Transcript Factor effect on body temperature

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Definition:
There are four objective assessment data that
indicate how well body is functioning and very
sensitive to alteration in physiology.
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Times to assess vital sign:
1) On admission to health care agency to obtain
base line data.
 2) When client has change in health status.
 3) Before and after surgery.
 4) Before and after administrat6ion of
medication.
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5) Before and after any nursing intervention
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1)Body temperature:
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Definition: the balance between the heat
production and heat lost from the body,
measured in heat unit called degree.
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* Fahrenheit scale uses 32F as the water
freeze point and 212F as boil point.
 *centigrade scale uses 0 as the water
freeze and 100C as boil point.
 Normal body temperature:
 98 – 98.6 F
 36.4 – 37.4 C
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Two type of body temperature:
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Core temperature: is the temperature of
deep tissue of the body such as thorax,
abdominal cavity. it relatively constant.
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Surface temperature:
is the temperature of skin, subcutaneous
tissue rise and fall in response to
environment.
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Factor effect on body heat production:
 Basal metabolic rate: is rate of energy
utilization in the body required to maintain
essential activity (metabolism).
 Metabolism:
the primary source of energy is
the sum of all the chemical process that
occurs in the body.
Muscle activity.
 Thyroxin out put.
 Epinephrine.
 Fever.
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Way of heat loss:
Radiation: is transfer of heat from one
object to another object with out contact.
 Conduction: is transfer of heat from one
molecules to another of lower
temperature.
 Convection: dispersion of heat by air
current.
 Evaporations: continuous evaporation of
the moisture from the respiratory tract.
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Temperature regulation:
Hypothalamus: a structure within the
brain that helps controls various metabolic
activities.
It acts as the center of temperature
regulation.
 When sensor of hypothalamus detect
heat, they send signals intend to reduce
temperature
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Factor effect on body temperature:
Age
 Circadian rhythm
 Exercise
 Hormones
 Stress
 Environment.
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Terms:
Pyrexia: body temperature above the usual
range (fever). (38 – 40).
 Hyperpyrexia: very high temperature more
than 40 C.
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Hypothermia : body temperature less than 35.
My be induced or accidental.
 Note: the client who has a fever is referred to as
febrile, the one who has not called A febrile.
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Clinical sign of fever:
Increase heart rate
 Increase respiratory rate
 Shivering
 Palled
 Cyanotic nail beds
 Increase thirst.
 Loss of appetite.
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Assessment site:
 Oral site: mouth, convenient, it is contraindicated for:
uncooperative client, children, unconscious, shivering
and prone to seizers.
Delay taking oral temperature at least 10min if client
been smoking, eating hot or cold food or drinks.
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Rectal site: can be embarrassing for alert client,
inconvenient, improper placement, stool in rectum.
Auxiliary: are preferred site for infant, unconscious
patient but it takes long time about 5 min.
Tympanic: tympanic membrane suitable for children,
more reliable for core temperature.
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Type of thermometer:
Mercury glass thermometer.
 Electronic thermometer.
 Skin tape.
 Tympanic thermometer.
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Four common types of fevers
Intermittent: the temperature alternate
regular interavel between period of fever.
 Remittent: it is wide range of of
temperature fluctuation, all of which are
above normal.
 Relapsing fever: is short febrile period
of a few days with period 1-2 days.
 Constant fever always remain above
normal.
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2) Pulse:
Is the wave of blood created by
contraction of the ventricles of the heart.
 Cardiac out put = Stroke volume * heart
rate.
Two type of pulse:
 Peripheral pulse is pulse located in
peripheral of the body, foot, hand.
 Apical pulse is centered pulse located
above the apex of the heart.
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Factor effect the pulse:
 Age.
 Exercise.
 fever
 medication
 Hemorrhage.
 Stress.
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Pulse site:
 temporal
 radial
 carotid
 apical
 brachial
 posterior tibial
 Dorsal spedis pulse.
 Popliteal
 Femoral
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Pulse sites
Temporal: where the temporal artery
pass over the temporal bone.
 Carotid: at the side of the neck where
carotid artery runs between the trachea
and sternoclidomastiod muscle.
 Apical: at the apex of the heart.
 Brachial: at the inner aspect of the
biceps tendon or medial antecubital fossa.
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Pulse sites
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Femoral: where the femoral artery passes
along side of inguinal ligaments.
Radial: on the long radial bone, on thumb side
of the inner aspect of the wrist.
Popliteal: behind the knee.
Positerior tebial: behind the medial malleolus.
Dorsalis pedis: on the dorsum of the foot,
upper surface.
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Terms:
Tachycardia: when pulse increase more
than 100 bm.
 Bradycardia: when pulse decrease less
than 60 bm.
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Respiration:
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Definition: is act of breathing, the
normal respiratory rate is 16 – 20 bpm.
Two types of respiration:
 External: the exchange of oxygen and
carbon dioxide between the alveoli of the
lung and blood.
 Internal: is the exchange of the same
gas between blood and cell of the body
tissue
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The muscle that contribute in the
respiration:
 Diaphragm muscle ( main muscle).
 Intercostals muscle.
 Sternoclidomastiod muscle.
Note:
 In female, observe chest movement.
 In male, observe abdominal movement.
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Terms:
Inhalation (inspiration): intake of air into lung.
 Exhalation (expiration): breathing out or the
movement of gases from the lung in to atmosphere.
 Breathing pattern:
1) Volume:
 Hyperventilation: refer very deep and rapid
respiration.
 Hypoventilation: refer to shallow respiration.
 Eupnea: normal respiratory rate and depth.
 Bradypnea: slow breathing.
 Tachypnea: fast respiratory rate.
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Mechanism of respiration:
 During inhalation: the diaphragm
contracts( flatten) and the ribs move up
wards and out ward and the sternum
move out ward.
 Exhalation: the diaphragm relaxes, ribs
moves down ward and inwards the
sternum move in ward and decrease the
size of thorax.
 Inspiration time 1 – 1.5 sec.
 Expiration time 2 – 3 sec.
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Regulation of respiration:
 Controlled by respiratory
center in the medulla
oblingata.
 Chemoreceptor located
centrally in medulla and
peripheral in carotid and
aortic body.
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Factor influence of respiratory rate:
Exercise.
 stress
 Environmental factor.
 Increase altitude.
 Certain medication (narcotic)
 Increased intracranial pressure.
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4) Blood pressure:
Definition: is measure of pressure
exerted by the blood as it flows through
the arteries.
 Systolic blood pressure: the pressure
of the blood as result of contraction of the
ventricles.
 Diastolic blood pressure: the pressure
when the ventricles are at rest
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The differences between the diastolic and
systolic pressure called pulse pressure.
 The normal blood pressure reading:
systolic 100 – 140 mmhg and diastolic
60 – 90mmhg.
 Example: (130/80), 130= systolic, 80 =
diastolic, 50 = pulse pressure.
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Determinant of blood pressure:
a) Cardiac out put (COP).
b) Peripheral resistance (PR).
Some factor effect on peripheral
resistance:
1) Size of artery.
2) Compliance of arteries.
3) Viscosity.
c) Blood volume.
d) Blood viscosity
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Factor effect on the blood pressure:
1) Age.
2) Exercise.
3) Stress.
4) Obesity.
5) Sex.
6) Medication.
7) disease process.
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Hypertension: blood pressure that is
persistent above the normal.
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hypotension: the blood pressure is blow
normal range.
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Part of sphygmomanometer:
a) Cuff. b) Mercury meter. c) Tubes.
d) Bulp.
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The recommended bladder size for blood
pressure measurement for adult:
13cm width, 24cm length, for children
8cm width, 13cm length.
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The correct way to measure your blood pressure is:
Do not use caffeine, tobacco, or alcohol for 30 minutes
before you measure.
 Measure your blood pressure when you first wake up
and before dinner. (Unless your doctor tells you other
times.)
 Before you measure your blood pressure, sit in a chair
with a back on it for 3-5 minutes, and do not talk. Use
the correct sized cuff for your arm
 Put the cuff in the proper place on your arm by placing
the arrow or tubing on the inside of the elbow
 Keep your arm at heart level while doing a blood
pressure measure
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