Đang tải... (xem toàn văn)
Chapter 6 - Obtaining vital signs and measurements. After completing chapter 6, you will be able to: Describe vital signs and common body measurements; differentiate measurement systems; identify the instruments used to measure vital signs and body measurements; carry out vital signs and body measurements of infants, children, and adults;…
CHAPTER Obtaining Vital Signs and Measurements © 2011 The McGraw-Hill Companies, Inc All rights reserved 62 Learning Outcomes 6.1 Describe vital signs and common body measurements 6.2 Differentiate measurement systems 6.3 Identify the instruments used to measure vital signs and body measurements 6.4 Carry out vital signs and body measurements of infants, children, and adults © 2011 The McGraw-Hill Companies, Inc All rights reserved 63 Learning Outcomes (cont.) 6.5 Recognize abnormal vital signs and body measurements 6.6 Write vital signs and body measurements using accurate terminology and abbreviations 6.7 Implement growth charts © 2011 The McGraw-Hill Companies, Inc All rights reserved 64 Introduction • Vital signs – Temperature – Pulse – Respirations – Blood pressure – Pain assessment • Body measurements – Height – Weight – Head circumference Vital signs and body measurements are used to evaluate health problems Accuracy is essential © 2011 The McGraw-Hill Companies, Inc All rights reserved 65 Vital Signs • Provide information about patient’s overall condition • Taken at each visit and compared to baseline • Protected health information – HIPAA © 2011 The McGraw-Hill Companies, Inc All rights reserved 66 Temperature • Febrile – body temperature above patient’s normal range – Fever – sign of inflammation or infection – Hyperpyrexia – extremely high temperature • Afebrile – normal body temperature © 2011 The McGraw-Hill Companies, Inc All rights reserved 67 Temperature (cont.) • Measurements Ear Mouth Temperature Routes Axilla Rectal Temporal Artery – Degrees Fahrenheit (°F) – Degrees Celsius (centigrade; °C) • Normal adult oral temperature – 98.6°F – 37°C © 2011 The McGraw-Hill Companies, Inc All rights reserved 68 Thermometers • Electronic digital thermometer – Accurate, fast, easy to read – Comfortable for the patient • Tympanic thermometer • Temporal scanner • Disposable thermometer – Single use – Less accurate Disposable sheaths are used with electronic thermometers to prevent cross-contamination © 2011 The McGraw-Hill Companies, Inc All rights reserved 69 Taking Temperatures • Measure to nearest tenth of a degree • Oral temperatures – Wait at least 15 minutes after eating, drinking, or smoking – Place under tongue in either pocket just offcenter in lower jaw © 2011 The McGraw-Hill Companies, Inc All rights reserved 610 Taking Temperatures (cont.) • Tympanic temperatures – Proper technique essential – Adult – pull ear up and back – Child – pull ear down and back – Fast, easy to use, and preferred in pediatric offices © 2011 The McGraw-Hill Companies, Inc All rights reserved 640 Correct! Apply Your Knowledge A 26-year-old athlete visits the medical office for a routine checkup The medical assistant takes T-P-R and obtains the following: Temperature 98.8°F, Pulse 52 beats/minute, and Respirations 18/minute What should the medical assistant about these results? ANSWER: The temperature and pulse are within the normal range The pulse of 52 is below the normal range Check the patient’s previous vital sign results Some patients, especially athletes, normally have a low pulse rate, so these results may be within normal limits for this patient © 2011 The McGraw-Hill Companies, Inc All rights reserved 641 Apply Your Knowledge A 67-year-old patient is in the medical office complaining of a headache The blood pressure reading is 212/142 What should the medical assistant in this situation? ANSWER: This blood pressure reading is very high and should be reported to the physician at once The complaint of headache should also be reported to the physician Hypertension is a major contributor to stroke and heart attacks 3 FOR 3! Very Good! © 2011 The McGraw-Hill Companies, Inc All rights reserved 642 Body Measurements • Adults and older children – Height – Weight • Infant measurements – Length – Weight – Head circumference Provide baseline values for current condition and enable monitoring of growth and development of children © 2011 The McGraw-Hill Companies, Inc All rights reserved 643 Body Measurements (cont.) • Adult weight – Taken at each office visit – Record to nearest quarter of a pound • Height of adults – Taken on initial visit and yearly thereafter – Height bar on scale – Record to nearest quarter of an inch © 2011 The McGraw-Hill Companies, Inc All rights reserved 644 Body Measurements (cont.) • Weight of children and infants – Children • Adult scales if able to stand • Held by an adult using the adult scale, and subtract adult weight from total to yield child’s weight Infants Infant scales â 2011 The McGraw-Hill Companies, Inc All rights reserved 645 Body Measurements (cont.) • Height of children and infants – Children • Height bar on scale • Wall charts – Infants • Length measured at each visit • Built-in bar on exam table • Tape measure or yardstick © 2011 The McGraw-Hill Companies, Inc All rights reserved 646 Body Measurements (cont.) • Head circumference of infants – An important measure of growth and development – Tape measure is placed around head at its largest circumference to obtain measurement © 2011 The McGraw-Hill Companies, Inc All rights reserved 647 Body Measurements (cont.) • Other measurements – Diameter of limb – measure both to determine difference in size – Wound, bruise, or other injury – length and width to evaluate healing process – Chest circumference in infants – Abdominal girth in adults © 2011 The McGraw-Hill Companies, Inc All rights reserved 648 Apply Your Knowledge The medical assistant is about to weigh a 6-month-old infant using the infant scale When the medical assistant places the infant on the scale she notices the diaper is very soiled What should the medical assistant do? ANSWER: The diaper could be changed prior to weighing However, if the infant is weighed with the soiled diaper, the medical assistant should weigh the diaper after weighing the infant and subtract the difference to obtain the infant’s accurate weight © 2011 The McGraw-Hill Companies, Inc All rights reserved 649 In Summary 6.1 Vital signs include temperature, pulse, respirations, blood pressure and assessment of pain The most common body measurements are height, weight, and head circumference 6.2 Mathematical formulas used to convert between Celsius and Fahrenheit and kilograms and pounds are: °F = ( °C X 9/5 + 32) [set fraction 9/5 on top] °C = ( °F – 32) X 5/9 [set fraction 5/9 on top] lbs = kb X 2.205 kg = lbs X 0.454 © 2011 The McGraw-Hill Companies, Inc All rights reserved 650 In Summary (cont.) 6.3 Instruments used to measure vital signs and body measurements include a thermometer, temporal scanner, stethoscope, sphygmomanometer, scale, and tape measure 6.4 The procedure to measure vital signs and body measurements is done with extreme care to ensure accuracy Standard Precautions and aseptic technique must be utilized to prevent the spread of infection Document information according to your facility policy © 2011 The McGraw-Hill Companies, Inc All rights reserved 651 In Summary (cont.) 6.5 All vital signs have a normal range based upon the patient To recognize an abnormality, you must know these ranges In addition, recognizing any significant change in the vital signs of a particular patient, even if they are not outside of the normal range, is essential © 2011 The McGraw-Hill Companies, Inc All rights reserved 652 In Summary (cont.) 6.6 Common terminology used when discussing vital signs includes: afebrile, antecubital space, apnea, apex, apical, auscultated blood pressure, axilla, brachial artery, bradycardia, calibrate, Celsius (centigrade), Cheyne-Stokes respirations, dyspnea, Fahrenheit, febrile, hyperpnea, hyperpyrexia, hypotension, meniscus, orthostatic hypotension, palpatory method, positive tilt test, postural hypotension, radial artery, rales, and tachycardia, Common abbreviations used when documenting vital signs include: T = temperature, BP = blood pressure, P = pulse, R = respirations, and VS = vital signs © 2011 The McGraw-Hill Companies, Inc All rights reserved 653 In Summary (cont.) 6.7 To maintain a growth chart, you must accurately measure the height, weight, and head circumference of the infant or child These measurements are plotted on a chart that will identify the growth progress and compare the patient’s size to other children of the same age © 2011 The McGraw-Hill Companies, Inc All rights reserved 654 End of Chapter One way to get high blood pressure is to go mountain climbing over molehills ~ Earl Wilson © 2011 The McGraw-Hill Companies, Inc All rights reserved ... reserved 6 16 Pulse (cont.) • Indirect measurement of cardiac output • Problems if – – – – Tachycardia Bradycardia Weak Irregular • Sites of measurement – Adults – radial artery – Children – brachial... (cont.) • Check respirations – Look, listen, and feel for movement of air – Count with a stethoscope • Count for one full minute – Rate – Rhythm – regular – Effort (quality) – normal, shallow, or deep... temperature – 98 .6 F – 37°C © 2011 The McGraw-Hill Companies, Inc All rights reserved 6 8 Thermometers • Electronic digital thermometer – Accurate, fast, easy to read – Comfortable for the patient