TEMPERATURE, PULSE, RESPIRATIONS

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TEMPERATURE, PULSE, RESPIRATIONS

• Abbreviated TPR

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TEMPERATURE

• The measurement of core body heat

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ROUTES TO MEASURE TEMPERATURE

• Oral By mouth
• Rectally By rectum
• Axillary Under the arm in the armpit
• Tympanic In the ear

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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

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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

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• Which of the following is a normal temperature?
• A) 98.9 axillary
• B) 101 .2 rectal
• C) 99.6 oral
• D) 98.6 rectal

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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.

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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

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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

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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)

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Factors affecting vital signs

• Sleep
• Activity
• Eating wait 15 minutes
• Weather
• Noise
• Exercise
• Meds
• Emotions
• Time of day

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• 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

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• F to C
• F-32 divided by 1.8 equal C
• C to F
• C X 1.8 plus 32 F

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• 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

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PULSE

• The wave of blood created by the heart pumping,
  that travels along the arteries.

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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

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• The pulse should be measured with which of the
  following?
• A) 2-3 fingers
• B) thumb
• C) whole hand
• D) index and baby finger

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PULSE POINTS AND THEIR LOCATIONS

• Temporal
• Carotid
• Apical
• Brachial

• Radial
• Femoral
• Popliteal
• Dorsal Pedalis

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• Where is the popliteal pulse located?
• A) on top of the foot
• B) antecubital of the arm
• C) ulna
• D) behind the knee

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HOW TO MEASURE?

• Measured in beats per minute
• Count the waves for 60 seconds
• Or, count the waves for 30 seconds - multiply by 2

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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

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• Greater than 100 BPM indicates
• A) tachycardia
• B) bradycardia
• C) tachypnea
• D) cheyne stokes

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QUALITY OF PULSE

• Rhythm regular or irregular
• Rate Within the normal limits
• Strength Strong, bounding, thready

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WHAT AFFECTS PULSE RATES AND QUALITY

• Body Temperature
• Emotions
• Activity Level
• Health of the Heart

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RESPIRATION

• The mechanical act of breathing in air
  (inspiration) and expelling air (expiration) from
  the body

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• Beats per minute equals
• A) rate
• B) rhythym
• C) strength
• D) none of the above

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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

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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

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CHARTING

• Chart in order temperature - pulse - respiration.
• Do not write T , etc.
• Write (Ax) after axillary temperatures
• Write (R) after rectal temperatures

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ABBREVIATIONS

• SOB - Short of breath
• TPR - Temperature, pulse, and respiration Within
  normal limits
• P.O. - By mouth
• BID -Twice a day
• TID -Three times a day

• QID - Four times a day
• QS - Every shift
• QD - Every day
• PRN - As needed
• Ad Lib - At liberty
• B/P - Blood Pressure
• VS - Vital Signs

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ABBREVIATIONS

• SOB
• TPR
• WNL
• PO
• BID
• TID

• QID
• QS
• QD
• PRN
• Ad Lib
• B/P
• VS

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ABBREVIATIONS

• Short of breath
• Temperature, pulse, and respiration Within normal
  limits
• By mouth
• Twice a day
• Three times a day

• Four times a day
• Every shift
• Every day
• As needed
• At liberty
• Blood Pressure
• Vital Signs

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TERMS

• Eupnea - Normal breathing
• Orthopnea - Sitting upright to breath more easily
• Apnea - No breath
• Hyperpnea - Fast, deep breathing
• Tachypnea - Fast, shallow breathing

• Bradypnea - Slow breathing
• Dyspnea - Painful or difficult breathing
• Tachycardia - Pulse rate in excess of 100 bpm
• Bradycardia - pulse rate less than 60 bpm

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TERMS

• Eupnea
• Orthopnea
• Apnea
• Hyperpnea
• Tachypnea

• Bradypnea
• Dyspnea
• Tachycardia
• Bradycardia

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TERMS

• Normal Breathing
• Sitting upright to breath more easily
• Fast, deep breathing
• Fast, shallow breathing

• Slow breathing
• Painful or difficult breathing
• Pulse rate in excess of 100 beats per minute
• Pulse rate less that 60 beats per minute

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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.

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TERMS

• Bounding pulse

• Thready pulse

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TERMS

• Excessively strong pulse

• Pulse difficult to palpate because heart not
  beating heard enough

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NORM

• Norm120/80
• Report 100/60 hypotension
• 140/90 hypertension

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Factors that affect blood pressure

• Age
• Gender
• Pain
• Emotions
• Weight
• Blood volume
• Exercise
• meds

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• Which of the following bp is hypotension?
• A) 140/80
• B) 110/59
• C) 120/60
• D) 120/66

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Types of sphygmomanometer

• Aneroid
• Mercury
• electrical

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What causes high blood pressure?

• The arteries constrict and the blood cant easily
  pass causing the heart to pump harder.
• Primary causes hereditary, obesity, sedentary
  lifestyle, diet, and race

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Secondary hypertension

• Kidney disease
• Brain disorders
• PIH

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• Which of the following are secondary reasons for
  hypertension?
• A) kidney disease
• B) smoking
• C) race
• D) diet

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Treatment

• medication

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DIET
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smoking
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Low salt diet
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Complications of hypertension

• Arteriosclerosis
• Atherosclerosis
• Retinal detachment
• Aneurysms
• Enlarged hearts

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• Left ventricular hypertrophy
• CVA(stroke)
• Blood clots
• 90 of heart attacks are due to blood clots
• Renal artery stenosis leads to kidney
  deterioration

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• Which of the following are possible complications
  of hypertension?
• A) enlarged heart
• B) blood clots
• C)aneurysm
• D)all of the above