Transcript Vital Signs x

+
Vital Signs
Signs of life
+
Vital signs:

1. Temperature - T

2. Pulse – HR (heart rate)

3. Respirations – RR (respiration rate)

4. Blood pressure - BP

5. Pain level on a scale 1-10

6. Oxygen saturation – O2SAT
+
What can vital signs tell us?
+
Temperature
Regulatory center Hypothalamus
+
Core temperature

Oral – mouth

Rectal – rectum

Tympanic – ear

36.8±0.7 °C,
or 98.2±1.3 °F
 97.6
– 99.6 per
Hartman
+
Celsius vs. Fahrenheit
36.8±0.7 °C
+
Fahrenheit
98.2±1.3 °F
+
Circadian rhythm

Normal body temperature
may differ as much
as 0.5 °C (1.0 °F) from day
to day.

The lowest temperature
occurs about two hours
before the person normally
wakes up
+
Oral temperature

Oral temperatures are
influenced by drinking,
chewing, smoking, and
breathing with the mouth
open. Cold drinks or food
reduce oral temperatures;
hot drinks, hot food,
chewing, and smoking raise
oral temperatures
+
Wait to take oral T for 10-20 min

If patient just chewed gum, ate,
smoke, or had hot or cold
drink
+
Oral temperature

Do not take an oral
temperature on a confused
patient.

Why?

Facial trauma

Using O2

Just had cold or hot drink

Younger than 6 years old

Why do you think the
tympanic (ear) thermometer is
a preferred method of taking
temperature at health care
facilities?
+
Research on oral T

National Institute of Health –
NIH:

http://www.ncbi.nlm.nih.gov/
pubmed/22488144

Read a conclusion, discuss the
trustworthiness of the research
article.
+
Tympanic temperature
+
Rectal temperature
+
Rectal temperature

Insert a thermometer ½ to 1 inch into rectum and hold onto
thermometer at all times.

Why?
+
Rectal thermometers for the
home use
+
Rectal vs. Oral Probe
Rectal probe/thermometer is red
Oral probe/thermometer is blue
+
Fertility Rectal Temperature
Application
Ovulation and pregnancy cycle:
+
Ovulation and pregnancy
cycle:
+
No ovulation cycle
+
Auxiliary temperature (Ax)

Hold a glass thermometer in
underarm space for 5 min

Hold an electronic
thermometer till the beep
+
(Ax)

Good alternative for rectal on
kids, but you need to convert it
to rectal, since Ax is much
lower as core temperature
+
Temporal Temperature
Sliding thermometer against
temporal artery
Safe and easy
Medical research hasn't determined an exact correlation between
oral, rectal, ear, armpit, and forehead temperature measurements.
Generally, the correlation of temperature results are as follows:
The average normal oral temperature is 98.6°F (37°C).
A rectal temperature is 0.5°F (0.3°C) to 1°F (0.6°C) higher than an
oral temperature.
An ear (tympanic) temperature is 0.5°F (0.3°C) to 1°F (0.6°C) higher
than an oral temperature.
An armpit (axillary) temperature is usually 0.5°F (0.3°C) to 1°F
(0.6°C) lower than an oral temperature.
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C)
lower than an oral temperature.
+
Charting Temperature

36.6 C° (O)
 98.8
F° (Ax)
 101.3
 37.5
F° (R)
C° (T)
+
Oxygen Saturation – O2Sat

Normal range 93-100%

Measuring O2SAT
http://www.youtube.com/watch?v=cxaoxc-xMKs

Oximetry
http://www.youtube.com/watch?v=irVEYvEIb6o
+
Respiration Rate- RR

Normal rate 12-20

Patients shouldn’t know when you start counting their
RR, because they can start breathing either too slow or
too fast.

Keep your fingers on radial pulse, pretending that you
counting pulse, but count respirations instead (in real
life, but not for the state test)
+
Cardiovascular VS – HR and BP
Anatomy and physiology

Intro to anatomy of the heart
https://www.youtube.com/watch?v=DAXa4eR1s0M

Visible Body.


Cardiologist explains heart anatomy 4

https://www.youtube.com/watch?v=QXckE_DlFAM
+
Khan Academy

Khan academy – Meet the Heart!
https://www.youtube.com/watch?v=Vi1JK6IYVt8
Homework – Khan academy:

Layers of the heart,

Lub Dub,

Flow through the heart

Activity – Draw a heart with four chambers, identify four
valves, and eight major vessels. Option for extra credit –
make heart out of clay.
+
Pulse – Heart Rate - HR

Normal range – 60-100
beats per minute - bpm

Note rate, rhythm, and
strengths
+
Homework
Advanced Circulatory System
Physiology in Khan Academy:
Health and Medicine


https://www.khanacademy.org
/science/health-andmedicine/circulatory-system
https://www.youtube.com/wat
ch?v=QXckE_DlFAM

What is blood pressure? 6

http://www.youtube.com/watc
h?v=J97G6BeYW0I

For Christmas potluck – one
documentary and one movie
about medicine and health
related isssues
+
Rate
Fast
Slow

Tachycardia

Bradycardia

HR above 100 bpm

HR below 60 bpm
+
Rhythm
Regular
Irregular
+
Strength
Strong = normal
Weak
+
Activity

Find pulses on yourself.
+
Radial Pulse
+
Activity
Check apical pulse on yourself
+
Pulse deficit and A-Fib

Pulse deficit is the difference
between the heart rate and the
palpable pulse, as is often
seen in atrial fibrillation.

Atrial fibrillation or A-Fib is
the most common abnormal
heart rhythm. It may cause no
symptoms, but is often
associated with palpitations,
fainting, chest pain, or
congestive heart failure.
+
Resting Heart rate

Your resting heart rate refers
to the body's lowest heart rate,
when your body is close to
absolute rest, such as upon
awakening in the morning.

Lowering your resting heart
rate can significantly reduce
your risk of heart attack and
stroke and increase your
endurance and feelings of
well-being.
+
Resting Heart rate

Knowing your resting heart
rate can help you to assess
your overall health and
condition and help you set
heart rate targets.

Fitted athlete's heart rate is
40-60 per minute
+
Maximum heart rate

Maximum heart rate. This is
the highest your pulse rate can
get. To find yours, follow this
formula: 220-(your
age)=(predicted maximum
heart rate)
+
Target heart rate

Target heart rate. This is 60 to
85 percent of your maximum
heart rate. This is usually
accomplished through
exercise.
+
Why do I care for target heart rate?

If your heart rate is lower than
a target rate, then this exercise
is good for flexibility or
strength training, but wouldn’t
train your heart.

Aerobic exercise are the ones
which train the heart
+
Diversify your exercise

1.
To train
Strength - ?
2.
flexibility - ?
3.
heart - ?
+
Diversify your exercise

1.
To train
Strength - ?
2.
flexibility - ?
3.
heart - ?
+
Diversify your exercise

1.
To train
Strength - ?
2.
flexibility - ?
3.
heart - ?
+
Diversify your exercise

1.
To train
Strength - ?
2.
flexibility - ?
3.
heart - ?
+
Blood Pressure 110/70

Systolic Blood Pressure – the
top (first) number – the
pressure in the heart during
systole – the squeezing phase

Diastolic blood pressure – the
bottom (second) number – the
pressure during the relaxation
phase of the heart diastole –
shows the resistance in the
vessels of the body
+
Khan Academy

Advanced Circulatory System Physiology in Khan Academy:
Health and Medicine

https://www.khanacademy.org/science/health-andmedicine/circulatory-system
What is blood pressure? 6
http://www.youtube.com/watch?v=J9
7G6BeYW0I
+
Normal range for BP


Systolic 90-120 – absolute normal,
120-140 pre hypertension,

above 140 - HTN

Diastolic below 80 - absolutely normal,

80-90 pre HTN

Above 90 – HTN
+
Hypertension

Nucleus – medical media 5

http://www.nucleusanimationlibrary.com/animationpreview?ccat=all&clang=English&animationid=76622
+
Blood pressure (Korotkoff) sounds

24 min training video: https://vimeo.com/26580985

Youtube practice
http://www.youtube.com/watch?v=NRxCM8f9uwE&oref=http
%3A%2F%2Fwww.youtube.com%2Fresults%3Fsearch_quer
y%3Dblood%2Bpressure%2Bsounds%26oq%3Dblood%2Bp
res
+
Activity – measure BP