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Define Various determinations that provide information about the patients basic body condition Often the first sign that there is a problem. Vital Signs. VITAL SIGNS. Temperature Pulse Respirations Blood Pressure. Other Vital Signs. Pain assessment Skin color Pupil size and reaction
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Define Various determinations that provide information about the patients basic body condition Often the first sign that there is a problem Vital Signs
VITAL SIGNS • Temperature • Pulse • Respirations • Blood Pressure
Other Vital Signs • Pain assessment • Skin color • Pupil size and reaction • Level of consciousness • Response to stimuli
Temperature • Measurement of the balance between heat loss and heat produce • Types • Oral - mouth • Rectal - rectum • Axillary - armpit • Aural (tympanic) – ear
Heat Produced Metabolism of food Muscle and gland activity Heat Lost Perspiration Respiration Excretion of feces and urine Heat Produced and Lost
Normal Body Temperature • Normal range 97 – 100 degrees F
Lower in morning Higher in evening Eating or drinking anything hot or cold, smoking a cigarette or exercising in the last 15 minutes Measured in degrees Celsius or degrees Fahrenheit Variations in Normal Body Temperature
Oral Temperature • Taken in the mouth • Thermometer left in for 3-5 minutes • Most common, convenient, comfortable way to take temperature • Check for eating/drinking anything hot/cold exercising or smoking a cigarette 15 minutes prior
Rectal Temperature • Taken in the rectum • Thermometer left in for 3-5 minutes • Most accurate • Insert 1-1 ½ inches, hold in place and screen patient for privacy
Axillary/Groin Temperature • Taken under the armpit or in the groin fold • Thermometer left in for 8-10 minutes • Least Accurate • Dry armpit/groin, place in center and hold in place
Aural/Tympanic Temperature - taken in the ear - measures the thermal infrared energy radiating from the blood vessels in the eardrum - position and ear wax can affect readings -left in until it beeps -temperature is calculated into an equivalent by mode
Temperature By Body Site • Oral • Normal temp 98.6 • Normal Range 97.6-99.6 • Rectal • Normal temp 99.6 • Normal Range 98.6-100.6 • Axillary/groin • Normal temp 97.6 • Normal Range 96.6-98.6 • Tympanic • Normal temp 98.6
Factors that Increase Temperature • Illness • Infection • Exercise • Excitement • High temps in the environment
Factors that Decrease Temperature • Starvation/fasting • Sleep • Decreased muscle activity • Mouth breathing • Exposure to cold temperatures • Certain diseases
Temperature Conditions • Hyperthermia • Increased body temp • Body temp >104ºF • >106 ºF will cause convulsions and death • Fever • temp over 101 ºF R • Due to illness or injury
Temperature Conditions • Hypothermia • Body temp below 96 ºF • due to exposure to cold temperatures • Depends on core temperature, age and length of exposure
Types of Clinical Thermometers • Clinical thermometers • Slender glass tube containing mercury or colored fluid • Types • Oral – blue tip, long slender bulb, marked oral • Security – plain tip • Rectal – red tip, short stubby bulb, marked rectal
Mercury Thermometers • Not used now • Colored column of red alcohol • Toxic to the body and environment • Can be absorbed through the skin and inhaled as a vapor through the lungs • Heavy metal that accumulates in the brain and causes mental retardation
Clean up Broken Mercury Thermometer • Use appropriate PPE’s • Do not touch mercury • Seal in a glass container • Dispose according to regulations
Electronic Can be used for oral, rectal, or axillary Blue probe for oral Red probe for rectal Disposable probe covers prevent cross-contamination Types of Thermometers
Tympanic - used to record temperature in the ear - Records temperature in 1-3 seconds
Positioning the Patients Ear for Tympanic temperature • Infants under 1 year • Pull ear pinna straight back • Infants over 1 year and adults • Pull ear pinna straight back and down • Positioning the pinna correctly straightens the auditory canal so the probe will point directly at the tympanic membrane • Pull ear pinna straight back and down
Reading Thermometers • Digital thermometers -until you hear the beep •Tympanic thermometers - hold in place for 2-3 seconds, remove and read
Reading a Glass Thermometer • Hold thermometer at eye level • Find the column of mercury/red liquid • Each long hash mark represents one degree • Each short hash mark represents 2/10th of a degree • Exception: long line at 986 ºF represent normal body temperature
Charting a Temperature • Use a superscript to record 10th’s • 102.2 should be written as 102.2 • This avoids errors • Use a TPR Chart • Mark temp under correct date and time • Indicate method of taking temperature - R - rectal - Ax – axillary - T - tympanic • No abbreviation indicates an oral temp
Clean A Clinical Thermometer • Use warm water to clean and rinse • Soak in a disinfecting solution such as alcohol for 20 minutes