ret 1024l introduction to respiratory therapy lab module 4.1 bedside assessment of the patient...

RET 1024LRET 1024LIntroduction to Respiratory Introduction to Respiratory TherapyTherapy

LabLabModule 4.1 Module 4.1

Bedside Assessment of the PatientBedside Assessment of the Patient—Vital Signs: Pulse, Respiratory Rate,Vital Signs: Pulse, Respiratory Rate,

Blood Pressure, Pulse Blood Pressure, Pulse OximetryOximetry

Bedside Assessment of the PatientBedside Assessment of the Patient

Physical ExaminationPhysical Examination Vital SignsVital Signs

Pulse RatePulse Rate Palpated at various sites Palpated at various sites

TemporalTemporal CarotidCarotid Apical (heart)Apical (heart) BrachialBrachial RadialRadial FemoralFemoral PoplitealPopliteal Posterior TibialPosterior Tibial Dorsalis - PedisDorsalis - Pedis



Pulse RatePulse Rate Radial artery most common site to palpate pulse Radial artery most common site to palpate pulse

Use first, second, or third finger to palpate – not thumbUse first, second, or third finger to palpate – not thumb

Ideally, counted for 1 minute, but can be counted over Ideally, counted for 1 minute, but can be counted over 15 or 30 seconds and then multiplied appropriately to 15 or 30 seconds and then multiplied appropriately to determine the pulse per minutedetermine the pulse per minute



Respiratory RateRespiratory Rate Counting breaths:Counting breaths: Breathing should be counted for Breathing should be counted for

one full minute (60 seconds)one full minute (60 seconds)

LookLook at chest and abdomen rise and fall at chest and abdomen rise and fall

FeelFeel the chest or abdomen rise and fall by placing the chest or abdomen rise and fall by placing your hand on the person's chest or abdomenyour hand on the person's chest or abdomen

ListenListen to the breaths if the person is breathing loud to the breaths if the person is breathing loud enoughenough



Respiratory RateRespiratory Rate Do not ask the patient to “breathe Do not ask the patient to “breathe

normally” while you are counting normally” while you are counting respiratory rate – they will respiratory rate – they will inadvertently change the pattern and inadvertently change the pattern and raterate

Try counting the respiratory rate by Try counting the respiratory rate by observing the chest and abdomen observing the chest and abdomen while continuing to palpate the radial while continuing to palpate the radial artery. The patient will think you are artery. The patient will think you are still taking their pulse and will not still taking their pulse and will not change their respiratory pattern and change their respiratory pattern and raterate


Physical ExaminationPhysical Examination Measuring BPMeasuring BP

Commonly measured Commonly measured using auscultationusing auscultation

SphygmomanometeSphygmomanometer and stethoscoper and stethoscope

BP cuffs come in BP cuffs come in different sizesdifferent sizes



Most BP cuffs are marked Most BP cuffs are marked with an with an O O or an or an indicating where the cuff indicating where the cuff should be placed over the should be placed over the brachial arterybrachial artery



Palpate the brachial artery and then Palpate the brachial artery and then wrap the deflated cuff snugly around wrap the deflated cuff snugly around the patient’s upper arm, ensuring it the patient’s upper arm, ensuring it is properly positioned over the is properly positioned over the brachial artery. The lower edge brachial artery. The lower edge should be about 1 inch above the should be about 1 inch above the antecubital fossa antecubital fossa



Grasp the inflation bulb Grasp the inflation bulb in such a way that you in such a way that you can inflate the cuff and, can inflate the cuff and, with your thumb and with your thumb and index finger, easily index finger, easily open and close the open and close the valvevalve



While palpating the While palpating the brachial pulse, inflate brachial pulse, inflate the cuff to the cuff to approximately 30 mm approximately 30 mm Hg above the point at Hg above the point at which the pulse can no which the pulse can no longer be feltlonger be felt



Place the diaphragm of Place the diaphragm of the stethoscope over the the stethoscope over the artery and deflate the artery and deflate the cuff at a rate of 2 – 3 cuff at a rate of 2 – 3 mm Hg/sec while mm Hg/sec while observing the observing the manometermanometer



The The systolic pressuresystolic pressure is is recorded at the point at recorded at the point at which the first Korotkoff which the first Korotkoff sounds are heard. The sounds are heard. The point at which the point at which the sounds become muffled sounds become muffled is the is the diastolic pressurediastolic pressure

Korotkoff sounds; partial obstruction of blood flow creating turbulence and vibration


Measuring BPMeasuring BP


Pulse oximetryPulse oximetry SpO2SpO2

ret 1024l introduction to respiratory therapy lab module 4.1 bedside assessment of the patient...

Documents