Lecture 2-Vital Signs

Lecture 2-Vital Signs - Vital signs CindyFenskeRN,MS, Vital...

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Cindy Fenske RN, MS,  Vital signs
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Vital Signs Definition:  Respiratory and  heart rates, blood pressure  measurement and temperature
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Vital signs ü Appropriate assessment: ü During physical exams ü Screenings during health fairs, blood  donations ü During home visits ü Before and after diagnostic /surgical  procedures ü Upon admission and discharge from health  care facility, ü Prior to administration of certain medications
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Vital signs ü Documentation: * Imperative! To establish baseline and trends  
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Blood pressure ü Definition: Force of the blood against  the arterial walls ü  Systolic pressure (top number. High  number. Amount of pressure in blood  vessels when the heart is pumping).  and diastolic pressure (amount of  pressure in blood vessels when the  heart is resting). ü Pulse pressure (the difference  between the systolic and the diastolic  pressure). 
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Blood pressure ü Regulation: ü Peripheral resistance—the resistance  the blood encounters as it flows within  the vessels ü Pumping action of the heart ü Blood volume ü Viscosity of blood ü Elasticity of vessel walls
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Blood pressure ü Influencing factors ü Gender ü Stress ü Medications ü Circadian rhythms ü Race ü Exercise ü Body weight
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Blood pressure ü Routes of monitoring: ü Directly via arterial line(looks  like an IV that is inserted into  the arterial line in the wrist;  gives a direct and continuous  BP reading).  ü Auscultation—to listen; use a  stethoscope ü Palpation– a way to estimate  systolic BP if physician and  patient aren’t sure what 
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Blood Pressure CAUSE SYSTOLIC BP CORRECTIVE ACTION Sit without back support + 6 to 10 Support back (sit in chair) Full bladder + 15 Empty bladder before BP taken Tobacco/caffeine use + 6 to 11 Don’t use before clinic appointment BP taken when arm is: Parallel to body Unsupported Elbow too high Elbow too low + 9 to 13 + 1 to 7 + 5 False low While seated in chair, patient’s arm must be straight out and supported, with elbow at heart level “White coat” reaction + 11 to 28 Have someone else take the BP Talking or hand gestures + 7 No talking or use of hands during BP Cuff too narrow/small + 8 to 10 Right-sized cuff properly placed over bare upper arm Cuff too wide/large False low Cuff not centered + 4 Cuff over clothing + 5 to 50 (Pickering et al., 2005; Perry & Potter, 2006)
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BP – It’s all about the Numbers! Terminal Digit Preference
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Lecture 2-Vital Signs - Vital signs CindyFenskeRN,MS, Vital...

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