Transcript VITAL SIGNS AND OXYGEN ADMINISTRATION

VITAL SIGNS AND OXYGEN
ADMINISTRATION
CHAPTER 6
MEASURING VITAL SIGNS
VITAL SIGNS ARE ALSO CALLED
CARDINAL SIGNS.
1.
BODY TEMPERATURE
2.
PULSE
3.
RESPIRATION
4.
BLOOD PRESSURE
CHANGES IN VITALS INDICATE A
POTENTIAL PROBLEM!
VITALS
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OXYGEN IS VITAL TO SURVIVE.
THE HUMAN BRAIN CAN NOT
FUNCTION FOR LONGER THAN 4 TO 5
MINUTES WITHOUT OXYGEN!
IT IS YOUR RESPONSIBILITY TO KNOW
WHAT ARE NORMAL VITAL SIGNS.
VITAL SIGNS
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A PHYSICIANS ORDER IS NOT
REQUIRED FOR VITAL SIGNS TO BE
MEASURED. UNLESS A NURSE IS
PRESENT IT IS YOUR JOB TO TAKE
VITAL SIGNS ON A PATIENT.
BODY TEMPERATURE
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DEFINED BY THE HEAT PRODUCED IN
THE BODY TISSUES TO THE HEAT
LOST TO THE ENVIRONMENT.
CAN VARY 2 TO 3 DEGREES.
BODY TEMPERATURE IS CONTROLLED
BY THE BASAL REGION OF THE BRAIN
CALLED THE HYPOTHALAMUS (BODY
THERMOSTAT)
FACTS
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THE ENVIRONMENT, TIME OF DAY, WEIGHT,
EMOTION, EXERCISE, DISEASE, DIGESTION
OF FOOD AND INJURY ALL HAVE AN EFFECT
ON TEMPERATURE.
FEVER OR PYREXIA IS ELEVATED TEMP.
AS BODY TEMP. INCREASES THE BODIES
DEMAND FOR OXYGEN INCREASES.
TEMPERATURE RANGES
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3 MONTHS TO 3 YEARS IS 99 DEGREES
5 TO 13 YEARS IS 97.8-98.6
SYMPTOMS OF A FEVER ARE
INCREASED PULSE AND INCREASED
RESPIRATIONS, ACHINESS ,FLUSHED
DRY SKIN, CHILLS AND LOSS OF
APPETITE.
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LOW BODY TEMPERATURE IS CALLED
HYPOTHERMIA.
HYPOTHERMIA CAN BE AN
INDICATION OF A PATHOLOGICAL
PROCESS AND CAN REDUCE A
PATIENTS NEED FOR OXYGEN.
MEASURING TEMPERATURE
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1.
2.
3.
4.
THERE ARE FOUR WAYS TO MEASURE
TEMPERATURE.
ORAL
TYMPANIC
RECTAL
AXILLARY
MEASURING TEMPERATURE
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AVERAGE ORAL READING IS 98.6
AVERAGE RECTAL READING IS 99.6
AVERAGE AXILLARY READING IS 97.698 DEGREES.
AVERAGE TYMPANIC READING IS 97.6
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THE SITE SELECTED FOR MEASURING
TEMPERATURE MUST BE CHOSEN
CAREFULLY DEPENDING ON STATE OF
MIND, AGE AND THE ABILITY TO
COOPERATE.
ALERT!
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PATIENTS WHO ARE DISORIENTED,
DELUSIONAL, DELIRIOUS OR WHO
HAVE FACIAL INJURIES OR A HISTORY
OF CONVULSIONS SHOULD NEVER USE
AN ORAL THERMOMETER.
TYMPANIC THERMOMETER
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THIS IS PLACED IN THE EAR AND IS
CALLED AN AURAL THERMOMETER
MEASURES THE BLOOD VESSELS IN
THE TYMPANIC MEMBRANE OF THE
EAR.
AXILLARY
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SAFEST METHOD OF MEASURING
BODY TEMPERATURE.
USEFUL FOR INFANTS.
RECTAL
MOST RELIABLE MEASURE OF
TEMPERATURE.
CLOSE PROXIMITY TO THE CORE OF
THE BODY.
PULSE
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AS THE HEART
BEATS, BLOOD IS
PUMPED IN A
PULSATING
FASHION INTO THE
ARTERIES. THIS
RESULTS IN A
THROB SOUND!
PULSE
1.
2.
3.
4.
5.
6.
7.
8.
APICAL: OVER THE APEX OF THE HEART
(HEARD WITH STETHOSCOPE)
RADIAL: RADIAL ARTERY OF WRIST
CAROTID: FRONT OF NECK
FEMORAL: GROIN
POPLITEAL: BACK OF KNEE
TEMPORAL: FRONT OF THE EAR
DORSALIS PEDIS: TOP OF FOOT
POSTERIOR TIBIAL: INNER SIDE OF
ANKLES.
PULSE
THE NORMAL AVERAGE PULSE RATE IN
AN ADULT IS BETWEEN 60 AND 90
BEATS PER MINUTE.
THE NORMAL PULSE FOR INFANTS IS
120 BEATS PER MINUTE.
A CHILD 4 TO 10 YEARS OLD 90-100
BEATS PER MINUTE.
ASSESSMENT OF THE PULSE
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PULSE ASSESSES CARDIOVASCULAR FUNCTION.
TACHYCARDIA IS A RAPID HEART BEAT (OVER 100
BEATS)
BRADYCARDIA IS AN ABNORMALLY SLOW HEART
BEAT (BELOW 60).
PULSE RATE SHOULD BE COUNTED FOR A FULL
MINUTE.
FOR INFANTS AND CHILDREN THE APICAL PULSE IS
MOST ACCURATE.
TO ASSESS THE PULSE YOU NEED A WATCH WITH A
SECOND HAND.
RESPIRATION
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THE AVERAGE RATE OF RESPIRATION
FOR AN ADULT IS 15 TO 20 BREATHS
PER MINUTE AND 30-60 BREATHS FOR
AN INFANT.
RESPIRATION LESS THAN 10 BREATHS
PER MINUTE MAY RESULT IN
CYANOSIS, APPREHENSION AND A
CHANGE IN CONSCIOUSNESS BECAUSE
OF INADEQUATE OXYGEN.
ASSESSMENT OF
RESPIRATION
1.
2.
3.
4.
KEEP PATIENT IN PRESENT
POSITION.
OBSERVE CHEST WALL FOR
SYMMETRY OF MOVEMENT.
OBSERVE SKIN COLOR.
COUNT THE NUMBER OF TIMES THE
CHEST RISES AND FALLS FOR ONE
MINUTE.
BLOOD PRESSURE
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IN GENERAL TERMS, IS DEFINED AS THE
PRODUCT OF FLOW TIMES RESISTANCE.
BLOOD PRESSURE IS THE AMOUNT OF
BLOOD FLOW EJECTED FROM THE LEFT
VENTRICLE OF THE HEART DURING
SYSTOLE AND THE AMOUNT OF RESISTANCE
THE BLOOD MEETS DUE TO SYSTEMIC
VASCULAR RESISTANCE.
BLOOD PRESSURE FACTS
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BLOOD PRESSURE VARIES WITH AGE,
GENDER, BODY POSITION, TIME OF
DAY AND HEALTH STATUS.
BLOOD PRESSURE IS USUALLY LOWER
IN THE MORNING AFTER A NIGHT OF
SLEEP THAN LATER IN THE DAY.
BLOOD PRESSURE FACTS
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MEN USUALLY HAVE HIGHER BLOOD
PRESSURE.
INFANTS HAVE HIGHER BLOOD
PRESSURE.
SPHYGMOMANOMETER IS THE
INSTRUMENT TO MEASURE BLOOD
PRESSURE.
FACTS CONTINUED
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BLOOD PRESSURE REQUIRES TWO
READINGS AND IS MEASURED IN
MILLIMETERS OF MERCURY.
THE TWO READINGS ARE CALLED SYSTOLIC
AND DIASTOLIC.
SYSTOLIC IS THE TOP NUMBER
DIASTOLIC IS THE BOTTOM NUMBER.
SYSTOLIC
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THIS READING IS THE HIGHEST POINT
REACHED DURING CONTRACTION OF
THE LEFT VENTRICLE OF THE HEART
AS IT PUMPS INTO THE AORTA.
THE NORMAL SYSTOLIC PRESSURE IS
110-140.
CHILDREN RANGE FROM 90-120.
ADOLESCENT RANGES FROM 85-130.
DIASTOLIC
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THIS IS THE LOWEST POINT TO WHICH THE
PRESSURE DROPS DURING RELAXATION OF
THE VENTRICLES AND INDICATES THE
MINIMUM PRESSURE EXERTED ON THE
ARTERIAL WALLS.
THE NORMAL RANGE IS 60-80 IN ADULTS.
CHILDRENS DIASTOLIC IS 50-70.
ADOLESCENT PRESSURE 45-85.
HYPERTENSION
A PATIENT IS CONSIDERED
HYPERTENSIVE IF THE SYSTOLIC
PRESSURE IS GREATER THEN 140 AND
THE DIASTOLIC PRESSURE IS
GREATER THAN 90.
BLOOD PRESSURE CUFFS
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THE BLOOD PRESSURE CUFF SHOULD
BE SELECTED ACCORDING TO THE
PATIENTS SIZE.
A CUFF TO LARGE OR SMALL WILL
GIVE AN IMPROPER READING.
OXYGEN THERAPY
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OXYGEN IS ESSENTIAL TO LIFE.
OXYGEN CAN NOT BE STORED AND IS DEPENDANT ON THE
ENVIRONMENT.
IT IS YOUR RESPONSIBILITY AS A RADIOGRAPHER THAT
EQUIPMENT TO ADMINISTER OXYGEN IS AVAILABLE AND
WORKING.
IT IS YOUR RESPONSIBILITY TO ASSIST WITH
ADMINISTRATION OF OXYGEN IN EMERGENCY SITUATIONS.
THE AMOUNT OF OXYGEN IN EITHER AIR OR BLOOD IS
CALLED OXYGEN TENSION.
INADEQUATE OXYGEN IS CALLED HYPOXEMIA.
WHEN TO MUCH CARBON DIOXIDE IS RETAINED IN THE
ARTERIAL BLOOD IT IS CALLED HYPERCAPNEA.
PULSE OXIMETRY
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A DEVICE PLACED AT THE END OF A
PATIENTS FINGERTIP OR EARLOBE
AND MEASURES OXYGEN SATURATION
OF HEMOGLOBIN.
NORMAL OXYGEN SATURATION IS 90100 PERCENT .
BELOW 85% INDICATES THE TISSUES
ARE NOT GETTING ENOUGH OXYGEN.
HAZARDS OF OXYGEN
ADMINISTRATION
1.
2.
3.
4.
5.
OXYGEN IS CONSIDERED A MEDICATION AND
MUST BE PRESCRIBED.
SPECIAL CARE IS NECESSARY WHEN
ADMINISTERING OXYGEN TO COPD PATIENTS.
INFECTIONS AND BACTERIA THRIVE IN
OXYGEN ENVIRONMENTS.
BE CERTAIN THAT TUBING, CANNULAS AND
MASKS ARE USED ONE TIME AND FOR ONE
PATIENT ONLY.
NO SMOKING AROUND OXYGEN!!!!!!!!!!!!!!!
OXYGEN DELIVERY SYSTEMS
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HIGH FLOW RATES REQUIRE
HUMIDIFICATION TO PREVENT DRY
MUCOUS MEMBRANES.
OXYGEN IS PIPED TO ROOMS IN A
HOSPITAL TO A WALL OUTLET.
A FLOWMETER IS ATTACHED TO EACH
WALL OUTLET.
TYPES OF OXYGEN DELIVERY
SYSTEMS
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NASAL CANNULA
NASAL CATHETER
FACE MASK
OXYGEN TENT
EQUIPMENT NEEDED FOR
THE IMAGING DEPARTMENT
1.
2.
3.
4.
5.
6.
OXYGEN SOURCE ( TANK, PIPED IN )
A STERILE CANNULA OR MASK IN A
SEALED PACKING.
CONNECTING TUBING
A HUMIDIFIER , IF NEEDED.
A FLOW METER.
A “NO SMOKING” SIGN.
CHEST RADIOGRAPHY
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PLACEMENT OF TUBES
CRITICAL THINKING
PATHOLOGIES AND TECHNIQUE
PORTABLES
THE END
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OXYGEN DELIVERY WILL BE TAUGHT
MORE EXTENSIVELY IN TOPGRAPHIC
ANATOMY 2.