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VITAL SIGNS
BLOOD PRESSURE PULSE TEMPERATURE RESPIRATIONS
WHY MEASURE VITAL SIGNS?
REFLECTIVE OF THE HEALTH STATUS OF AN INDIVIDUAL
EASILY OBTAINABLE
BLOOD PRESSURE
1 in 3 Americans have high blood pressure
31.6% of persons that have high blood pressure are unaware that they have it
High blood pressure(hypertension) significantly increases the risk for heart disease and stroke
What is Blood Pressure?
Blood pressure is the force in the arteries when the heart beats(systolic), and when the heart is at rest(diastolic)
Blood pressure is measured in millimeters of mercury(mmHg)
HEART FUNCTION IN BP
NORMAL BLOOD PRESSURE
HYPERTENSION
PERSISTENTLY ELEVATED BLOOD PRESSURE – CURRENT
STANDARDS > 140/90
METHODS FOR OBTAINING A BLOOD PRESSURE
DIRECT – Direct intra-arterial measurement with a catheter
INDIRECT – Compression of the brachial artery using a sphygmomanometer(blood pressure cuff)
INDIRECT METHOD OF OBTAINING A BLOOD
PRESSURE
Introduced in 1896 by Riva Rocci The method involves occluding the
brachial artery and listening for audible sounds
These sounds are called “Korotkoff” sounds named after the Russian physician that described them
Systolic – Pressure at which the sounds first appear
Diastolic – Pressure at which the sounds are no longer audible
EQUIPMENT FOR OBTAINING A BLOOD
PRESSURE
DEVICES FOR OBTAINING A BLOOD PRESSURE
STETHOSCOPE
PLACEMENT OF EAR PIECES
METHOD FOR TAKING A BP
SEAT THE PATIENT IN A COMFORTABLE POSITION
SELECT THE APPROPRIATE SIZE CUFF
Adult – The bladder should encircle 80% of the arm
Children – The bladder should encircle 100% of the arm
Palpate and locate the brachial artery
Position the cuff so the bladder is over the artery and the cuff is 1-2cm above the
antecubital fossa
Position the cuff so you can see the manometer
Inflate the BP cuff Inflate to 70 mm
Hg and increase by 10 mm until the radial pulse disappears
Note this level and inflate the cuff 20 -30 mm Hg more to overcome an ausculatory gap
Recording the BP Place the
stethoscope over the brachial artery just above the antecubital fossa
Inflate the cuff slowly, then release the valve
Record the systolic and diastolic readings
First sounds heard will be the systolic
Continue deflating the cuff until the last sound is heard the diastolic
Measurement should be repeated after 30 seconds
The blood pressure is the average of the two readings
ERRORS IN TAKING BP
Cuff too big – BP too high Cuff over clothing – inaccurate
reading Stethoscope occluding ear –
distorted sound Stethoscope turned incorrectly –
no sound
PULSE Palpate the radial
artery Use the middle and
index fingers(NO thumb)
Count the pulses for 15, 30 seconds and X
Count the pulses for 1 minute
RESPIRATIONS Seat the patient in a quiet
comfortable environment Count the number of times the chest
rises and falls in 30 or 60 seconds Average number of respirations 12 –
20/minute Bradypnea – Slower that 12/minute Tachypnea - Persistent over
20/minute
TEMPERATURE
TEMPERATURE
ORAL
AXILLARY - LOWER
RECTAL - HIGHER
PRACTICE!!!!
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