Chapter 9



Chapter 15 Notes

Measuring Height, Weight, and Vital Signs

• Measure some of the body’s essential functions

• Information is essential for hc professionals to monitor the patient’s condition and diagnose, treat, and prevent many disorders

Ch 15.1 - HEIGHT AND WEIGHT

Weight

• Baseline measurement at patient’s first visit

• Required for pregnant patients, infants, children, older adults, patients prescribed medication based on body weight, those attempting to lose or gain weight, & those with certain conditions

• Types of scales: balance beam, dial, digital

• Units of measurement: kg or lbs

Height

• Measured by movable ruler on back of most balance beam scales or mounted on wall

• Parallel bar on ruler is moved down against patient’s head

• Units of measurement: inches or cm

Ch 15.2 - TEMPERATURE

Overview

• Balance between heat produced by body & that lost by body

• Core temperature: relatively constant internal temperature of body

• Normal: 97°F to 99°F (36.1°C to 37.2°C)

• Afebrile: normal body temperature range

• Febrile: above (99°F (37.2°C) or feverish

• Hypothermic: below (95°F (35°C)

Factors Influencing Body Temperature

• Brain Control

o Hypothalamus: part of brain that regulates body temperature

o If body too cool, brain signals to conserve & generate heat through shivering

o If body too warm, brain signals to carry heat away from core to surface and produce perspiration

• Causes of Temperature Change

o Age: higher in children than adults; lower in older adults

o *Temperature of very young and very old are easily affected by the environment

o Gender: slightly higher in women

o Exercise: increases temperature

o Time of day: lowest in early morning, before activity

o Emotions: rises with stress, falls with depression

o Illness: can increase or lower

Sites for Measuring Temperature

• Mouth (most common)

• Rectum (most accurate)

• Axillary: ear or temple (best for children)

Types of Thermometers

• Electronic

• Tympanic (ear)

• Temporal Artery (forehead)

• Disposable

Ch 15.3 - PULSE

Overview

• Pulse (P)= heartbeat= expansion & relaxation of arteries = heart rate

• Indicates flow of blood to a particular area

Factors Influencing Pulse

• Age: greater in infants, children, & some older adults

• Fitness: lower in conditioned athletes

• Time of day: lower in early morning, higher later in day

• Body type & size: lower in tall, thin people; higher in shorter, stockier people

• Exercise: higher during exercise

• Stress or emotion: higher in anger, fear, excitement, & stress; lower in depression

• Fever: higher during fever

• Medications: higher or lower

• Blood volume: higher with decreased blood volume

Pulse Sites

• Carotid artery (neck)

• Brachial artery (bend of elbow)

• Radial artery (wrist)

• Femoral artery (thigh/torso)

• Popliteal artery (back of knee)

• Posterior tibial artery (ankle)

• Dorsalis pedis (top of foot)

• Apical (with stehoscope over left ventricle of the heart)

Pulse Characteristics

• Pulse rate

o # of heartbeats in 1 min (bpm)

o Average: 60 to 100 bpm

o Bradycardia: pulse 100 bpm

• Pulse rhythm

o Pattern of heartbeats

o Arrhythmia: abnormal heart rhythm

• Pulse strength: soft, bounding, weak, thready, strong, or full

Taking a Pulse Manually

• Place index & middle fingers or middle & ring fingers (or all 3) over pulse point

o Thumb should NOT be used since your own pulse can be felt in your thumb

• Radial artery (on inside of wrist) is most common site

• Count heartbeats for 30 seconds (& multiply by two) or for 1 full minute

Using a Stethoscope

• Auscultate: to hear a pulse

• Place stethoscope over patient’s heart

• Doppler ultrasound stethoscope: amplifies sound of pulse; used when pulse is difficult to palpate

Ch 15.4 - RESPIRATION

Overview

• Respiration (R)= Exchange of gases between atmosphere & blood in body

• Inhale (breathing in O2): air flows into lungs, diaphragm contracts & flattens out, & rib cage rises & expands

• Expire (breathing out CO2): air flows out of chest cavity, diaphragm relaxes & moves into dome-like shape, & rib cage contracts

• Each respiration: 1 full inhalation & 1 full expiration

Characteristics of Respiration

• Rate

o # of respirations per minute

o Normal (adults): 12 to 20 times per minute

o Eupnea: normal respiration

• Rhythm: pattern of spacing/time between breaths

• Depth: volume of air inhaled & exhaled

Factors Influencing Respiration

• Physical condition

• Disease

• Medication

• Exercise (

• Pain(

• Emotions (

Breathing Conditions

• Tachypnea: fast respiratory rate

• Bradypnea: slow respiratory rate

• Dyspnea: difficult or labored breathing

• Orthopnea: condition in which breathing is easier in an upright position

• Apnea: temporary cessation of breathing

Assessing Respiration

• 1 respiration = the complete cycle of one rise and one fall of a patient’s chest

• Place hand on chest if movement not visible

• Count respirations for 30 seconds (& multiply by 2) or 1 full minute

• Note any abnormal sounds: wet, dry (crackles), high-pitched (wheezes)

Ch 15.5 - BLOOD PRESSURE

Overview

• Blood Pressure (BP)= Pressure of blood against arterial walls during contraction & relaxation phases of heartbeat

• Systolic pressure: highest pressure level in arteries during contraction (first sound)

• Diastolic pressure: lower pressure level when heart relaxes

• Measured using stethoscope & sphygmomanometer (blood pressure cuff)

• Measured in millimeters of mercury (mm Hg)

• Written as systolic/diastolic

• Normal: ................
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