Basic Observations

Question 1

What is the pulse?

Answer 1

A pressure wave which is transmitted through the arterial tree and the rhythmic expansion and recoil of the elastic arteries as the left ventricle ejects blood into the circulation

Question 2

What are the indications to measure a pulse?

Answer 2

• On admission (baseline)
• To monitor deviations
• To monitor wellbeing
• During labour
• During auscultation
• PN assessment (if required)
• SROM

Question 3

What does pulse rate mean?

Answer 3

Number of beats per minute

Question 4

What does pulse volume mean?

Answer 4

The force with which the heart beats, indicating the amount of blood being pumped through the heart. Can be:

• Strong
• Full/bounding
• Weak /thread

Question 5

What does pulse rhythm mean?

Answer 5

The spacing of the heartbeats (regular/normal or irregular/intermittent)

Question 6

What are the three main places to take a pulse?

Answer 6

Carotid (neck)
Brachial (elbow)
Radial (wrist)

Question 7

How long should we measure a pulse for?

Answer 7

1 minute

Question 8

What is tachychardia?

Answer 8

Heart rate over 100bpm.

Question 9

What is bradychardia?

Answer 9

Heart rate below 60bpm.

Question 10

What is a normal pulse range?

Answer 10

Between 60-100bpm

Question 11

How does maternal BPM change during pregnancy?

Answer 11

Increases 10-20bpm from 7-32 weeks gestation. Lowers slightly during third trimester but increases during labour.

Question 12

What is the procedure for taking a pulse reading?

Answer 12

1. Obtain informed consent
2. Ensure woman is comfortable
3. Wash hands
4. Locate radial artery and press index and middle finger gently but firmly while supporting the arm
5. Count for 60 seconds
6. Repeat (can count for 30 seconds and double)

Try and use the same wrist and same HCP for continuity and to reduce mistakes

Question 13

What is bradypnoea and tachypnoea?

Answer 13

Bradypnoea - Resp rate less than 12bpm

Tachypnoea - Resp rate above 20bpm

Question 14

What is the normal range for newborn respiratory rate?

Answer 14

30-60bpm

Question 15

What is the normal range for adult respiratory rate?

Answer 15

12-20bpm

Question 16

What is the procedure for measuring respiratory rate?

Answer 16

1. Count breaths by observing chest movement over 60 seconds

2. Record

Question 17

Why might you NOT obtain informed consent for measuring respiratory rate?

Answer 17

It makes people aware of their breathing and may affect the findings

Question 18

What is the normal range for temperature?

Answer 18

36.0-37.5 degrees Celsius.

Question 19

Where are the 5 temperature recording sites?

Answer 19

1. Skin
2. Mouth (under tongue)
3. Rectal
4. Axillary (armpit)
5. Ear (tympanic membrane)

Question 20

A temperature of 38 degrees Celsius can indicate what?

Answer 20

Low grade pyrexia - mild infection, allergy, labour

Question 21

How does the body adapt to heat loss?

Answer 21

Shivering
Goose bumps
Behavioural changes

Question 22

How does the body adapt to heat production?

Answer 22

Sweating
Flushed skin
Behavioural changes

Question 23

What is the procedure for measuring temperature?

Answer 23

1. Obtain informed consent
2. Wash hands
3. Place disposable cover on thermometer
4. Place thermometer in correct position and press start (preferably in same position to ensure continuity)
5. Remove when the instrument indicates to do so
6. Read temperature and document findings
7. Discard probe cover