Vital Signs Lesson 3: Pulse and Respirations

1. Vital Signs Lesson 3: Pulse and Respirations 35

2. Lesson Objectives Upon completion of this lesson, students should be able to … • Define and spell the terms to learn for this chapter. • State the normal values of temperature, pulse, respiratory rates, and blood pressure. • List and describe the nine pulse sites. • Describe the respiratory rate range for the various age groups.

3. The Pulse • The amount of times the heart beats per minute (bpm) • Wave of blood created each time the left ventricle of the heart contracts • Each pulse beat is one cardiac cycle or one heartbeat • Normal heartbeat is about 70 times per minute • Increased oxygen results in a faster pulse rate • Tachycardia = pulse rate above 100 bpm • Bradycardia = pulse rate below 60 bpm

4. Factors that Influence Pulse Rate • Exercise • Age • Gender • Size • Physical condition • Disease states • Medications • Depression • Fear, anxiety, anger

5. Average Pulse Rates by Age • Less than 1 year:120-160 bpm • 2-6 years:80-120 bpm • 6-10 years:80-100 bpm • 11-16 years:70-90 bpm • Adult: 60-80 bpm • Older adult:50-65 bpm

6. Characteristics of Pulse • Rate • Volume • Rhythm • Compliance of the arterial wall

7. Rate and Volume of Pulse • Rate – describes the number of pulse beats per minute • Volume – refers to the strength of the pulse • Volume is noted as: • Full or bounding pulse, indicating an increase in blood volume • A strong or normal amount of force or blood volume • A weak or thready pulse (barely perceptible) force or blood volume

8. Rate and Volume of Pulse • Volume is influenced by the forcefulness of the heartbeat, the condition of the arterial walls, and dehydration • A variance in intensity of the pulse may indicate heart disease

9. Rhythm • Refers to the regularity, or equal spacing, of all the beats of the pulse • Various aspects of rhythm are as follows: • Normally, the intervals between each heartbeat are of the same duration • A pulse with an irregular rhythm is known as a dysrhythmia or arrhythmia • The irregular rhythm may be random irregular beats or a predictable pattern of irregular beats • It is not considered abnormal if the heart occasionally skips a beat – This is referred to as an intermittent pulse

10. Common Pulse Sites • Radial • Brachial • Carotid • Temporal • Femoral • Popliteal • Posterior tibial • Dorsalis pedis • Apical

11. Brachial

12. Radial

13. Carotid

14. Femoral

15. Popliteal

16. Posterior Tibial

17. Pedal (Dorsalis Pedis)

18. Steps in Measuring a Radial Pulse Rate Step 5: Check quality of pulse. Step 4: Place finger tips on radial artery on thumb side of wrist. Step 3: Ask patient to sit down and place arm in a comfortable, supported position. Step 2: Explain procedure to the patient and ask the patient about any recent physical activity or smoking. Step 1: Perform hand hygiene. Identify the patient.

19. Steps in Measuring a Radial Pulse Rate Step 9: Perform hand hygiene and record the pulse beats per minute in the patient’s record. Step 8: Immediately write the pulse beats per minute on a piece of paper. Step 7: Count the pulse for 1 full minute. Step 6: Start counting pulse beats when second had on watch is at 3, 6, 9, or 12.

20. Respiration • The act of breathing • The exchange of oxygen and carbon dioxide • Consists of one expiration and one inspiration • Each rise and fall of a patient’s chest equals one respiration • Taken typically at the same time as a pulse

21. Characteristics of Respiration • Rate • Rhythm • Depth • Quality • Breath sounds

22. Respiratory Rate Ranges by Age Group • Newborn: 30-50 • 1 year old: 20-40 • 2-10 years: 20-30 • 11-18 years: 18-24 • Adult: 14-20

23. Allergic reactions Medications Disease Exercise Emotions Fever Hemorrhage High altitudes Obstruction of air passage Pain and shock Situations that Alter Respirations