PPE
•Hand hygiene
•Personal protective equipment (PPE-gloves, masks, eye protection, gowns)
•Standard precautions should be used by healthcare personnel caring for patients regardless of the patient’s diagnosis
What are standard precautions?
•drop in blood pressure noted when patient moves from a lying to a standing position
What is orthostatic hypotension?
•If sitting, seat the patient comfortably back supported
•legs uncrossed
•palm facing up
•the arm resting at the level of the fourth inter-costal space (heart level) and not tensed
What are recommendations for measuring vital signs?
-always start with this
-use soap and water if hands are visibly soiled or after using the bathroom or from spores contact
-otherwise use alcohol-based rubs
-15 seconds fully to wash hands
-do not forget the back of hands and thumb
-before and after patient care
What is hand hygiene?
Are the sounds heard in auscultation of blood pressure
the sounds arise from a combination of turbulent blood flow and oscillations of the arterial wall
What are korotkoff sounds?
Putting on appropriate personal protective equipment
What is donning?
Oral, tympanic, axillary, temporal,
What is the forms of measuring temperature
Even numbers by 2s
What numbers are on the dial of the manometer?
•Inspection -- see
•Palpation -- feel
•Percussion --air of fluid
•Auscultation --listen
What are general assessment techniques?
Systolic between 140-159
Diastolic 90-99
What is the hypertension stage?
What is doffing?
For every 1°F (0.6°C), the temperature rises, the pulse rate increases on average about 10 beats/minute]
Fever increases the pulse and respiratory rate
What is the rule of thumb?
•0 Absent – not palpable
•1+ Diminished – barely palpable
•2+ Normal strength
•3+ Strong – full increased
•4+ Bounding against fingertips
What is the scoring amplitude of a pulse?
used to obtain a self-report of pain from children or older or those that do not understand
What is defense and veterans pain rating scale?
Measures the pressure in the arteries when the heart muscle contracts
Highest number
What is systolic?
PPE
BP cuff
Watch with second hand
Stethoscope
Equipment
Measuring how much oxygen the blood is carrying
Observing the patient's rise and fall of the chest area or counting the number of respirations for 60 seconds
What is assessing pulse oximetry and counting respirations?
•Palpate the brachial artery for viable pulse.
•Position the arm so that the brachial artery is at heart level.
•If below heart level, will be higher
•If above heart level, will be lower
•If patient is seated, rest arm on table a little above patient’s waist.
You may use a paper measuring tape, and measure the circumference of the midpoint of the upper arm between the shoulder and the elbow to help choose the correct cuff size for your patient
What is choosing cuff size?
Increased respirations over 20 respirations in 1 minutes
What is tachypnea?
Bacteria can survive for days on patient care .....
What is the equipment?
Holding your watch in the opposite hand, start counting the pulsations for 30 seconds
What is heart rate?
Inflation bulb
air-release valve
manometer
arm cuff
stethoscope
What are the components of the blood pressure equipment?
•Check placement of stethoscope
•Check that stethoscope turned to correct side
•Consider possibility of shock
•Try to amplify using special techniques
How to measure weak or inaudible korotkoff sounds?
Nasal flaring
Sternal retractions
tripoding
use of accessory muscles
trachypnea
cyanotic
What are signs of pediatric respiratory distress?