RET 1024L Introduction to Respiratory Therapy Lab
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Transcript of RET 1024L Introduction to Respiratory Therapy Lab
RET 1024LRET 1024LIntroduction to Respiratory Introduction to Respiratory TherapyTherapy
LabLabModule 4.1 Module 4.1
Bedside Assessment of the PatientBedside Assessment of the Patient—Vital Signs: Pulse, Respiratory Rate,Vital Signs: Pulse, Respiratory Rate,
Blood Pressure, Pulse Blood Pressure, Pulse OximetryOximetry
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Vital SignsVital Signs
Pulse RatePulse Rate Palpated at various sites Palpated at various sites
TemporalTemporal CarotidCarotid Apical (heart)Apical (heart) BrachialBrachial RadialRadial FemoralFemoral PoplitealPopliteal Posterior TibialPosterior Tibial Dorsalis - PedisDorsalis - Pedis
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Vital SignsVital Signs
Pulse RatePulse Rate Radial artery most common site to palpate pulse Radial artery most common site to palpate pulse
Use first, second, or third finger to palpate – not thumbUse first, second, or third finger to palpate – not thumb
Ideally, counted for 1 minute, but can be counted over Ideally, counted for 1 minute, but can be counted over 15 or 30 seconds and then multiplied appropriately to 15 or 30 seconds and then multiplied appropriately to determine the pulse per minutedetermine the pulse per minute
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Vital SignsVital Signs
Respiratory RateRespiratory Rate Counting breaths:Counting breaths: Breathing should be counted for Breathing should be counted for
one full minute (60 seconds)one full minute (60 seconds)
LookLook at chest and abdomen rise and fall at chest and abdomen rise and fall
FeelFeel the chest or abdomen rise and fall by placing the chest or abdomen rise and fall by placing your hand on the person's chest or abdomenyour hand on the person's chest or abdomen
ListenListen to the breaths if the person is breathing loud to the breaths if the person is breathing loud enoughenough
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Vital SignsVital Signs
Respiratory RateRespiratory Rate Do not ask the patient to “breathe Do not ask the patient to “breathe
normally” while you are counting normally” while you are counting respiratory rate – they will respiratory rate – they will inadvertently change the pattern and inadvertently change the pattern and raterate
Try counting the respiratory rate by Try counting the respiratory rate by observing the chest and abdomen observing the chest and abdomen while continuing to palpate the radial while continuing to palpate the radial artery. The patient will think you are artery. The patient will think you are still taking their pulse and will not still taking their pulse and will not change their respiratory pattern and change their respiratory pattern and raterate
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Measuring BPMeasuring BP
Commonly measured Commonly measured using auscultationusing auscultation
SphygmomanometeSphygmomanometer and stethoscoper and stethoscope
BP cuffs come in BP cuffs come in different sizesdifferent sizes
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Measuring BPMeasuring BP
Most BP cuffs are marked Most BP cuffs are marked with an with an O O or an or an indicating where the cuff indicating where the cuff should be placed over the should be placed over the brachial arterybrachial artery
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Measuring BPMeasuring BP
Palpate the brachial artery and then Palpate the brachial artery and then wrap the deflated cuff snugly around wrap the deflated cuff snugly around the patient’s upper arm, ensuring it the patient’s upper arm, ensuring it is properly positioned over the is properly positioned over the brachial artery. The lower edge brachial artery. The lower edge should be about 1 inch above the should be about 1 inch above the antecubital fossa antecubital fossa
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Measuring BPMeasuring BP
Grasp the inflation bulb Grasp the inflation bulb in such a way that you in such a way that you can inflate the cuff and, can inflate the cuff and, with your thumb and with your thumb and index finger, easily index finger, easily open and close the open and close the valvevalve
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Measuring BPMeasuring BP
While palpating the While palpating the brachial pulse, inflate brachial pulse, inflate the cuff to the cuff to approximately 30 mm approximately 30 mm Hg above the point at Hg above the point at which the pulse can no which the pulse can no longer be feltlonger be felt
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Measuring BPMeasuring BP
Place the diaphragm of Place the diaphragm of the stethoscope over the the stethoscope over the artery and deflate the artery and deflate the cuff at a rate of 2 – 3 cuff at a rate of 2 – 3 mm Hg/sec while mm Hg/sec while observing the observing the manometermanometer
Bedside Assessment of the PatientBedside Assessment of the Patient
Physical ExaminationPhysical Examination Measuring BPMeasuring BP
The The systolic pressuresystolic pressure is is recorded at the point at recorded at the point at which the first Korotkoff which the first Korotkoff sounds are heard. The sounds are heard. The point at which the point at which the sounds become muffled sounds become muffled is the is the diastolic pressurediastolic pressure
Korotkoff sounds; partial obstruction of blood flow creating turbulence and vibration
Bedside Assessment of the PatientBedside Assessment of the Patient
Measuring BPMeasuring BP
Bedside Assessment of the PatientBedside Assessment of the Patient
Pulse oximetryPulse oximetry SpO2SpO2