Module AA Measurement - Key Terms

Page 2: Definition List (Key Terms)

  • Afebrile – without a fever.

  • Analog Watch – a watch that has moving hands and is typically marked from numbers 1 through 12.

  • Aneroid Manometer – that part of the sphygmomanometer (BP cuff) that includes the dial that indicates the systolic and diastolic pressures during blood pressure checks.

  • Apical Pulse – a pulse point located over the heart.

  • Arteries – blood vessels that carry blood with oxygen and nutrients away from the heart and to the cells.

  • Blood pressure – the amount of force exerted by the blood against the walls of the artery.

  • Body temperature – how much heat is in the body and balances the heat created by the body and heat lost to the environment.

  • Brachial Pulse – pulse points located in the crooks of the elbows typically used during blood pressure checks.

  • Carotid Pulse – pulse points located on both sides of the neck.

  • Catheter Bag – collection device for urine that is connected to an indwelling (Foley) catheter which drains the bladder.

  • Centigrade – metric scale used to measure temperature, expressed in degrees.

  • Commode Hat (or specimen pan) – a plastic collection container placed under a commode lid, used when resident has bathroom privileges and is on output and/or has a urine or stool specimen ordered.

  • Cubic Centimeter (or cc) – a unit of measure in the metric system used to count the volume of anything (including fluids); is equal to 1 milliliter.

  • Diaphragm –the part of the stethoscope located on the chest-piece used to listen to the presence or absence of brachial artery blood flow during blood pressure check.

  • Diarrhea – frequent passage of loose, watery stools (bowel movements).

  • Diastole – the resting phase of the heart when the heart fills with blood; the bottom number of a blood pressure reading (diastolic).

Page 3: Definition List (continued)

  • Emesis Basin – a plastic, shallow basin shaped like a kidney that fits against the resident’s neck and collects body fluids when a resident is nauseated and during mouthcare.

  • Eupnea – normal breathing.

  • Exhale – when carbon dioxide is expelled out of the nose and the mouth from the lungs.

  • Expiration – also called exhalation and involves the breathing out of carbon dioxide through the nose and mouth, the chest falls.

  • Fahrenheit – scale used to measure temperature, expressed in degrees.

  • Febrile – with a fever.

  • Fever – an elevated temperature.

  • Fluid Balance – fluid intake roughly equals fluid output.

  • Food Intake – comparison of the amount of food eaten by a resident at mealtimes with the amount of food provided.

  • Gastric Suction Material – stomach contents that are suctioned out using a nasogastric tube.

  • Graduated Specimen Container – an accurate measuring device for fluids used in a health care setting.

  • Heart – the pump of the cardiovascular (circulatory) system consisting of four chambers.

  • Height Rod – the device used on a standing scale that measures a resident’s height (or tallness).

  • Inhale – when air (or oxygen) is pulled in through the nose and down into the lungs.

  • Intake (input) – the amount of fluid taken in by the body.

  • Intake and Output (I&O) – used to evaluate fluid balance whereby intake and output are measured and documented.

  • Inspiration – also called inhalation and involves the breathing in of oxygen through the nose; chest rises.

  • Kilogram – a unit of measure in the metric system used to determine weight.

Page 4: Definition List (continued)

  • Lungs – elastic, spongy, cone-shaped air-filled structures involved and the location where the exchange of oxygen and carbon dioxide occurs.

  • Milliliter (mL) – a unit of measure in the metric system used to count fluids; is equal to 1 cubic centimeter.

  • Millimeters of Mercury – (mm Hg) the unit of measure for blood pressure.

  • Objective – information collected by the nurse aide’s senses.

  • Orthostatic Hypotension – abnormal low blood pressure occurring when the resident suddenly stands up; resident complains of weakness, faintness, dizziness, and seeing spots.

  • Output – the amount of fluid lost from the body.

  • Pain – Pain is whatever the resident says it is and response to pain varies from resident to resident.

  • Pedal Pulse – pulse points located in the top of the feet and used to check circulation of the leg.

  • Pulse – is the beat of the heart felt at an artery, as a wave of blood passes through the artery; is the numbers of heart beats per minute.

  • Pulse Force – the strength of the pulse and should be easy to feel.

  • Pulse Rate – the number of heart beats (or pulses) per minute.

  • Pulse Rhythm – the regularity of the heart beats (pulses) and should be the same interval between beats.

  • Radial Pulse – pulse points located in the wrists, which are used most often, easy to reach, easy to find, and used for routine vital signs.

  • Respiration – the process that supplies oxygen to the cells and removes carbon dioxide from cells.

  • Respiratory rate (or respirations) – the number of inspirations (inhalations) a person takes in a minute.

  • Sphygmomanometer – also known as the BP cuff; is the equipment used to check a person’s blood pressure.

  • Stethoscope – instrument used to listen to heart sounds, lung sounds, and the brachial pulse during blood pressure checks.

  • Subjective – information provided by the resident.

Page 5: Definition List (continued)

  • Systole – the working phase of the heart when the heart is pumping blood to the body; the top number of a blood pressure reading (systolic).

  • Temporal Pulse – a pulse point located in the temples of the head.

  • Temporal Thermometer – a thermometer that measures heat from skin over the forehead, specifically over temporal artery.

  • Thermometer – a device used to check a resident’s temperature.

  • Tympanic Thermometer – a thermometer that uses the ear as the site to check a resident’s temperature.

  • Urinal – a plastic, elongated device used by an individual to urinate into, particularly when confined to bed or on measured output.

  • Vital Signs – (also called TPR & BP) include the measurement of temperature, pulse, respiration, and blood pressure that show how well vital organs are functioning.

  • Vomitus – food and fluids ejected from the stomach via the esophagus and mouth.

Page 6: Vital Signs – Overview (S-1 to S-8)

  • Vital Signs Definition – show how well vital organs are functioning (heart and lungs) and the regulation of temperature; include:

    • Temperature,

    • Pulse,

    • Respiration,

    • Blood pressure.

  • The 5th Vital Sign – Pain

    • Some facilities treat pain as a 5th vital sign because it is as important as the others.

    • Pain is subjective; reported by resident to the health care provider.

    • Pain is whatever the resident says it is; responses vary.

    • Pain will be studied more in Module V.

  • Why Check Vital Signs – Importance

    • Changes may indicate worsening condition.

    • Reflects response to medications/treatments.

    • May influence medications (e.g., dosing decisions).

    • Accuracy is crucial; do not guess – ask for help if unsure.

    • Report abnormal vital signs immediately per facility policy.

  • Equipment Needed for Vital Signs

    • Blood pressure cuff,

    • Stethoscope,

    • Non-mercury glass thermometers (oral and rectal).

    • Physician Beam Scale for height and weight,

    • Digital thermometer,

    • Electronic thermometer,

    • Tympanic thermometer,

    • Notepad, Pen,

    • Analog watch.

Page 7: Analog Watch (S-9 to S-12)

  • Analog Watch – Definition (S-9)

    • A watch with moving hands labeled 1–12; has hour, minute, and second hands.

    • Second hand is used to count pulse and respirations.

  • How to Use an Analog Watch (S-10)

    • Identify the starting number on the second hand, then count until the second hand returns to that same number.

    • Practice to check pulse and respirations.

  • Body Temperature – Definition (S-11)

    • Amount of heat created by the body; balance between heat produced and heat lost.

    • Temperature typically stable; produced by cellular energy; lost via skin, breathing, urine, stool.

    • Helps identify immune issues, brain temperature control issues, and response to treatment.

    • Common terms: fever/febrile vs afebrile.

    • Thermometer is the instrument used to obtain temperature.

    • Measured in degrees Fahrenheit or degrees Centigrade.

  • Factors Affecting Temperature (S-12)

    • Age, illness, stress, environment, exercise, time of day, etc.

Page 8: Temperature Sites and Types (S-13 to S-17)

  • Sites for Checking Temperature (S-13)

    • Mouth (oral), Rectum (rectal) – most accurate; never let go of rectal thermometer, Armpit (axillary) – least accurate, Ear (tympanic), Temporal artery (forehead).

  • Types of Thermometers (S-14)

    • Digital – oral, rectal, axillary;

    • Electronic – oral, rectal, axillary;

    • Tympanic – ear;

    • Temporal – forehead;

    • Non-mercury, liquid-filled glass (oral – green tipped; rectal – red tipped).

  • Temperature Values (S-15 to S-16)

    • Oral: Baseline 98.6^\circ ext{F}, Normal range 97.6^\circ ext{F} ext{ to } 99.6^\circ ext{F}.

    • Rectal: Baseline 99.6^\circ ext{F}, Normal range 98.6^\circ ext{F} ext{ to } 100.6^\circ ext{F}.

    • Axillary: Baseline 97.6^\circ ext{F}, Normal range 96.6^\circ ext{F} ext{ to } 98.6^\circ ext{F}.

    • Tympanic: Baseline 98.6^\circ ext{F}, Normal range 97.6^\circ ext{F} ext{ to } 99.6^\circ ext{F}.

    • Temporal: Baseline 98.6^\circ ext{F}, Normal range 97.6^\circ ext{F} ext{ to } 99.6^\circ ext{F}.

  • Digital Thermometer (S-17)

    • Oral, rectal, or axillary;

    • Displays results digitally; quick (2–60 seconds); battery-operated; may beep; requires disposable sheath.

Page 9: Electronic, Tympanic, Temporal, Non-Mercury (S-18 to S-22)

  • Electronic Thermometer (S-18)

    • Oral, rectal, or axillary; blue oral tip, red rectal tip; probe cover required.

    • Digital results; quick; battery-operated; stored in recharging device.

  • Tympanic Thermometer (S-19)

    • Ear site; registers temperature in seconds; may require extra practice.

  • Temporal Thermometer (S-20)

    • Measures heat from skin over the forehead over temporal artery; noninvasive; rapid (≈3 seconds).

  • Non-Mercury, Liquid-filled Glass Thermometers (S-21)

    • Oral, rectal, or axillary; color-coded (oral green/blue; rectal red).

    • Takes longer to register (3–10 minutes); read at eye level; nurse should read after registering.

  • Using Non-Mercury Thermometers (S-22)

    • Requires: thermometer, sheath, gloves, watch, pen, notepad, alcohol wipe, water-soluble lubricant (rectal only).

Page 10–11: Pulse and Pulse Sites; Measurement & Documentation (S-23 to S-35, S-28 to S-35)

  • Reading Non-Mercury Thermometer to document (S-23 to S-24)

    • For Fahrenheit readings: long line = 1 degree; short line = two tenths of a degree.

    • Example: Oral temp 102.8°F.

  • Notable contraindications for oral temperature (S-25)

    • Unconscious, facial/mouth surgery, mouth injury, sores/pain, confused or agitated, seizures, oxygen use, mouth-breather, feeding tube.

  • Notable contraindications for rectal temperature (S-26)

    • Diarrhea, rectal problems, heart disease, recent rectal surgery, confusion/agitation.

  • Pulse Definitions (S-27)

    • Pulse: beat of heart felt at an artery; Pulse rate = # of heartbeats per minute; Pulse rhythm = regularity; Pulse force = strength.

  • Pulse Sites (S-28)

    • Temporal, Carotid (do not check both carotids at once), Apical (over the heart; with stethoscope), Brachial (often for BP), Radial (most common for vitals), Pedal (feet).

  • Radial Pulse Site (S-29)

    • Located on the thumb side of the wrist; use first 2–3 fingers; never use the thumb.

  • Pulse Values (S-30)

    • Normal adult pulse: Rate 60–100 bpm; Regular and Strong;Abnormalities covered in Module H.

  • Counting Pulse – Equipment (S-31)

    • Watch with second hand; Notepad and pen.

  • Pulse Documentation (S-32 to S-35)

    • Count for 60 seconds; document if pulse is 60–100, regular, strong; notify if abnormal.

    • Example #1: 82 bpm in 60 sec; document 82.

    • Example #2: 109 bpm in 60 sec; notify nurse.

  • Respiration (S-35)

    • Definition: process that supplies oxygen to cells and removes carbon dioxide.

    • Involves Inspiration (inhalation) and Expiration (exhalation).

Page 12: Respirations – Normal Values and Counting (S-36 to S-41)

  • Respiratory Rate (respirations) – number of inspirations/exhalations per minute.

  • Normal (eupnea) Values (S-36)

    • Rate: 12–20 breaths per minute; Regular, quiet, chest rises and falls equally.

  • Checking Respirations – Equipment (S-37)

    • Analog watch with second hand; Notepad/assignment sheet and pen.

  • Respirations – Observation and Documentation (S-38)

    • Count for 60 seconds; 1 respiration = 1 inspiration + 1 expiration; document if within 12–20, regular, quiet, and chest rises/falls equally; notify if abnormal.

  • Stealth Respirations (S-39)

    • Check respirations right after pulse to avoid resident noticing; avoids altered pattern.

  • Respirations – Example #1 (S-40)

    • 16 respirations in 60 seconds.

  • Respirations – Example #2 (S-41)

    • 24 respirations in 60 seconds; nurse should be notified.

Page 13–14: Blood Pressure – Concepts and Values (S-42 to S-53)

  • Blood Pressure Definition (S-42)

    • Amount of force exerted by the blood against artery walls; top = systolic (heart contracts); bottom = diastolic (heart rests and fills).

  • Blood Pressure as an Indicator (S-43)

    • Important health status indicator; can change quickly with activity, lifestyle, stress, injury, medications.

  • Factors Affecting Blood Pressure (S-44 to S-45)

    • Genetics, Age, Gender, Race.

  • BP Site (S-45)

    • Brachial artery in the upper arm is the common site.

  • BP Values (S-46 to S-47)

    • Measured in mmHg; recorded as systolic/diastolic (e.g., 120/80).

    • Normal adult ranges: Systolic 90–119 mmHg; Diastolic 60–79 mmHg.

  • Abnormal BP and documentation (S-48)

    • Above 120/80 should be documented and nurse notified (abnormalities covered in Module H).

  • Sample BP Scenarios (S-49 to S-51)

    • Example #1: 116/72 (64-year-old female) with no risk factors.

    • Example #2: 162/86 (72-year-old male; high risk factors).

    • Example #3: 180/94 (22-year-old male; acute injury).

  • Checking Blood Pressure – Multisensory Approach (S-52)

    • Seeing the needle, hearing through stethoscope, and touching (inflation/deflation) are used together.

  • BP Equipment (S-53)

    • Stethoscope, Sphygmomanometer (BP cuff), Alcohol wipes, Notepad/pen.

Page 15–17: Blood Pressure – Equipment, Cuff, and Diaphragm (S-54 to S-75)

  • Stethoscope (S-54)

    • Listen to heart and lung sounds; for BP checks, listen to sounds in brachial artery; single-head or dual-head.

  • Stethoscope – Parts (S-55)

    • Ear pieces, Binaurals, Tubing, Chest-piece (diaphragm or diaphragm/bell).

  • Stethoscope – Ear Pieces (S-56)

    • Clean before/after with alcohol wipe; ears placed forward toward nose; snug fit.

  • Dual-head Stethoscope – Diaphragm (S-57)

    • Activate diaphragm; determine active side.

  • Active Diaphragm (S-58)

    • Test by tapping diaphragm or rotating chest-piece to find active diaphragm.

  • Diaphragm Concepts (S-59)

    • Clean before use; warm diaphragm with hand; press to seal against brachial artery; indicator dot opened/closed indicates active side (dual-head).

  • BP Cuff Types (S-60)

    • Electronic (digital) and Manual (aneroid).

  • Electronic BP Cuff (S-61)

    • No stethoscope; cuff inflates/deflates automatically; BP reading displayed.

  • Aneroid BP Cuff – Parts (S-62)

    • Manometer, Cuff with bladder, Inflation bulb with air-release valve, Tubes connecting cuff to manometer and to inflation bulb.

  • Manometer Details (S-63 to S-66)

    • Long lines mark 10 mmHg; short lines mark 2 mmHg.

    • When the systolic sound is heard or diastolic sound ends, round to next 2 mmHg; odd numbers are not recorded with manual cuffs.

    • Reading is backwards as cuff deflates.

  • BP Reading Example (S-66)

    • Example: Systolic 150 mmHg, Diastolic 88 mmHg; BP written as 150/88.

  • Cuff Placement (S-67 to S-69)

    • Wrap cuff around bare upper arm; cuff inflated to press on brachial artery; deflate to determine BP.

    • Cuff sizes: child, small (7–9 inch), regular (9–13 inch), extra-large (13–17 inch).

    • Place cuff 1 inch above elbow; avoid placing over clothing.

  • BP Cuff Tubing (S-70)

    • Two tubes: cuff to manometer; cuff to handheld inflation bulb.

  • Inflation Bulb with Air-Release Valve (S-71 to S-75)

    • Inflate by squeezing bulb; valve closes when turned clockwise (thumb up).

    • Deflate slowly by turning counterclockwise (thumb down); observe needle.

    • Inflate cuff to 160–180 mmHg; if beat heard immediately, deflate and wait 30–60 seconds; re-inflate no higher than 200 mmHg.

    • Tip: practice inflating/deflating slowly; cuff on a foam “swim noodle” for practice.

  • BP-Timing and Technique Tips (S-75)

    • Do not take BP on an arm with IV, dialysis shunt, or device; avoid arms with injury, burns, casts, or mastectomy; don’t place cuff over clothing (increases 10–40 mmHg); ensure empty bladder (+10 to +15 mmHg increase); limit conversation (+10 to +15 mmHg); keep arm at heart level (+10 mmHg); proper chair/bed position; avoid leg crossing (+2–8 mmHg).

Page 18: Orthostatic Hypotension and Height/Weight (S-76 to S-79)

  • Orthostatic Hypotension (S-76)

    • Defined as abnormal low BP upon standing; may cause dizziness, faintness, weakness, spots.

    • Often related to bed rest.

    • Nurse aide may be asked to perform orthostatic BP measurement:

    • BP lying down; record.

    • Sit up after 2 minutes; record.

    • Stand up after 2 minutes; record.

    • Report findings and monitor for symptoms during process.

  • Height and Weight – Overview (S-77)

    • Measured on admission; height units: feet/inches or inches (policy may differ); weight units: pounds or kilograms (policy).

    • Post-admission: height not usually re-measured; weight measured per policy or doctor’s orders (daily/weekly/monthly).

  • Physician Mechanical Beam Scale (S-78 to S-79)

    • Used for height and weight; for non-ambulatory residents, height can be measured in bed and weight with chair/bed mechanical lift as directed.

    • Components include balance beam, height rod, head piece, scale platform, etc.

Page 19: Height Components and Measuring (S-80 to S-86)

  • Height Component – Head Piece (S-80)

    • Active when extended; placed on head to measure height; lowers to rest when flat.

  • Height Component – Rod (S-81 to S-82)

    • Dual units: Inches and Centimeters; two sections: movable upper, non-movable lower.

  • Measuring Height (S-83 to S-85)

    • When using feet and inches, long lines = inches; shorter lines = ¼ inch; read to nearest ¼ inch.

    • Example: Height 68 inches equals 5 feet 8 inches: 68/12 = 5 feet, remainder 8 inches.

  • Converting Inches to Feet/Inches (S-85 to S-87)

    • 1 foot = 12 inches.

    • For 68 inches: 68 ÷ 12 = 5 with remainder 8; so 5 feet 8 inches.

  • Weights and Trends in Long-Term Care (S-87 to S-97)

    • Baselines on admission; weekly for first 4 weeks; then monthly per policy.

    • Scales should be calibrated; consistent weighing process.

    • Weight reflects nutritional status; rapid changes may indicate fluid/electrolyte imbalance or malnutrition; review if significant weight loss.

    • Weight components: Balance beam with upper/lower bars; weight indicators; can be pounds and kilograms; read weight by adding lower bar value to upper bar value.

  • Height/Weight Documentation (S-95 to S-97)

    • Keep consistent posture and technique; ensure proper alignment and zeroing the scale.

Page 20–21: Intake and Output (I&O), Milliliters, and Fluids (S-96 to S-101)

  • Intake and Output (I&O) Overview (S-96)

    • Intake (input): amount of fluid taken in; Output: amount of fluid lost.

    • I&O commonly abbreviated; for fluid balance roughly equal intake and output.

  • I&O Documentation (S-97)

    • Ordered by doctor, included in care plan/directive; typically calculated at end of each shift and totaled every 24 hours; documented on facility form; measurements in mL.

  • Milliliter (mL) (S-98)

    • Unit for fluids; 1 mL = 1 cc.

    • 1 oz = 30 mL (conversion).

    • Teaspoon ≈ 5 mL.

  • Graded Measuring Devices (S-99)

    • Graduated specimen container for accurate I&O; fluids measured in mL; measure at eye level on flat surface; if both intake and output, use two separate containers labeled accordingly.

  • Units on Graduated Container (S-100)

    • 1 cc = 1 mL; shortest lines represent 25 mL (cc) or 75 mL; longest lines represent multiples of 50 mL.

  • Fluids Considered as Intake (S-101)

    • Liquids resident drinks; semi-liquid foods; IV fluids and tube feeds maintained/measured by nurse.

Page 21–23: Fluids Types and Measuring Intake (S-102 to S-115)

  • Fluids – Types (S-102 to S-104)

    • Fluids: Water, Milk, Coffee, Tea, Juices, Soups, Soft drinks.

    • Semi-liquid foods: Milkshakes, Ice cream, Sherbet, Custard, Pudding, Gelatin, Popsicles.

  • Determining Oral Fluids as Intake (S-104)

    • Know serving sizes per facility; typical containers listed on I&O sheet; serving sizes are learned over time.

  • Typical Serving Sizes of Liquids (S-105)

    • Water glass = 240 mL, Tea glass = 180 mL, Juice glass = 120 mL, Milk carton = 240 mL, Coffee cup = 240 mL, Soft drink can = 360 mL, Gelatin = 120 mL, Soup bowl = 180 mL.

    • Ice chips = 1/2 the amount of mL in container.

  • Determining Intake – Fractions (S-107 to S-113)

    • Two methods: using graduated container (subtract remaining from total) or using fractions of the whole container.

    • Fractions: whole = 1; parts correspond to portions eaten/drunk (e.g., 2/3 of 240 mL coffee = 2/3 × 240 = 160 mL).

    • Example: 2/3 of 240 mL coffee = 160 mL.

    • Example: 1/2 of 240 mL coffee = 120 mL.

    • Quick method: divide total by denominator to get value per part, multiply by numerator.

  • Milliliters and Ounces (S-113)

    • 1 oz = 30 mL; to convert oz to mL multiply by 30.

  • cc and mL Equivalence (S-114)

    • 1 cc = 1 mL; convert cc to mL identically.

  • Grape and Apple Juice Conversions (S-116 to S-117)

    • Example: 120 cc = 120 mL; 120 mL equals 4 oz approximately.

  • Fluids Considered as Output (S-117)

    • Urine, Vomit, Diarrhea, Wound drainage, Gastric suction material.

  • Output Collection Devices (S-118)

    • Graduated specimen container, Catheter bag, Urinal, Commode hat, Emesis basin.

  • Foley Catheter Bag (S-119)

    • Connected to Foley catheter; emptied into measuring device; measurement more accurate in graduated container than bag.

  • Urinal (S-120)

    • Plastic device used for urine; marked in oz and cc/mL; 100 mL increments with 50 mL minor marks.

  • Commode Hat / Specimen Pan (S-121)

    • Used when resident is on output or needs specimens; marked in oz/cc; edge grooves for easy pouring; avoid placing toilet paper in hat.

Page 22–23: More on I&O and Intakes (S-122 to S-129)

  • Emesis Basin (S-122)

    • Kidney-shaped plastic basin used during mouthcare or nausea; marked in oz and cc; used for measurement.

  • Measuring Urine – Examples (S-123 to S-125)

    • Example 1: Long line = 200 mL; Short line = 25 mL; Amount = 225 mL.

    • Example 2: Long line = 500 mL; Amount = 500 mL.

    • Example 3: Long line = 300 mL; Short line = 25 mL; Amount = 325 mL.

  • Importance of Identifying Meal Intake (S-126)

    • Accurate meal intake helps identify risk of impaired nutrition; poor intake may indicate illness; meals contribute to daily fluid intake.

  • Food Intake and Percentages (S-127 to S-129)

    • Compare amount eaten to amount served; use exact items or percentages (0%, 25%, 50%, 75%, 100%); sample meal descriptions given.

Page 28: Handout AA9 – Analog Watch (Practical Tips)

  • Handout AA9 details:

    • Reproduces instructions for using an analog watch to count pulse and respirations.

    • Start and stop counting on the same number; do not wait for the hand to reach 12.

    • Reminder of how to align the counting with the second hand (the chart shows the numbers to start/stop).

Page 29–31: Handouts and Practice Scenarios (AA24, AA28, AA49, AA62AA, AA66, AA95)

  • Handout AA24 – Fahrenheit Temperature (Oral/Rectal) Practice

    • Includes sample OCR-like prompts to determine if resident is afebrile or febrile; actions: notify supervisor or document the temperature.

  • Handout AA28 – Pulse Sites

    • Identify and label temporal, carotid, apical, brachial, radial, and pedal pulses.

  • Handout AA49 – Blood Pressure and Factors of Select Examples

    • For numbers 1–4, fill in specific information; numbers 5–14 involve checking factors such as lying down, exercising, smoking, alcohol, overweight, high salt diet, stress, anxiety, injuries, pain.

  • Handout AA62AA – Aneroid Blood Pressure Manometer

    • Describes: long lines = 10 mmHg, short lines = 2 mmHg; rounding rules; written as 120 over 80; practice with various readings.

  • Handout AA66 – Aneroid Blood Pressure #1 to #4 (and #5–#10)

    • Series of BP reading practice: determine normal vs abnormal and whether to notify the supervisor or document.

  • Handout AA95 – Weight and Height #1 to #4

    • Practice calculating weight in pounds and height in inches/feet+inches; show calculations.

Page 32–33: Additional Handouts and BP Practice (AA114, AA62AA continuation)

  • Handout AA62AA (continued) – Aneroid BP nuances

    • Includes instructions for reading BP values, determining normal ranges, and whether to notify.

  • Handout AA66 – BP Drawings

    • Visuals for various BP values to draw and label S (systolic) and D (diastolic).

Page 34–35: More BP Practice, Weight/Height Calculations (AA66 continuation, AA95 continuations)

  • BP value drawing tasks (S-6 style tasks)

    • Draw several BP values, label S and D for each.

  • Weight calculations (AA95 #1–#4)

    • Instructions to write resident’s weight in pounds and show calculation.

Page 36–38: Height Calculations and Practice (AA95 #1–#4; #1–#4 continued)

  • Height calculations (AA95 #1–#4)

    • Write height in inches; convert to feet and inches; show calculations.

Page 39–41: Intake Calculations – AA114-1 and AA114-2 (Intake Practice)

  • Intake Calculations – AA114-1 (Serving Sizes)

    • Use serving sizes to determine intake for listed fluids using fractions. Serving sizes include: 240 mL (water), 180 mL (tea), 120 mL (juice), 240 mL (milk), 240 mL (coffee), 360 mL (soft drink), 120 mL (gelatin), 180 mL (soup).

  • Example problems – AA114-1 (Show Fractions)

    • Example prompts: 1/2 of orange juice; 1/3 of tomato soup; 2/3 of coffee; 3/4 of gelatin; 1/4 of tea.

  • Intake Calculations – AA114-2 (Show Subtraction)

    • Partially consumed drinks measured with graduated container; subtraction to find intake. Examples include 45 mL left in container (so drank total − 45 mL), etc.

  • Chart Practice – Activity AA114-2 (Let’s Make a Chart)

    • A Fractions-to-mL chart exercise; first example given: 1/4 of 120 mL = 30 mL; chart with container sizes; students fill remaining entries.

  • Urine Output Practice – AA125 (Activity)

    • Simple data entry for urine output amounts (example table with three/or four entries).

Summary of Practical Concepts and Formulas (selected highlights)

  • Vital signs comprise Temperature, Pulse, Respiration, and Blood Pressure (BP).

  • Normal ranges to memorize (typical adult values):

    • Temperature oral: ext{Normal range} = 97.6^
      deg ext{F} ext{ to } 99.6^
      deg ext{F}, Baseline 98.6^
      deg ext{F}, in Celsius roughly { ext{(use organization-specific conversions)}}.

    • Pulse: 60–100 bpm, regular, strong.

    • Respirations: 12–20 breaths per minute, regular and quiet.

    • BP: Normal systolic 90 ext{ to } 119 ext{ mmHg}; diastolic 60 ext{ to } 79 ext{ mmHg}.

  • BP measurement notes:

    • Use brachial artery in upper arm; cuff width and arm size matter for accuracy.

    • BP reading is written as systolic/diastolic; example: 150/88.

    • Key artifacts that increase readings: full bladder, talking during measurement, limb with casts or edema, etc.

  • Equipment and procedures:

    • Analog watch helps count pulse/respirations; the second hand is used for timing.

    • Stethoscope, sphygmomanometer (manual or electronic), and thermometers (digital/electronic/tympanic/temporal/non-mercury glass).

    • For non-mercury glass thermometers, read at eye level; dispose after use; use protective sheath.

  • Temperature measurement sites and accuracy: rectal is most accurate; oral/temporal/tympanic/axillary have varying accuracy and patient considerations.

  • I&O fundamentals: measurement units in mL; 1 mL = 1 cc; 1 oz ≈ 30 mL; common containers in mL: 240 mL (water/milk), 180 mL (tea/soup), 120 mL (juice/gelatin).

  • Fractions in intake calculations: understand denominators/numerators to compute portions consumed; example: 2/3 of 240 mL coffee → 160 mL.

  • Measuring multiple outputs: urine, vomit, diarrhea, wound drainage, gastric suction material; use appropriate containers for accuracy.

  • Special cases: orthostatic BP measurements; avoid BP in arms with IVs or injuries; ensure patient comfort and safety throughout measurement.

If you would like, I can reorganize these notes into a shorter study guide or expand any section with more examples, step-by-step procedures, or practice questions (e.g., convert 8 oz to mL, read a sample BP value, or calculate intake from a given scenario).