vital signs · infant 30 - 60 per minute . terms ... orthostatic vital signs wait 1 minute after...
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Vital Signs
Blood pressure
Pulse
Respirations
Temperature
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will cover later...
Level of consciousness
pupil status
breath sounds
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Signs & Symptoms
Signs are observed or measured
Symptoms are told to you by the patient
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Respirations
1. Count number of breaths per minute
2. Assess Quality • Rhythm
• Effort
• Noise
3. Assess tidal volume • Increased
• Normal
• Decreased
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Normal values
Adult 12 - 20 per minute
Child 18 - 30 per minute
Infant 30 - 60 per minute
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Terms
Apnea = not breathing
Bradypnea = slow breathing
Tachypnea = fast breathing
Hypoventilation = poor tidal volume
Hyperventilation = deep tidal volume
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Pulse
Rate Number of beats in one minute or in
30 seconds multiplied by 2
Strength Bounding, strong, or weak (thready)
Regularity Regular or irregular
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Pulse Points
Femoral
Apical
Carotid
Radial
Brachial
Temporal
Dorsalis Pedis
Popliteal
Posterior Tibialis
(AKA Medial Tibialis)
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normal values
Adult 60 - 100
Child 70 - 120
Toddler 90 - 150
Newborn 120 - 160
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Terms
Bradycardia = slow pulse under 60 (adult)
Tachycardia = fast pulse 100 or more (adult)
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Blood Pressure
The pressure of the circulating blood against the walls of the arteries.
A drop in blood pressure may indicate:
Loss of blood
Loss of vascular tone
Cardiac pumping problem
Blood pressure should be measured in all patients older than 3 years.
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Blood pressure
Systolic - higher number pressure at ventricular contraction
Diastolic - lower number pressure at ventricular relaxation
Measured in millimeters of mercury (mm Hg)
Recorded as systolic/diastolic
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Auscultation vs Palpation
Using a sphygmomanometer there are two methods
Auscultation obtains both systolic & diastolic readings
Palpation = to feel only systolic reading obtained
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Normal Ranges of Blood Pressure
Age Range
Adults (systolic) 100 to 140 mm Hg
(diastolic) 60 to 90 mm Hg
Children (systolic) 80 to 110 mm Hg
Infants (systolic) 60 mm Hg
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terms
Hypotension - low blood pressure
Hypertension - high blood pressure
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BP indicators – If you can get
this pulse, the BP is:
Carotid - at least 60 systolic
Femoral - at least 70 systolic
Radial - at least 80 systolic
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Pulse Pressure
pulse pressure is the difference between systolic & diastolic readings.
120/80 pulse pressure = 40
156/66 pulse pressure = 90
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What is Blood Pressure?
BP = CO x PVR
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orthostatic vital signs
AKA - postural vital signs
assessment for hypovolemia/shock
Take blood pressure & pulse supine - sitting - standing
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orthostatic vital signs
wait 1 minute after changing positions.
increase in pulse or decrease in blood pressure of 20 points or more equals hypovolemia. Indicates 15% volume loss.
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Temperature
Axillary
Oral
Rectal
Other***
Normal = 98.6
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core temp
rectal temp
THE MOST ACCURATE METHOD
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The Skin
Color
Pink, pale, blue, flushed, or jaundice
Temperature
Warm, hot, or cool
Moisture
Dry, moist, or wet
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Capillary Refill
Evaluates the ability of the circulatory system to restore blood to the capillary system (perfusion)
Tested by depressing the patient’s fingertip and looking for return of blood
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Remember ...
Treat the patient not the numbers!!!
Look at the whole picture!
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END
questions?