3 Vital Signs & Findings
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vital signs
temperature, pulse, respirations, blood pressure
**+ sO2
(TPR & BP)
**+ sO2
(TPR & BP)
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before taking temperature make sure
you wait 15 mins after smoking, eating, drinking (oral) and 15 minutes after coming from the cold
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expected range for oral temperature
36.5 - 37.5
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expected range for temperature in general
35.9 - 38.1
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axillary temperature
0.5 lower
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tympanic & oral
0.5 higher
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fever (oral)
>38
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expected adult pulse
60 - 100bpm
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tachycardia
>100 bpm (trauma, anemia, infection, fever, pain, fear, anxiety, shock)
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bradycardia
<60 bpm
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astyole
absence of pulse
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pulse: rhythm
regular (evenly spaced intervals) vs irregular (varied interval between beats)
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if pulse is irregular
auscultate apical pulse for 1 minute
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where to find apical pulse?
5th intercostal space, midclavicular space using diaphragm of stethoscope
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pulse: amplitude
0 non-palpable/absent
1+ weak/diminishedarely palpable
2+ strong
3+ full, increased
4+ bounding
1+ weak/diminishedarely palpable
2+ strong
3+ full, increased
4+ bounding
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full expected finding for pulse
60-100 bpm (adult); regular; 2+; no deficit, artery feels smooth and resilient
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pulse: elasticity
should be smooth, straight, resilient
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expected RR for adults
12-20 breaths/min
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expected RR in adults 65 and older
12-24 breaths/min
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eupnea
normal RR, rhythm, effort, no use of accessory muscles
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tachypnea
>20 breaths/min (rapid, persistent, fever, exercise, anxiety)
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dyspnea
difficulty breathing
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hypernea
deeper and more rapid
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bradypnea
decreased respiratory rate
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apnea
absence of spontaneous breathing for more than 10 secs
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depth of RR
shallow, moderate, deep?
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quality of respiration
use of accessory muscles?
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expected oxygen saturation
>92-100%
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full expected finding of RR in adults
12-20 breaths per minute, regular, easy, no accessory muscles used, SpO2 > 92%
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bell
low pitched sounds
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diaphragm
high pitched sounds
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desired BP
120/80
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SBP range
low <90
low expected: 90-120
high expected: 130-140
high 140-150
low expected: 90-120
high expected: 130-140
high 140-150
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expected DBP range
low <60
60-80
high >90
60-80
high >90
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mean arterial pressure
[SBP + (2x DBP)] / 3
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pulse pressure
systolic - diastolic pressure
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red flags in vital signs
-Acute change
-Agitation, restlessness
-Newnresponsive chest pain
-sudden changes in ABCs
-Increased shortness of breath; stridor!
-RR <10 or >32/min
-O2 sat <92% when no other pathology
-HR <55 or >120 bpm
-SBP <100 or >170 mmHg
-drop of >30 mmHg
-Temperature <35 or >39.5 C
-Oral Temperature >37.5-38 in neutropenic patients/transplant
-Agitation, restlessness
-Newnresponsive chest pain
-sudden changes in ABCs
-Increased shortness of breath; stridor!
-RR <10 or >32/min
-O2 sat <92% when no other pathology
-HR <55 or >120 bpm
-SBP <100 or >170 mmHg
-drop of >30 mmHg
-Temperature <35 or >39.5 C
-Oral Temperature >37.5-38 in neutropenic patients/transplant
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