Lecture 2: General Survey VS Pain

Which pulse is commonly used to measure the heart rate?

radial pulse

What fingers do you use to measure the heart rate?

the pads of the index and middle finger

How do you calculate heart rate?

number of beats in 30 seconds multiplied by 2

What is a normal heart rate?

60-100 bpm

What is the heart rate for Bradycardia?

HR < 60

What is the heart rate for tachycardia?

HR < 60

When it comes to the assessment of pulse, what does amplitude or character mean?

refers to how strong, forceful, or full the pulse is

A weak, thready, or feeble pulse may be a sign of ...

emergent low blood pressure

Why can't you use your own thumb to find the heart rate of a patient?

because you may mistake their pulse for yours

What is contour of pulse?

measured by waveform of brachial artery while using cuff

What is the pulse grading scale?

3+ --> bounding

2+ --> brisk, expected

1+ --> diminished, weaker than expected

0 --> absent, unable to palpate

What is a normal pulse grade?

2+

What is a normal respiration rate?

<20 breaths per minute (12-20 Bpm)

What is a normal temperature?

oral --> 98.6 F or 37 C

What is the proper width and length off a blood pressure cuff?

Width: the bladder should be 40% off arm circumference

Length: the bladder should be 80% of upper arm circumference

What is blood pressure? (definition)

measure of the force used by heart to pump blood around the body

What is systolic blood pressure?

pressure when the heart beats while heart muscle is contracting/squeezing

What is diastolic blood pressure?

pressure when heart muscle relaxes; always lower than systolic

What is an auscultatory gap?

silent interval which may be present between systolic and diastolic pressures

Which condition could you find a auscultatory gap?

coronary artery disease (CAD)

What is normal blood pressure?

less than 120/80 mmHg

What is orthostatic hypotension?

A drop in systolic BP or diastolic BP, or experiencing lightheadedness or dizziness is considered abnormal. This occurs when standing up after sitting or lying down

How can you check if a patient has orthostatic hypotension?

1. Have the patient lie down for 3-10 minutes

2. Measure blood pressure. One side is sufficient

3. Have the patient stand

4. Repeat blood pressure measurements after standing 1 and 3 minutes

In which group of people is orthostatic hypotension common in?

1. Senior citizens

2. patients with blood loss

3. use of certain medications (blood pressure meds, diuretics, pain meds, etc)

4. Patients who are dehydrated or on prolonged bed rest

What are the different types of pain?

nociceptive, neuropathic, central sensitization, and pyschogenic and idiopathic

What is nociceptive (somatic) pain?

pain due to tissue damage of skin, muscle, or viscera (dull, pressing, pulling, throbbing, spasmotic)

What is neuropathic pain?

direct consequence of lesion or disease affecting the somatosensory system (electric shocks, stabbing, burning, pins, and needles)

What is central sensitization pain?

chronic pain

What is psychogenic and idiopathic pain?

psychological/unknown etiology (cause)