Core PO3 - Physiological measurments Flashcards
Define blood pressure.
Blood pressure is the force of blood against the arteries walls.
What is the normal range for a blood pressure?
90 - 120 / 60 - 80
What is blood pressure measured in?
mmHg (millimetres of mercury).
What equipment do you use to take a manual blood pressure?
A stethoscope and a sphygomometer.
What is the normal range for body temperature?
36.0 - 37.5 degrees celsius.
What equipment do you use to take a temperature?
A thermometer.
What is the normal range for respiratory rate?
12-20 BPM (breaths per minute).
What is the normal range for heart rate?
60-100 BPM (beats per minute).
How do you measure heart rate?
By resting your finger on pulse points or using a pulse oximeter.
What is the healthy range for a BMI?
18.5 - 24.9
What does BMI stand for?
Body mass index.
How do you calculate BMI?
Weight in pounds (squared) / height in inches x 703
What is the normal range for urinary output?
800-2000ml daily.
What is oxygen saturation?
The amount of haemoglobin that binds to oxygen in the blood, forming oxyhaemoglobin.
What is the normal range for oxygen saturation?
95-100%
What equipment do you use to measure oxygen saturation?
A pulse oximeter.
If needed it can be used on a persons ear lobe.
What is the normal range for blood glucose levels?
4.0 - 7.0
This differs in people with diabetes.
What can affect blood glucose levels?
Readings can fluctuate if the person has diabetes or due to the distance of time between taking the measurement and eating.
How do you measure blood glucose levels?
Penetrate the skin with a spring loaded lancet to produce a blood droplet from the surface capillaries.
Touch the glucose test strip to the finger tip and insert the strip into the glucometer.
The glucose level is displayed in seconds.
When are physiological measurements taken and why?
• Upon arrival to look for early warning signs.
• At regular intervals to observe deterioration or improvement in condition.
• Before, during and after a surgery or procedure to monitor condition.
• During sleep if the individual has sleep apnea.
What is sleep apnea?
When breathing temporarily stops while the individual sleeps.
It is good practice to monitor the persons respiratory rate and oxygen saturation.
Anaesthesia adds to the risks associated with sleep apnea.
In what ways can equipment be maintained?
• Follow the manufacturers instructions of storage and use.
• Check for signs of wear and tear before and after use.
What should you do if you notice a faulty piece of equipment?
• Take it out of practice.
• Label it as faulty.
• Report it to your line manager.
• File a written report.
What is the range for an elevated blood pressure?
120 - 129 / below 80
What is the range for hypertension stage 1?
130 - 139 systolic or 80 - 89 diastolic.
What is the range for hypertension stage 2?
140+ systolic or 90+ diastolic.
What is the range for a hypertensive crisis?
180+ systolic and/or 120+ diastolic.
What is a blood capillary sample?
This is where you collect a small volume of blood from an arterial to observe/ look for information on a number of things.
This is easy to collect and can be done at home as it is done through a finger or ear lobe prick.
What can a blood capillary sample provide information about?
• Blood sugar
• Blood count
• Blood gasses
• Blood type
• Inflammatory markers
• Calcium and iron levels
• Cholesterol levels
What is a venous blood sample?
This is where you collect a large amount of blood from a vein.
Different sizes and types of needles are used. A tourniquet is tightened around the arm to dilate the veins, making them more prominent. Blood is then withdrawn and the tourniquet is removed. A cotton ball is then applied to prevent bleeding.
This requires lab analysis, so there is different blood vials for the different types of testing needed.
What can a venous blood sample provide information about?
• Organ and gland function
• Disease presence
(If a substance an organ or gland produces is higher or lower than usual, it is an indicator that there is an issue)
• Blood clotting (coagulation test)
• The same as a capillary sample
What are ways of observing elimination?
• Measuring fluid balance
• Urine pot dipstick test
• Urine culture test
• Stool specimen
How can you measure nutritional intake?
• Food diary
• Fluid balance
• Blood sample
How can weight affect your physiological measurements?
Severe obesity can cause an irregular or high heart rate due to strain on the heart from higher metabolic demand, oxygen demand and cardiac workload.
High BP due to increased vascular resistance.
Being underweight causes your muscles to weaken, slowing the heart rate.
How can disease and illness impact physiological measurements?
They can vary depending on the disease or illness.
E.g. Hypercholesterolemia is when a person has high cholesterol levels, resulting in atherosclerosis which increases blood pressure.
How can the external environment impact physiological measurements?
Heat can cause a high HR to promote heat loss via the skin through sweat. Sweat contain fluid and electrolytes, which the loss of reduces BP, increasing HR. High temp if exceed cooling capacity.
Cold causes vasoconstriction, increasing HR and BP.
High humidity impairs sweat evaporation, reducing ability to cool down causing a high HR and risk of heat stroke.
Low humidity causes dehydration via rapid evaporation of moisture from the skin.
Higher altitudes cause oxygen stats to drop due to the lower atmospheric oxygen pressure causing a high RR and HR.
Homeostasis mechanisms overwhelm in extreme heat which can lead to hyperthermia (38+) or hypothermia (below 35).
How can dehydration impact physiological measurements?
Dehydration can cause a low BP, high heart rate as body compensates for decrease in blood volume, high body temp due to inability to release heat through sweat/evaporation and an impaired cognitive function.
How can a persons lifestyle impact their physiological measurements?
(Smoking, drinking caffeine, cocaine use and stress)
• Nicotine causes temporary vasodilation, resulting in a high BP.
• Caffeine causes a short term spike in BP.
• Cocaine is a stimulant that increases the demand for oxygen, causing a high BP and heart rate when using.
• Stress causes the release of adrenaline, resulting in a high BP and heart rate.
How can medication impact physiological measurements?
(Beta blockers, statins and paracetamol)
• Beta blockers block the effects of adrenaline, lowering BP.
• Statins slow the absorption of cholesterol, allowing vessels to clear for more efficient blood flow, lowering BP.
• Paracetamol reduces a fever by interrupting chemical messengers to the part of the brain that controls body temperature (hypothalamus), lowering body temperature.
How can age impact physiological measurements?
An older person may have a higher BP due to arterial stiffness (diastolic may plateau) and impaired gas exchange.
HR lowers due to changes in the autonomic nervous system.
Lower baseline temperature causing masked fever.
What policies should be followed when taking physiological measurements?
• Gain informed consent from the patient or their advocate.
• If they refuse to give consent, explain the important of the produced and if they continue to refuse, document it.
• Follow infection control guidelines like wearing PPE, sanitise equipment, wash your hands and dispose of things correctly.
• Follow best practice.
Why is it important to follow policy when taking physiological measurements?
• Accurate measurements = accurate care
• Encourages good practice
• Respects patients rights
• Reduces the risk of infection
• Ensures legislation compliance
• Abides by GDPR 2018
What is type 1 diabetes?
When the pancreas makes little to no insulin, making it unable to respond to an increase in blood glucose levels?
What is type 2 diabetes?
When your cells have an insulin resistance, so the pancreas’s makes more insulin in an attempt to get a response.
Eventually the pancreas can’t keep up, causing blood sugar levels to rise.
Who can take blood glucose levels?
Nurses and HCA.
What should an adult with type 1 diabetes blood sugar levels be in the morning, before and after meals?
Morning - 5-7
Before meals - 4-7
After meals - 5-9 atleast 90 minutes after eating
What should an adults with type 2 diabetes blood sugar levels be before and after meals?
Before meals - 4-7
After meals - less than 8.5 two hours after eating
What should a child with type 1 diabetes blood sugar levels before before and after meals?
Before meals - 4-7
After meals - 5-9
What should the average blood sugar level always be?
4-7
What is blood glucose measured in?
mmol/l
How does an infection impact physiological measurements?
High temp as the body tries to kill of pathogens by making the body inhospitable.
High HR due to the inflammatory response and fever.
High HR to compensate for the increased metabolic rate and fever.
Hypotension in a severe infection like sepsis. BP drops due to vasodilation and reduced cardiac output.
Hypoxia in a respiratory infection.
How does nicotine affect the body?
It’s stimulate stem heart, increasing HR and BP.
The carbon monoxide in cigarettes binds to the haemoglobin in red blood cells, reducing their oxygen transport capacity, causing a low oxygen saturation.
Carbon monoxide also inflates the airway causing a high RR.
How can malnutrition impact physiological measurements?
It can cause bradycardia and hypotension due to the reduced metabolic demand and blood volume.
It also weakens the respiratory muscles, reducing lung volume and efficiency.
How does obesity impact physiological measurements?
Tachycardia and hypertension due to increased cardiac workload.
Increase in mechanical restriction when breathing, causing a low RR.
How can being over hydrated impact physiological measurements?
Low HR due to fluid overload.
High blood volume due to increased fluid intake and vascular pressure causing a high BP.
High urine output causing diluted urine.
How does dehydration impact physiological measurements?
High HR due to reduced blood volume and compensatory mechanism to maintain cardiac output.
Low blood volume causing hypotension.
Mild increase in RR to compensate for metabolic acidosis from fluid loss.
Impaired thermoregulation causing a high temp.
Low urine output causing concentrated urine.
What is sputum tested for?
Fungal growth.
