Chapter 9 General Survey Measurement Vital Signs General

General Survey Physical appearance ◦ Age ◦ Gender ◦ Level of consciousness ◦ Skin

General Survey, cont. Mobility ◦ Gait ◦ Range of motion Behavior ◦ ◦ ◦

Measurement Weight ◦ Balance scale ◦ Recommended range for height Height Slide 10 -

Vital Signs Temperature ◦ Hypothalamus as thermostat mechanism ◦ Influences on temperature Diurnal cycle

Vital Signs, cont. Pulse ◦ Stroke volume ◦ Technique of measurement ◦ Rate Normal

Vital Signs, cont. Respirations ◦ Technique of measurement ◦ Normal rate for age group

Vital Signs, cont. Blood pressure ◦ Systolic pressure ◦ Diastolic pressure ◦ Pulse pressure

Vital Signs, cont. Blood pressure measurement ◦ Sphygmomanometer ◦ Cuff width and size ◦

Which patient would be most likely to present with a pulse rate that is

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Chapter 9 General Survey, Measurement, Vital Signs

General Survey Physical appearance ◦ Age ◦ Gender ◦ Level of consciousness ◦ Skin color ◦ Facial features Body structure ◦ Stature ◦ Nutrition ◦ Symmetry ◦ Posture ◦ Position ◦ Body build, contour Slide 10 -

General Survey, cont. Mobility ◦ Gait ◦ Range of motion Behavior ◦ ◦ ◦ Facial expression Mood and affect Speech Dress Personal hygiene Slide 10 -

Measurement Weight ◦ Balance scale ◦ Recommended range for height Height Slide 10 -

Vital Signs Temperature ◦ Hypothalamus as thermostat mechanism ◦ Influences on temperature Diurnal cycle Menstrual cycle Exercise Age ◦ Routes of temperature measurement Oral Electronic thermometer Axillary Rectal Tympanic membrane thermometer (TMT) Temporal Thermometer Slide 10 -

Vital Signs, cont. Pulse ◦ Stroke volume ◦ Technique of measurement ◦ Rate Normal rate for age group Bradycardia <60 Tachycardia >100 ◦ Rhythm Sinus arrhythmia ◦ Force ◦ Elasticity Slide 10 -

Pulse rate-adult

Children

Vital Signs, cont. Respirations ◦ Technique of measurement ◦ Normal rate for age group Slide 10 -

Vital Signs, cont. Blood pressure ◦ Systolic pressure ◦ Diastolic pressure ◦ Pulse pressure ◦ Mean arterial pressure (MAP) ◦ Influences on blood pressure: Age Sex Race Diurnal rhythm Weight Exercise Emotions Stress ◦ Physiologic factors controlling blood pressure: Cardiac output Peripheral vascular resistance Volume of circulating blood Viscosity Elasticity of vessel walls Slide 10 -

Vital Signs, cont. Blood pressure measurement ◦ Sphygmomanometer ◦ Cuff width and size ◦ Blood pressure measurement in the arm Position of person Palpate brachial artery Proper inflation and deflation technique Korotkoff’s sounds I, systolic pressure IV, muffling of sounds V, diastolic pressure ◦ Common errors in blood pressure measurement ◦ Orthostatic (or postural) hypotension ◦ Blood pressure measurement in the thigh Thigh pressure higher than in the arm Screen for coarctation of aorta Slide 10 -

Blood Pressure

Estimating Blood Pressure

Which patient would be most likely to present with a pulse rate that is lower than normal? A 70 -year-old telephone salesman presenting with dehydration. B. A 20 -year-old runner who had surgery 4 days ago for a fractured leg. C. A 67 -year-old who presented with an exacerbation of his COPD A. Sli de 915