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Health Care Needs for Individuals with Disabilities

by: Sierra Kosh

Health Care Needs for Individuals with Disabilities NURS 45070

Marketplace > Kent State University > Nursing and Health Sciences > NURS 45070 > Health Care Needs for Individuals with Disabilities
Sierra Kosh
GPA 2.8

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About this Document

These notes cover: How to take vital signs
Healthcare Needs for Individuals with Disabilities
Jennifer Metheney and Heather Weil
Class Notes
vital sign
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This 6 page Class Notes was uploaded by Sierra Kosh on Wednesday September 7, 2016. The Class Notes belongs to NURS 45070 at Kent State University taught by Jennifer Metheney and Heather Weil in Fall 2016. Since its upload, it has received 8 views. For similar materials see Healthcare Needs for Individuals with Disabilities in Nursing and Health Sciences at Kent State University.

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Date Created: 09/07/16
Week 2 Sept 5- Sept 9 Vital Signs   Wednesday, Sept 7- ➔ The Five Vital Signs ◆ Temperature ◆ Pulse ◆ Respiration ● Pulse Oximetry ◆ Blood Pressure ◆ Pain ➔ Pulse ◆ Definition: Number of ventricular contractions or pulsing sensations that occur in one minute. ◆ Normal Rate in adults: 60-100 beats per minute (bpm) ◆ Bradycardia​: less than 60 bpm ◆ Tachycardia​: more than 100 bpm Never take pulse via both carotid arteries at once (patient will pass out) ◆ Rhythm ● Regular ○ Check for 30 seconds and multiply by 2 ● Irregular ○ Check for 1 minute ○ Dysrhythmia ◆ Determined by ECG/ EKG monitoring ◆ Where to take the pulse   ● Carotid, radial, femoral ◆ Strength ● 0 (absent) requires Doppler for assessment ● +1 (thready) ● +2 (normal) ● +3/+4 (bounding) ◆ Radial-inner (wrist/thumb side) ● Lightly press with middle and pointer fingertips ◆ Factors affecting pulse ● Age, Exercise, Fever, Pain, Anxiety, Caffeine, Medication, Postural changes ◆ Resportations ● Checking respiratory rate: watching rising and falling of stomach, putting hand on back (doing it without addressing what you're doing- people will change breathing patterns when they know what you're doing) ● Normal rate: 12-20 respirations per minute ● Tachypnea: greater than 20 ● Bradypnea: less than 12 ● Dyspnea ● Hyperventilation ● Hypoventilation ◆ Respiratory Physiology ● Ventilation ○ When you're moving gasses in and out of the lungs ○ Assessed by respiratory rate ● Diffusion ○ Movement of oxygen and carbon dioxide between alveoli and the red blood cells ○ Assessed by oxygen saturation ● Perfusion ◆ Pulse Oximetry Assessment ➔ Temperature ◆ Normal range: 96.6-100.6o F (35.8-38.1o C) ◆ Factors affecting temp ➔ Pain ◆ Recognized as the fifth vital sign within the last decade ◆ Must be assessed frequently Ex. If a child is nonverbal you can detect signs of pain through raised blood pressure and heart rate. A student might try to adjust themselves, you can tell through facial expressions, they might make up their own signal to communicate. ◆ Factors affecting pain Ex. Sometimes people’s neurological pain receptors do not work as well and they may not feel pain but they will be enduring pain. Someone could put their hand on a burning stove and not feel their hand burning. Systolic is the top number and diastolic is the bottom number ○ How much blood you have (If you are dehydrated you have less blood) ● Blood viscosity ○ Thickness of the blood (High cholesterol would be an example) ● Arterial elasticity ◆ Factors affecting blood pressure ● Age, Gender, Ethnicity, Medications, Diurnal variations, Hemorrhage, Body position, General anesthesia Anxiety, fear, & emotional stress, Pain, Increased intracranial pressure (ICP), Chronic renal failure (CRF) ◆ Unexpected Findings ● Hypotension: <90/60 ○ Dizziness, blurred vision, confusion, cool/clammy skin ● Hypertension: >140/90 ○ Blurred vision, severe headache, nausea and vomiting (N/V) ◆ Orthostatic hypotension ● Decrease in blood pressure of 25 mmHg or more with position change ◆ Blood pressure measurement ● Direct Method​-catheter directly in artery (via arterial line - used in critical care settings) ● Indirect Method​-auscultation with the diaphragm of the stethoscope & sphygomanometer ◆ Blood Pressure Assessment ● Position cuff on the arm at the level of the heart ● Choose the appropriate cuff size ● If cuff is too narrow → false high reading ● If cuff is too wide → false low reading ● The bladder length should cover 80-100% of the circumference of the upper arm ● Inflate the cuff 30 mmHg beyond a patient’s typical systolic pressure or the point at which the pulse disappeared on palpation ● Inflate and deflate the cuff at a steady, moderate rate (about 2-3 mmHg/sec) ● Wait 2 minutes before repeating a blood pressure assessment ◆ If you have difficulty hearing: ● Check positioning of chest piece (“turned on”) ● Reduce sound in room ● Hold hands & tubing as still as possible ● Hold diaphragm firmly against skin ● Remove clothing that may be rubbing against tubing ● Maintain ear pieces towards nose ● Check positioning over brachial artery ● Practice timing of inflation/deflation ● Try opposite arm or bell of stethoscope ● Have hearing acuity tested


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