Chapter 7 Basic Nursing Skills
Vital signs- measurements including temperature, pulse, respirations, and BP.
Temperature sites: | Fahrenheit: | Celsius: |
| 97.6-99.6 | 36.5-37.5 |
| 98.6-100.6 | 37-38.1 |
| 96.6-100.6 | 35.9-37 |
| 96.6-99.7 | 35.9-37.6 |
| 97.2-100.1 | 36.2-37.8 |
Types of thermometers:
Digital- used for oral, rectal, and axillary.
Temporal artery- measure heat with a gentle stroke across the forehead.
Rectal- MOST accurate
Axillary- LEAST accurate
Mercury free thermometers are color-coded:
green/blue= oral
red= rectal
Blood Pressure:
Normal | Systolic Diastolic | 90-119 60-79 |
Low (hypertensive) | Systolic Diastolic | >90 >60 |
Elevated | Systolic Diastolic | 120-139 >80 |
Stage 1 Hypertension | Systolic Diastolic | 130-139 80-89 |
Stage 2 hypertension | Systolic Diastolic | =/<140 =/<90 |
Hypertension crisis | Systolic Diastolic | <180 <120 |
Systolic- first measurement of blood pressure, phase when the heart is active, contracting and pushing blood out the left ventricle. (top number, normal range is below 120 mm Hg)
Diastolic- second measurement of blood pressure, phase when the heart is resting. (bottom number, normal range is below 80 mm Hg)
Radial pulse- pulse located inside the wrist.
Brachial pulse- pulse located inside the elbow.
Respiration:
Adults- 12 to 20 breaths per minute
Infants- 30 to 40 breaths per minute
Pulse:
Adults- 60 to 100 BPM
Children- 100-120 BPM
Infants- 120 to 140 BPM
Systolic- first measurement of blood pressure, when the heart is at work, contracting and pushing blood out the left ventricle. (top number, normal range is below 120 mm Hg)
Diastolic- second measurement of blood pressure, phase when the heart is relaxing. (bottom number normal range is below 80 mm Hg)
Pulse oximetry is used to measure pulse rate and blood oxygen level.
One lbs= 16 ounces
One kg= 1000 g
One kg= 2.2 lbs
Intake (input)- the fluid a person consumes.
Output- the fluid that is eliminated from the body. Urine, feces, vomit, sweat, and wound drainage.
Fluid balance- taking in and eliminating the same amount of fluid.
Conversions:
1 oz = | 30 mL = | 30 cubic centimeters (cc) |
2 oz = | 60 mL = | 60 cc |
3 oz = | 90 mL = | 90 cc |
4 oz = | 120 mL = | 120 cc |
5 oz = | 150 mL = | 150 cc |
6 oz = | 180 mL = | 180 cc |
7 oz = | 210 mL = | 210 cc |
8 oz = | 240 mL = | 240 cc |
¼ cup = | 2 oz = | 60 mL |
½ cup = | 4 oz = | 120 mL |
1 cup = | 8 oz = | 240 mL |
Specimen- a sample that is used for analysis in order to try and make a diagnosis.
Routine urine specimen- a urine specimen that can be collected anytime a person urinates/ voides.
Hat- in health-care, a collection container that can be inserted into a toilet bowl to collect and measure urine and stool.
Clean-catch specimen (mid-stream specimen)- a urine specimen that does not include the first and last urine voided.
Straight catheter- urinary catheter removed after urine is collected or voided.
Indwelling catheter (foley catheter)- urinary catheter that remains in the bladder for a period of time.
Condom catheter- urinary catheter that has an attachment on the end that fits over the penis.
Closed bed- a bed completely made with bedspread and blanket in place
Open bed- a bed made with linens folded down to the foot of the bed.