Vital+Signs

Vital Signs Group Project Goes here - describe how to measure the vital sign, what precautions (if any) need to be taken when taking the particular vital sign, anything special to be aware of when measuring a vital sign, etc. Pictures, video, sound file are all strongly encouraged. DO NOT repeat what a classmate has already said or embedded. DO add something to each area.

__**Diastolic Blood Pressure:**__

Here are the tools: A Stethoscope and a Sphygmomanometer. Make sure you place the round end of the stethoscope 'under' the blood pressure cuff. You inflate the sphygmomanometer (blood pressure cuff) to a little above 180 mm Hg. This collapses the major arteries to the arm (that's why it is uncomfortable). Then you __slowly__ release air by gently turning the air valve, and watch the pressure drop. When you first hear a sound, that will be the **Systolic** blood pressure. The sound you hear is the blood now flowing in the artery of the arm. This means that the systolic pressure is now greater than the pressure in the blood pressure cuff. As you continue to watch the pressure drop, when you no longer hear any sounds, that will be the **Diastolic** blood pressure.

Diastolic blood pressure measures the pressure in your blood vessels between heartbeats (when your heart is resting). Represented by the bottom number in a blood pressure reading, diastolic blood pressure is considered low when the blood pressure reading is below 60; a diastolic blood pressure reading higher than 90 is considered high. Lifestyle changes, such as losing weight, can help lower diastolic blood pressure

Diastolic blood pressure changes frequently throughout the day. Things that can make diastolic blood pressure change within a few minutes include:
 * Posture
 * Level of exercise
 * Amount of tension
 * Nicotine use.

**__Temperature:__ **

Temperature can be measured is several different ways:
 * **Oral** with a glass, paper, or electronic thermometer (normal 98.6F/37C)
 * **Axillary** with a glass or electronic thermometer (normal 97.6F/36.3C)
 * **Rectal** or "core" with a glass or electronic thermometer (normal 99.6F/37.7C)
 * **Aural** (the ear) with an electronic thermometer (normal 99.6F/37.7C)
 * **Temporal** temperature is taken by a special temporal sanning thermometer that measure temperature in the temporal artery

Variations in Body Temperature: Some people have accelerated body processes and have higher temperatures. The ones that have slower usually have lower temperatures. The time of day matters because people in the morning tend to have a lower temperature since thier body is rested. while later in the day muscle activity has occurred so the temperature is higher. Also as you see above the temperature of where things are taken also has an affect on temperature.

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 * __Pulse:__ **

Pulse can be measured in these places: Cartoid- At the nneck either side of the trachea Brachial- Inner aspect of the forearm at the antecubital space (crease of the elbow) Radial- At the inner aspect of the wrist, above the thumb Femoral- At the inner aspect of the upper thigh where the thigh joins whith the trunk of the body Popliteal- Behind the knee Dorsalis Pedis- At the top of the foot arch

Usual way to take pulse: Normal Pusles:
 * 1) Sit or stand facing your patient.
 * 2) Grasp the patient's wrist with your free (non-watch bearing) hand (patient's right with your right or patient's left with your left). There is no reason for the patient's arm to be in an awkward position, just imagine you're shaking hands.
 * 3) Compress the radial artery with your index and middle fingers.
 * 4) Note whether the pulse is regular or irregular:
 * **Regular** - evenly spaced beats, may vary slightly with respiration
 * **Regularly Irregular** - regular pattern overall with "skipped" beats
 * **Irregularly Irregular** - chaotic, no real pattern, very difficult to measure rate accurately
 * 1) Count the pulse for 15 seconds and multiply by 4.
 * 2) Count for a full minute if the pulse is irregular.
 * 3) Record the rate and rhythm.
 * Adult**: 60-100 beats per minute
 * Adult men:** 60-70 beats per minute
 * Adult women:** 65-80 beats per minute
 * Children over the age of 7:** 70-100 beats per a minute
 * Children range 1-7:** 80-110 beats per minute
 * Infants:** 100-160 beats per a minute



**__Respiration__**

Respiration (breathing) provides a way for the body to exchange of oxygen and carbon dioxide. Respiration is automatically controlled by the brain. A variety of factors can influence respirations, such as: To avoid voluntary changes in rate or depth, it is best to count the respirations in such a way that the patient is not aware they are being counted.
 * Head injury (Depressed with elevation of intracranial pressure)
 * Bleeding (Increased respirations with significant blood loss)
 * Stress (Rapid rate and increased depth)
 * Fever (Increased rate)
 * Hypothermia (Slower rate and shallow breaths)
 * Medications (Narcotics in large doses can depress both rate and depth)
 * Voluntary control can also influence breathing, up to a point.

When observing a patient, the temperature, pulse, blood pressure and respiration (breathing) rates are measured at regular intervals. The values can be plotted on a running chart which clearly shows the patient’s progress over a number of days.
 * __TPR:__** Temperature, pulse, and respiration.

The chart in the link above shows the patients who is recovering after an operation. Note the exact place where the temperature etc is plotted (in the middle of the column).

An Apical Pulse is when a person's pulse is taken from over their heart.
 * __Apical Pulse:__**


 * "How to take an apical (a-pih-kull) pulse:** The apical pulse is your heart rate when counted with a stethoscope (steth-uh-skop) placed over your heart. A watch with a second hand will be needed to take your apical pulse. The following steps may help you take your apical pulse.
 * You should sit up or lie down.


 * Put the tips of the stethoscope into your ears.

> || ||
 * Place the diaphragm (disk part) of the stethoscope over your heart. Your heart is found in the middle of your chest and toward the left side.
 * [[image:http://www.drugs.com/cg/images/en93432.jpg caption="Picture of how to check your own pulse using a stethoscope"]] ||


 * Count the beats for a full minute (60 seconds) when you hear your heartbeat. Notice if your heartbeat sounds strong, weak, or missing beats.


 * Write down your apical pulse rate and the date and time that your pulse was taken. Also write down if you feel your heartbeat is not beating as it usually does.
 * Care:** You or someone else will be taught how to take your pulse rate. Caregivers will tell you how often your pulse should be taken. You may need to take your pulse right before taking a medicine. It is important to write down the pulse rate each time it is taken. You will be told when to call your caregiver about your pulse rate."

[|**http://www.wisc-online.com/objects/index_tj.asp?objID=MEA1004**] Visit this ---^ website to learn more about __apical pulse__. It's a video with heart beat sounds!

About 1 in 3 adults in the United States has HBP. HBP itself usually has no symptoms. You can have it for years without knowing it. During this time, though, it can damage the heart, blood vessels, kidneys, and other parts of your body. This is why knowing your blood pressure numbers is important, even when you're feeling fine. If your blood pressure is normal, you can work with your health care team to keep it that way. If your blood pressure is too high, you need treatment to prevent damage to your body's organs.
 * __Blood Pressure:__**

Blood Pressure Numbers
Blood pressure numbers include systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures. Systolic blood pressure is the pressure when the heart beats while pumping blood. Diastolic blood pressure is the pressure when the heart is at rest between beats. You will most often see blood pressure numbers written with the systolic number above or before the diastolic, such as 120/80 mmHg. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) The table below shows normal numbers for adults. It also shows which numbers put you at greater risk for health problems. Blood pressure tends to goes up and down, even in people who have normal blood pressure. If your numbers stay above normal most of the time, you're at risk.

Risk: Somehow if there are mistake in doing blood pressure then the procedure that going with the patient may be wrong. Before doing blood pressure, M.D and M.A's have to practice a lot since the stethoscope is hard to hear.

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 * ~ Blood Pressure Classification in Adults ||
 * ~ Category ||~ Systolic ||~ Diastolic ||
 * Normal || <140 || <90 ||
 * Isolated Systolic Hypertension || >140 || <90 ||
 * Mild Hypertension || 140-159 || 90-99 ||
 * Moderate Hypertension || 160-179 || 100-109 ||
 * Severe Hypertension || 180-209 || 110-119 ||
 * Crisis Hypertension || >210 || >120 ||