Transcript TEMPERATURE, PULSE, RESPIRATIONS

TEMPERATURE, PULSE,
RESPIRATIONS
Abbreviated: TPR
TEMPERATURE
The measurement of core body heat
ROUTES TO MEASURE
TEMPERATURE
 Oral: By mouth
 Rectally: By rectum
 Axillary: Under the arm in the armpit
 Tympanic: In the ear
TYPES OF
THERMOMETERS
 Digital Electronic: To be used for oral,
rectal, and axillary
 Thermoscan - Digital: To be used for
tympanic
 Mercury or glass: To be used for oral,
rectal, and axillary
NORMS
 Orally: 97.6 - 99.6 degrees Fahrenheit
 Rectally: 99.6 - 100.6 degrees Fahrenheit
 Tympanic - manufacturers say to
measure as for rectal
 Axillary: 96.6 - 98.6 degrees Fahrenheit
 Which of the following is a normal
temperature?
 A) 98.9 axillary
 B) 101 .2 rectal
 C) 99.6 oral
 D) 98.6 rectal
WHAT THERMOMETER
SHOULD BE USED?
 Tympanic: Special device with plastic
covers.
 Electronic: All routes. Probes that are
red in color for rectal temperatures; blue
in color for oral and axillary.
 Mercury: All routes. Red ends are
rectal; blue ends oral and axillary.
DURATION FOR TAKING
TEMPERATURES
 Tympanic: As long as it takes to push a
button
 Electronic: Until the thermometer beeps
 Mercury Oral: Three minutes
 Mercury Rectal: Three minutes
 Mercury Axillary: Ten minutes
BE CAREFUL ON RECTAL
AND AXILLARY TEMPS
 Always hold the thermometer in place
while measuring both temperatures
 Always use lubricant with rectal
temperatures
 Always remove clothing around axilla
READING THE
THERMOMETER
 Mercury Fahrenheit thermometers are
read by degree and 0.2 of a degree
 Long lines indicate degrees
 Short lines indicate 0.2 of a degree
 Four short lines between each long line
(0.2, 0.4, 0.6, 0.8)
Factors affecting vital signs
 Sleep
 Activity
 Eating wait 15 minutes
 Weather
 Noise
 Exercise
 Meds
 Emotions
 Time of day
 Which of the following questions should
you ask for an oral temperature?
 A) when did you eat or drink last?
 B) when did you last ambulate?
 C) when did you last smoke?
 D) Both a and c
 F to C
 F-32 divided by 1.8 equal C
 C to F
 C X 1.8 plus 32 =F
 Which of the following formulas is used to
convert Fahrenheit to Celsius?
 A) Fahrenheit minus 32divided by 1.8
 B) Celsius minus 32 divided by 1.8
 C) Celsius plus 32 X 1.8
 D) Celsius plus 1.8 x 32
PULSE
The wave of blood created by the
heart pumping, that travels along
the arteries.
FIND WHERE TO PULSES
 At points where the artery is between
finger tips and a bony area
 Called pulse points
 Felt with 2-3 fingers, but never the thumb
 The pulse should be measured with which
of the following?
 A) 2-3 fingers
 B) thumb
 C) whole hand
 D) index and baby finger
PULSE POINTS AND THEIR
LOCATIONS
 Temporal
 Radial
 Carotid
 Femoral
 Apical
 Popliteal
 Brachial
 Dorsal Pedalis
 Where is the popliteal pulse located?
 A) on top of the foot
 B) antecubital of the arm
 C) ulna
 D) behind the knee
HOW TO MEASURE?
 Measured in beats per minute
 Count the waves for 60 seconds
 Or, count the waves for 30 seconds -
multiply by 2
NORMS
 Pulse norms are 60 - 100 beats per minute
 Pulses between 90 - 100 are in a gray area -
high normal
 Faster than 100 - tachycardia
 Slower than 60 - bradycardia
 Greater than 100 BPM indicates:
 A) tachycardia
 B) bradycardia
 C) tachypnea
 D) cheyne stokes
QUALITY OF PULSE
 Rhythm: regular or irregular
 Rate: Within the normal limits
 Strength: Strong, bounding, thready
WHAT AFFECTS PULSE
RATES AND QUALITY
 Body Temperature
 Emotions
 Activity Level
 Health of the Heart
RESPIRATION
The mechanical act of breathing in
air (inspiration) and expelling air
(expiration) from the body
 Beats per minute equals:
 A) rate
 B) rhythym
 C) strength
 D) none of the above
RESPIRATION
 Measured in breaths per minute
 Normal range is 12 - 24 breaths per
minute
 Greater than 24 is tachypnea
 Less than 12 is bradypnea
 Watch for rate, depth, quality of breath,
and difficulty in breathing
METHOD OF MEASURING
TPR
 If using a mercury thermometer, measure
the pulse and respiration while waiting
for the temperature
 If using another method of measuring the
temperature, complete the temperature then measure the pulse and respiration
 Keep you fingers on the pulse while
measuring the respiration
CHARTING
 Chart in order temperature - pulse -
respiration.
 Do not write T =, etc.
 Write (Ax) after axillary temperatures
 Write (R) after rectal temperatures
ABBREVIATIONS
 SOB - Short of breath  QID - Four times a
day
pulse, and respiration  QS - Every shift
Within normal limits  QD - Every day
 P.O. - By mouth
 PRN - As needed
 BID -Twice a day
 Ad Lib - At liberty
 TID -Three times a
 B/P - Blood Pressure
day
 VS - Vital Signs
 TPR - Temperature,
ABBREVIATIONS
 SOB
 QID
 TPR
 QS
 WNL
 QD
 PO
 PRN
 BID
 Ad Lib
 TID
 B/P
 VS
ABBREVIATIONS
 Short of breath
 Four times a day
 Temperature, pulse,
 Every shift
and respiration
Within normal limits
 By mouth
 Twice a day
 Three times a day
 Every day
 As needed
 At liberty
 Blood Pressure
 Vital Signs
TERMS
 Eupnea - Normal
 Bradypnea - Slow
breathing
 Orthopnea - Sitting
upright to breath
more easily
 Apnea - No breath
 Hyperpnea - Fast,
deep breathing
 Tachypnea - Fast,
shallow breathing
breathing
 Dyspnea - Painful or
difficult breathing
 Tachycardia - Pulse
rate in excess of 100
bpm
 Bradycardia - pulse
rate less than 60 bpm
TERMS
 Eupnea
 Bradypnea
 Orthopnea
 Dyspnea
 Apnea
 Tachycardia
 Hyperpnea
 Bradycardia
 Tachypnea
TERMS
 Normal Breathing  Slow breathing
 Sitting upright to
breath more easily
 Fast, deep
breathing
 Fast, shallow
breathing
 Painful or difficult
breathing
 Pulse rate in excess of
100 beats per minute
 Pulse rate less that 60
beats per minute
TERMS
 Bounding pulse -
excessively strong
pulse
 Thready pulse - Pulse
rate difficult to palpate
because the heart is not
beating hard enough to
produce a strong wave
of blood. Feels as
though there is a piece
of thread running under
the fingertips.
TERMS
 Bounding pulse
 Thready pulse
TERMS
 Excessively strong
pulse
 Pulse difficult to
palpate because heart
not beating heard
enough
NORM
 Norm:120/80
 Report: 100/60 hypotension
 140/90 hypertension
Factors that affect blood pressure
 Age
 Gender
 Pain
 Emotions
 Weight
 Blood volume
 Exercise
 meds
 Which of the following bp is hypotension?
 A) 140/80
 B) 110/59
 C) 120/60
 D) 120/66
Types of sphygmomanometer
 Aneroid
 Mercury
 electrical
What causes high blood
pressure?
 The arteries constrict and the blood can’t
easily pass causing the heart to pump
harder.
 Primary causes: hereditary, obesity,
sedentary lifestyle, diet, and race
Secondary: hypertension
 Kidney disease
 Brain disorders
 PIH
 Which of the following are secondary
reasons for hypertension?
 A) kidney disease
 B) smoking
 C) race
 D) diet
Treatment
 medication
DIET
smoking
Low salt diet
Complications of hypertension
 Arteriosclerosis
 Atherosclerosis
 Retinal detachment
 Aneurysms
 Enlarged hearts
 Left ventricular hypertrophy
 CVA(stroke)
 Blood clots
 90% of heart attacks are due to blood clots
 Renal artery stenosis leads to kidney
deterioration
 Which of the following are possible
complications of hypertension?
 A) enlarged heart
 B) blood clots
 C)aneurysm
 D)all of the above