

Review/Update medical history

At least 3 most asked question:

1.Any change in medical conditions

2.Any changes in medication

3. Any changes in allergies

Include data + obtain necessary signatures

Patients positioning

While taking vital signs, patient should be seated:

Nearly upright, comfortably

Temperature

During sickness a person body temp will become elevated

When to take? → when infection or fever is suspected, or patient feels ill

Average body temp in adult is 98.6F

Average range of oral temp of resting person is 97.6F - 99F

Body temp is higher in infant + younger children than adults

Factors that effect body temp

Increase - Exercise, infection, hot drink, time of day

Decrease - Starvation, hemorrhage, time of day

Types of thermometers

Digital - uses heat sensor to determine body temp

Tympanic- Ear canal, infrared signal bounce off the eardrum

Temporal scanner- Infrared sensor to measure temp of temporal artery on forehead

Pulse

Pulse represent the beating of the heart

Various site:

Radial artery: inner surface of wrist ( two bone in arm, radius and ulna) (most common in dent)

Brachial artery- inner fold of upper arm

Carotid artery- alongside the larynx

Pulse characteristic

Rate- # of beats

Rhythms: patterns of beats

Volume: force of beats

Factor that effect pulse rate

Increase: exercise, eating, strong emotion, stimulants

Decrease: sleep, depressant, fasting, low vitality, quieting emotions

Taking pulse reading

When to take: routine procedures at each visit or emergencies

Make sure patient is position w/ arm at same level or lower than the heart ( arm supported + extended straight out)

Normal Pulse: Resting adult- 60 -100 bpm

Child 1-3 → 80-130 bpm

child 3-5 → 80-120 bpm

Child 5-15 → 70-100 bpm

Respiration

Average reading

Adult (19+): 12-20 per min

Adolescent (12-18): 12 -16

Children (6-12): 18 -30 ( smaller lungs ig)

When to measure?

• during emergencies or routine procedures

Factors that effect respiration rate

Increase: pain, strong emotions, hemorrhage, exercise

decrease: Sleep, certain drugs, pulmonary insufficiency

How to assess respiration

Respiration characteristic includes:

Rate- number of breath per min

rhythm: Breathing pattern

Depth: amount of air inhaled or exhaled

Blood pressure

Reflects amount of work heart has to pump through body

2 Type of pressure

Systolic: reflects amount of pressure takes for L ventricle of heart to compress or push oxygenated blood out of vessels (s → statistic → reflect pressure that’s needed to push)

Diastolic: heart muscle at rest when its allowing heart to take in blood to be oxygenated before next contraction ( dia→ digest → process before going again)

Measured in mm of mercury, systolic/diastolic

norm range of adult is less than 120/80

Blood pressure equipment

sphygmomanometer - blood pressure cuff and meter

Stethoscope - used to amplify Korotkoff sound

Cuff size

If cuff to narrow: Blood pressure reading will be too high

If to wide: reading will be low ( w w/ w)

If too loose: reading will be too high

Placement of equipment

Lower border of cuff places 1’ above antecubital fossa

End-piece of stethoscope placed over brachial artery

Measuring blood pressure

1. equipment placement

2. position stethoscope and inflate cuff

3. Deflate cuff at rate of approx 2 mm Hg per second

factors that effect blood pressure

Increase- exercise, eating, stimulants, oral contraceptive, men have higher blood pressure than women until menopause, Bp will increase w/ age

Decrease: rest, fasting, depressant, fainting, blood loss, quiet emotions

Stages of hyerptensions

elevated Bp: 120-129/<80 mmHg

Hypertensive Bp:

Stage 1: 130-139/ 80/89 mmHg

Stage 2: >140/>90 mmHg

Hypertension crisis: higher than 180/120