Personal Characteristics
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Early – Middle AdulthoodCardiovascular Disease 
Cancer Diabetes Late AdulthoodCerebrovascular Accident Osteoporosis Dementia and Alzheimer’s Abuse and neglect Measuring and Recording Temperature Measurement of balance between heat lost and produced by the body. Lost through: Perspiration 
Respiration Excretion Produced by: Metabolism of food Muscle and gland activity Homeostasis = balance If the body temperature is too high or too low, homeostasis is affected. F = Fahrenheit C = Celsius or Centigrade Temperature is usually higher in the evening. Parts of the Body Where Temperature Can Be Taken Oral In the mouth Glass or electronic - Most common Normal 98.6º F (97.6 – 99.6º F or 37º C) Rectal Most accurate Normal 99.6º F
Armpit or groin Normal 97.6º F
In the ear or external auditor canal Uses different modes Usually in less than 2 seconds Normal 98.6º F
Illness Infection Exercise Excitement High temperatures in the environment Factors that body temperature Starvation or fasting Sleep Decreased muscle activity Exposure to cold in the environment Certain diseases Hypothermia Below 95º F Caused by prolonged exposure to cold Death when temp below 93º F Fever Elevated temperature, above 101º F Hyperthermia Elevated temperature, above 104º F Caused by prolonged exposure to hot temperatures, brain damage, or serious infection Temperatures above 106º F can lead to convulsions and death Measuring and Recording Temperatures Clinical (glass) thermometer contains mercury Comes in oral, security, and rectal Electronic can be used for oral, rectal, axillary or groin Most have disposable probe cover Tympanic placed in auditory canal Taker pushes the scan button Paper or plastic are used in some hospitals Contain special chemicals or dots that change colors To record temperature: 986 is an oral reading 996 (R) is a rectal reading 976 (Ax) is an axillary reading 986 (T) is an aural reading 
Eating, drinking hot or cold liquids, or smoking can alter oral temperature. Be sure it has been 15 minutes since the patient did any of those things before taking the temperature. Measuring and Recording Pulse The pressure of blood pushing against the wall of an artery as the heart beats and rests. 
Radial Artery Brachial Artery 
Temporal Artery 
Carotid Artery Femoral Artery Popliteal Artery 
Dorsalis Pedis Artery 
Apical Pulse Taken with a stethoscope at the apex of the heart Actual heartbeat heard and counted Tips of earpieces and diaphragm of stethoscope should be cleaned with alcohol before use Heart sounds heard resemble “lubb-dupp” 
Pulse Terminology Bradycardia – Under 60 beats per minute Tachycardia – Over 100 beats per minute Rhythm – Regularity of the pulse (regular or irregular) Volume – Strength or intensity (strong, weak, thready, or bounding) Pulse can be increased by: Exercise Stimulant drugs Excitement Fever Shock Nervous tension Pulse can be decreased by: Sleep Depressant drugs Heart disease Coma Measuring and Recording Respiration Process of taking in Oxygen (O2) and expelling Carbon Dioxide (CO2) 1 inspiration + 1 expiration = 1 respiration Normal rate = 14 – 18 per minute Character – depth and quality of respirations Deep Shallow Labored Difficult Sterterous Moist Dyspnea – difficult or labored breathing Apnea – absence of respirations Cheyne-Stokes – periods of dyspnea followed by periods of apnea; noted in the dying patient Rales – bubbling or noisy sounds caused by fluids or mucus in the air passages Leave your hand on the pulse while counting respirations and be sure the patient doesn’t know you are counting the respirations. Measuring and Recording Blood Pressure Measure of the pressure blood exerts on the walls of arteries Blood pressure read in millimeters (mm) of mercury (Hg) on an instrument known as a sphygmomanometer Systolic: Pressure on the walls of arteries when the heart is contracting. Normal range – 100 to 140 mm Hg Diastolic: Constant pressure when heart is at rest Normal range – 60 to 90 mm Hg Factors that blood pressure 
Excitement, anxiety, nervous tension Stimulant drugs Exercise and eating Factors that body temperature Rest or sleep Depressant drugs Shock Excessive loss of blood Blood pressure is recorded as a fraction. Sphygmomanometers: Usually aneroid or mercury, although many hospitals are using electronic.
Used to determine if a patient is underweight or overweight Height/weight chart used as averages + or - 20% considered normal 
When are height-weight measurements routinely done in a health care setting? Daily Weights Usually ordered for patients with edema due to heart, kidney, or other diseases. Be sure to: Use the same scale every day Make sure the scale is balanced before weighing the patient Weigh the patient at the same time each day Make sure the patient is wearing the same amount of clothing each day OBSERVE SAFETY PRECAUTIONS! Prevent injury from falls and the protruding height lever. Some people are weight conscious. Make only positive comments when weighing a patient. Types of Scales Clinical scales contain a balance beam and measuring rod. Some institutions have bed scales or chair scales. Infant scales come in balanced, aneroid, or digital. When weighing an infant…keep one hand slightly over but not touching the infant A tape measure is used to measure infant height. One way to accomplish this is to: Make a mark on the exam table paper at the top of the head. Stretch out the infant's leg and make a mark the paper at the heel. Use a tape measure to measure from mark to mark. Positioning a Patient Medical exam table Surgical table Bed Be sure you know how to operate the table! Paper covers are usually used on exam tables After use, tables are often cleaned with disinfectant During any procedure, reassure the patient Observe safety factors to prevent falls and injury Use correct body mechanics Observe the patient for signs of distress Protect the patient's privacy 
Learn the purpose and procedure for the following positions: 
Horizontal recumbent (Supine) Prone Sims' (Left lateral) Knee-chest* Fowler's Low-Fowler's Semi-Fowler's High-Fowler's Lithotomy Dorsal recumbent* Trendelenburg Jackknife* Patient Assessment Techniques Observation (Inspection) Physician observes skin color, rash, growths, swelling, scars, deformities, body movements and general appearance. Palpation Use of hands and fingers to feel various parts of the body – to determine whether a part of the body is enlarged, hard, out of place, or painful to the touch. Percussion Physician taps and listens for sounds coming from various body organs. The sounds emitted allow a trained individual to determine the size, density, and position of underlying organs. Auscultation Physician listens to sounds coming from within the body, usually with a stethoscope. Temperature Conversions To convert degrees F to degrees C use the formula: (o F – 32) 5/9 To convert degree C to degrees F use the formula: (o C x 9/5) + 32 Convert the following Fahrenheit temperatures to Celsius temperatures and round off answers to the nearest tenth or one decimal point. 1. 140o F = 140-32=108 108 X 5/9 (or 0.5556) = 60 60o C 2. 88o F ________________________________ ______ 3. 45o F ______________________________________ 4. 98.2o F ________________________________________________ 5. 64o F ______________________________________ 6. 73.4o F _____________________________________ ___________ 7. 212o F ________________________________________________ 8. 116o F _________________________________________________ 9. 97o F ______________________________________ 10. 101o F _______________________________________________ 11. 100o F _____________________________________ __________ 12. 104.6o F ______________________________________________ Convert the following Celsius temperatures to Fahrenheit temperatures and round off answers to the nearest tenth or one decimal point. 13. 65. o C 65.6 x 9/5 (or 1.8) = 118.1 118.1 + 32 = 150.1 150.1o F 14. 42.8o C ____________________________________ __________ 15. 54o C _____________________________________ __________ 16. 8o C _____________________________________ __________ 17. 91o C _____________________________________ __________ 18. 0o C _____________________________________ __________ 19. 72o C _____________________________________ __________ 20. 99.8o C ____________________________________ __________ 21. 59.2o C ____________________________________ __________ 22. 63o C _____________________________________ __________ 23. 85.8o C ____________________________________ __________ 24. 103o C _____________________________________ __________ Recording and Reporting Health care workers must listen carefully AND make observations. They use their senses to: See Color of skin, swelling or edema Presence of rash or sore Color of urine or stool Amount of food eaten Smell Body odor - Unusual odors of breath, wounds, urine or stool Touch Pulse Dryness or temperature of skin Perspiration Swelling Hearing Respirations Abnormal body sounds Coughs Speech Observations should be reported accurately – use facts and report what you saw, not the reasons. NOT – “Mr. Cromwell is in pain.” INSTEAD – “Mr. Cromwell is moaning and holding his side.” Observations on a patient’s health record (chart) should be accurate, concise, and complete. Objective observations – what was seen. DO NOT record what you feel or think. If a patient’s statement is recorded, use the patient’s words and use quotation marks. Sign entries with name and title of the person recording the information. Cross-out errors neatly with a straight line, write error, and initial error. Accurate Recording/Reporting Read the following communication statements in Column II and select the appropriate observation in Column I by placing the letter beside the number. |