patient vital signs draft rad tech a – week 13. patient assessment &vital signs patient...

Patient Vital SignsDRAFT

Rad Tech A – Week 13

Patient Assessment &Vital Signs

• Patient Interview

• Role of Radiologic Technologist

• Elements of the Clinical History

• Vital Signs

• Oxygen Therapy

• Oxygen Devices

• Chest Tubes and Lines

Vital Signs• Body Temperature

• Respiratory Rate

• Pulse / Heart Rate

• Blood Pressure

Vital Signs• Indication of

Homeostasis

• Primary Mechanisms– Heart beat– Blood pressure– Body temperature– Respiratory rate– Electrolyte

balance

• Physical assessment include measurement of vital signs

Body Temperature

Pulse

Respiration

Blood Pressure

Mental Status

Homeostasis

• Our bodies are always trying to maintain HOMEOSTASIS – a constancy in the internal environment of the body, naturally maintained by adaptive responses that promote healthy survival.

• Ex: sweating to cool body temperature

Body Temperature

• The human body has an ideal temperature, and it works to maintain it, this is called:

THERMOREGULATION

• Ideal temperature: 98.6 degrees F (oral)

• Acceptable range: 97.7 to 99.5 degrees F

• Measurement: oral, axillary, tympanic, rectal

Body Temperature

• Normal average body temperature: 98.6 F

Humans can survive between 106 F and 93.2 F.

–Hyperthermia Fever, febrile

–Hypothermia below normal range

Measuring Body Temperature

– Oral

– Rectal

– Axillary

– Tympanic

Pulse

• Pulse rate: Adult = 60 to 100 beats per minute

• Children under 10 = 70 to 120 beats per minute

• Tachycardia• Bradycardia

Blood PressureBlood Pressure Measure of the force exerted by blood on the

arterial walls during contraction & relaxation.

Measured pressure when the heart is relaxed: Diastolic

Measured pressure when the heart is contracted: Systolic

Measured with a Sphygmomanometer

Blood PressureBlood Pressure

Systolic pressure = 95-140 mmHg

Diastolic pressure = 60-90 mmHg

120/ 80 Normal

Blood Pressure cont’dBlood Pressure cont’d

Recorded in millimeters of mercury

(mm Hg) with systolic over diastolic

Normal adult systolic: 95-140 mm Hg Normal adult diastolic: 60-90 mm Hg

Persistent elevation of BP: HypertensionPersistent low BP: Hypotension

Respiratory RateRespiratory Rate

Respiratory System delivers oxygen to the body’s tissues & eliminates carbon dioxide.

Major muscle of ventilation: diaphragm Measured in “breaths per minute”

Adults: 12 – 20 bpmChildren: 20 – 30 bpmNewborns: 30 – 60 bpm

Respiratory Rate

• Breaths per minute: Adult = 12 to 20

• Children under 10 = 20 to 30 per min

• Dyspnea- difficulty breathing

• Apnea- no breathing

• Bradypnea – decrease is breathing

Pulse Oximeter

• Normal Pulse Oximeter = 95% to 100%

Methods of Delivering Oxygen

Ventilators

Nasal Cannula

Oxyhood

Masks

Oxygen

• Oxygen constitutes 21% of atmospheric gases

• If O2 levels in the body drop below 21% homeostasis is altered.

• Hypoxia: Inadequate amount of oxygen at the cellular level.

Chest Tubes & LinesThe Rad Tech’s Role

• Early detection of problems associated with malpositioned lines.

• X-rays assist physicians in determining if tubes and lines are placed correctly

• Correct positioning and technical exposure are crucial

Chest Tubes and LinesCHEST TUBESENDOTRACHEAL TUBES

CENTRALLINES

NASOGASTRIC TUBES

Tubes & Lines cont’d

• Endotracheal Tubes (ET tubes) – Known as “intubation”

-translaryngeal

-tracheostomy

-nasotracheal• Must be precise in

placement: 1-2 inches superior to the tracheal bifurcation (carina)

Intubation of the rt main-stem bronchus with complete occlusion of the lt bronchus causing lt lung atelectasis.

(A) Distal tip of endotracheal tube in rt main bronchus; (B) Central venous catheter in the lt subclavian vein.

CHEST TUBES

Tubes & Lines (last one)

• Common insertion sites for CV lines:-subclavian vein-internal jugular vein-femoral vein

• Most evaluated by a chest x-ray

• Extreme caution must be used when positioning for images!

NASOGASTRIC (NG) TUBE

CENTRAL LINESCENTRAL LINES

Rt hydrothorax caused by displacement of a central venous line during dressing change; 1300 ml of intravenous fluids were evacuated via thoracentesis.

Review

• Vital Signs

• Homeostasis

• Body Temperature

• Pulse

• Respiration

• Blood Pressure

• Mental Status

• Electrolyte balance

• Pulse Oximeter

• Oxygen

• Oxygen Devices

• Chest Tubes

• Chest Lines