PTA 250 - Test 2 (Chapters 3 & 5)

4 Primary Vital Signs

• Blood Pressure(mm/Hg)

• Heart rate (beats/minute)

• Respiration rate (respirations/minute)

• Body Temperature (°F)

Normal Body Temperature Range

96.8°F to 99.3°F

Average Body Temperature

98.6°F

Trachycardia

a rapid heart rate; more than 100 bpm

Bradycardia

a slow heart rate; less than 60 bpm

Normal Blood Oxygen Saturation

95-100%

Systolic Pressure

BP at the time of contraction of the left ventricle (top number)

Diastolic Pressure

BP at the time of the rest period of the heart (bottom number)

Factors Affecting Body Temperature

- Time of day

- Age

- Environmental Temperature

- Infection

- Physical activity

- Emotional Status

- Site of Measurement

- Menstrual Cycle

- Oral Cavity Temperature

Factors Affecting Pulse

Age

Gender

Environmental Temperature

Infection

Physical Activity

Emotional Status

Medication

Cardiopulmonary Disease

Physical Conditioning

Pulse Measurement Sites

temporal

carotid

brachial

radial

femoral

popliteal

dorsal pedal

posterior tibial

Normal Resting HR - Infants (3-6 Months)

90-120 beats/min

Normal Resting HR - Children (1-10 Years)

70-130 beats/min

Normal Resting HR - Children over 10 years and adults

60-100 beats/min

Normal Resting HR - Well-Conditioned Athletes

40-60 beats/min

Korotkoff sounds

1 - first faint, clear tapping sounds are detected

5 - Sounds essentially disappear totally

Hypertension Ranges (Systolic)

Prehypertension - 120-139 mm Hg

Stage 1 - 140-159 mm Hg

Stage 2 - 160-179 mm Hg

Hypertension Ranges (Diastolic)

Prehypertension - 80-89 mm Hg

Stage 1 - 90-99 mm Hg

Stage 2 - 100-109 mm Hg

Factors Affecting Blood Pressure

- age

- physical activity

- emotional status

- medications

- size and condition of arteries

- arm position

- muscle contraction

- blood volume

- dehydration

- cardiac output

- site of measurement

Factors Affecting Respiration

age

physical activity

emotional status

air quality

altitude

disease

Normal Respiration Rate for an Adult

12-18 respirations per min

Normal Respiration Rate for an Infant

30-50 respirations per min

Normal Blood Pressure for an Adult

120/80 mm Hg

Assessment of Pain

- Pain Onset

- Pattern/Duration of Pain

- Exact Location of Pain

- Results/Affects of Pain

- Description of Pain

- What activity(or sleep) is Affected by Pain

- Rate of Pain

Sphygomomanometer

instrument used to measure blood pressure

Preventative Positioning Guidelines/Recommendations - Hemiplegia

- Use sling to support extremity

- Extremities should be exercised several times per day and should not remain in a single position for a prolonged period

- Maintain normal alignment of patient's head & trunk

- Frequent adjustments are recommended

- When the patient's upper extremity is involved, avoid: prolonged shoulder adduction/internal rotation, elbow flexion, forearm supination/pronation, wrist/finer/thumb flexion, & finger/thumb adduction

- When the patient's lower extremity is involved, avoid: prolonged hip/knee flexion, hip external rotation, and ankle plantar flexion/inversion

Preventative Positioning Guidelines/Recommendations - Transfemoral Amputation

- Avoid Prolonged Hip Flexion

- Avoid Hip Abduction of the residual limb

- Avoid sitting for more than 40 minutes

- Lying in prone or sidelying is recommended

- Maintaining the pelvis in a level position and trunk in proper alignment is should be encouraged

Preventative Positioning Guidelines/Recommendations - Transtibial Amputation

- Avoid prolonged hip and knee flexion

- If the residual limb is elevated, the knee should remain extended

- Avoid sitting for more than 40 minutes

- When the patient sits, stands, or is recumbent, the hip and knee should maintain extension

- Lying in prone is recommended

Preventative Positioning Guidelines/Recommendations - Burn Patient

- Passive Exercise

- Avoid prolonged flexion or adduction

Bony Areas Susceptible to Pressure in Supine Position

Occipital Tuberosity

Spine of Scapula

Inferior Angle of Scapula

Vertebral Spinous Process

Sacrum

Medial Epicondyle of Humerus

Olecranon Process

Posterior Calcaneus

Greater Trochanter

Head of Fibula

Lateral Malleolus with Excessive External Rotation of Hip

Bony Areas Susceptible to Pressure in Sidelying Position

Lateral ear, ribs, & acromion process

Lateral head of humerus

Medical/Lateral Epicondyle of humerus

Greater trochanter of femur

Medical/Lateral condyles of femur

Malleolus of fibular/tibia

Fifth metatarsal

Bony Areas Susceptible to Pressure in Prone Position

Forehead

Lateral Ear

Tip of acromion process

Sternum

Anterior superior iliac spine

Anterior head of humerus

Clavicle

Patella

Ridge of tibia

Dorsum of foot

Bony Areas Susceptible to Pressure in Sitting Position

Ischial Tuberosities

Scapular and Vertebral Spinous Processes

Medial Epicondyle of humerus

Olecranon Process

Greater Trochanter

Popliteal fossa

Posterior calcaneus