Unit H: Diagnostic Skills

Measure and Record Vital Signs

Medical Assisting and Laboratory Skills

Temperature

• What is temperature?

Temperature

• What is temperature?

• The measurement of balance between heat lost and produced by the body.

How does heat get lost from our bodies?

How does heat get lost from our bodies?

• Perspiration

• Respiration

• Excretion (urine and feces)

How is heat produced in our bodies?

How is heat produced in our bodies?

• Metabolism of food

• Muscle and gland activity

What is homeostasis?

What is homeostasis?

• Equal balance in the body fluids

• Ideal state in the human body

• If body temperature is too high or too low, homestasis is affected!

Measurement of Temperature

• F = Fahrenheit• C = Celsius or Centigrade• Normal range of temperature: Oral = 97.6 - 99.6 F or 36.5 – 37.5 C Rectal = 98.6 – 100.6 F or 37 – 38.1 C Axillary = 96.6 – 98.6 F or 36 – 37 C Tympanic or Aural = placed in ear or auditory canal Temperature is usually higher in the evening why?

What factors affect body temperature?

What factors affect body temperature?

• What increases body temperature?

What factors affect body temperature?

• What increases body temperature?

Illness, infection, exercise,

excitement, and high temperatures

in the environment

What factors affect body temperature?

• What decreases body temperature?

What factors affect body temperature?

• What decreases body temperature?

Starvation or fasting, sleep, decreased

muscle activity, exposure to cold in

the environment, and certain diseases

Temperature Terms

• Hypothermia = prolonged exposure to cold Temp. below 95 F; death below 93 F • Hyperthermia = prolonged exposure to hot temperatures, brain damage, or serious infection Temp. above 104 F; death or convulsions above 106 F• Fever or pyrexia = elevated body temperature usually above 101 F

• Afebrile = temperature within a normal range Febrile = referring to elevated temperature Pyrogenic = producing fever Calibration = standard measure (line on a

thermometer or ruler)

Clinical Thermometer Typesand where temperature taken

• Oral – in the mouth with either glass or electronic thermometer

Most common method

Glass ones contain alcohol based

red dye; No longer use mercury

Long and slender bulb or blue

tip

If person eating, drinking, or smoking wait 15 minutes after they stop to take temperature.

• Rectal – temperature taken in the rectal

area

Most accurate way to measure

Has a red tip and bulb is short,

stubby, and rounded

Used when patients are less than 6 yrs. old, mouth breathers, on O2, weakness,

difficulty breathing, and confused, unconscious or senile.

• Aural or tympanic – taken in the ear Accurate and easy to use Can be used in place of oral temp.

Axillary – taken in the armpit Least accurate and only used if oral, rectal or aural temperatures cannot be used.

Temperature Conversion between Celsius and Fahrenheit

• To convert Celsius to Fahrenheit:

F = (C x 1.8) + 32

Example: 35 degree C to Fahrenheit

F = (35 x 1.8) + 32

F = (63) + 32

F = 95 degrees

Temperature Conversion between Fahrenheit and Celsius

• To convert Fahrenheit to Celsius: C = (F – 32) or (F - 32) divided by 1.8 1.8Example: Convert 104 F to degrees Celsius C = (104 – 32) divided by 1.8 C = (72) divided by 1.8 C = 40 degrees

Try your skill !!!!

• Convert the following temperatures:

A. 37.2 C to F

B. 101.6 F to C

C. 96 F to C

D. 41 C to F

Why is it important to double check your results when you do conversions?

Pulse Measurements

• What causes a pulse?

• The pressure of the blood pushing against the wall of an artery as the heart contracts and relaxes.

• Important because indicates how well the blood is circulating through the body.

Pulse Terminology

• Rate = number of pulse beats per minute

• Rhythm = regularity of beats

• Volume = strength or pressure felt with

each beat.

• Arrhythmia = an irregular pulse rate

• Bounding = leaping, strong, or forceful

pulse

• Thready = weak, barely felt pulse; thin, like

like a thread.

Tachycardia = pulse rate over 100 beats

per minute (for adults)

Bradycardia = pulse rate below 60 beats

per minute.

• Apex = pointed end of something; for example the pointed end of the heart is called the apex.

Stethoscope = instrument used to amplify sound. Used to listen to the Apical pulse; pulse counted at the apex of the heart.

Pulse Points

• Temporal – side of forehead

• Carotid – neck

• Brachial – crease of elbow

• Radial – thumb side of wrist

• Femoral – inner aspect of upper thigh

• Popliteal – behind knee

• Dorsalis pedis – top of foot arch

Normal pulse values

• Before birth – 140 – 150 bpm

• At birth - 90 – 160 bpm

• Children 1-7yr – 80 – 130 bpm

• Children over 7 – 70 – 115 bpm

• Adult men - 60 - 90 bpm

• Adult women - 65 – 80 bpm

• bpm = beats per minute

Factors that affect Pulse

• Factors that increase pulse rate:

exercise, stimulant drugs, fever,

shock, excitement, nervous tension

Factors that decrease pulse rate:

sleep, depressent drugs, heart disease

coma, physical training

Counting the pulse

• The radial pulse is the most commonly used pulse site.

• Count the beats for 30 seconds and multiply by 2.

• If can not count radial pulse and must use the apical pulse, count for one (1) full minute to get beats per minute.

• ALERT! Report any abnormal pulse rate

Measuring Respirations

• What constitutes respiration?

• It is the process of taking in oxygen (O2) into the body and expelling carbon dioxide (CO2) from the body.

• One inspiration (breathing in) and one expiration (breathing out) = one respiration

Normal Values of Respirations

• Newborn rates are 40 respirations per

minute

• Normal adult rates are 12 – 20 respirations

per minute

Respiratory Terms

• Rate – number of respirations per minute

• Rhythm – regularity or irregularity of

• breathing

• Quality – amount of air exchanged and the

• effort it takes to breath

• Dyspnea – shortness of breath

• Tachypnea – abnormally fast respirations

• Apnea – absence of respirations, has breathing stopped?• Cheyne-Stokes – periods of labored respirations followed by apnea; usually noted in the dying pt.• Rales – bubbling or rattling sounds cause by mucus in the air passagesALERT! Always report abnormal respirations

How to count respirations

• When counting a patients respirations:

• Do not want them to be aware that you are counting as he/she may not breath normally.

• Leave you hand on the pulse while counting respirations and count for 30 seconds and multiply by 2

Measuring Blood Pressure

• What is blood pressure?

• It is the force of the blood pushing against

the walls of the blood vessels.

It is measured with an instrument known

as a sphygmomanometer (blood

pressure cuff) and read in millimeters (mm)

of mercury (Hg)

Blood Pressure Terms

• Systolic pressure – is the greatest force exerted on the walls of the arteries when the heart is contracting. Normal range is 90 – 140 mm Hg• Diastolic pressure – is the least force exerted on the walls of the arteries when the heart is at rest. Normal range is 60 – 90 mm Hg

Blood Pressure Terms cont.

• Pulse pressure - difference between the

systolic and diastolic pressure.

Normal pulse pressure is 30-40 mm Hg

• Hypertension – high blood pressure

• Hypotension – low blood pressure

Types of equipment for BP

Two main blood pressure apparatus:• Aneroid – have a round gauge with long and short lines; long are 10 mm intervals and the short are 2 mm intervals and used with a stethoscope to hear beats.

Electronic/digital – push a button and are battery powered or plugged in and gives a reading on a screen.

Factors that affect BP

• Factors that increase BP: stress, anxiety, obesity, high salt intake, aging, kidney disease, thyroid deficiency, eating, arteriosclerosis

Factors that decrease BP: heart failure, hemorrhage, inactivity, fasting, suppressants, depression, shock, severe burns

Recording Vital Signs

• Now lets record what we have learned about.• Always record the temperature, pulse and

respirations in the same order:

T P R• Example: T 98.6 F P 72 R 16• If temperature is rectal put an ® next to the

number; if axillary put an (AX) next to the number; if aural put a (T) next to the number.

Recording BP

• Blood pressure is always recorded as a fraction:

• Example 120/76 mm Hg =

120 systolic

76 diastolic

ALERT !!!! Always report any abnormal findings in vital signs to your supervisor.