physiological measurements Flashcards
what does NEWS stand for?
- national early warning score
what is NEWS 2?
- tool that acts as a track and trigger response
- hospital deterioration or cardiac arrest preceded by change in vital signs
what physiological indices is NEWS 2 based on? (6)
- respiratory rate
- oxygen saturation
- blood pressure
- heart rate
- ACVPU
- temperature
what does ACVPU stand for?
- alert
- confusion
- voice
- pain
- unresponsive
what is the scale for NEWS 2?
- each have a score ranging from 0 normal range and 3 extreme cases
how do you calculate NEWS?
- if 1-5 cause for concern and should be escalated to change nurse, junior doctor
- if no improvement should be escalated to critical care outreach
what does a NEWS score of over 5 mean?
- critical care outreach needs to be informed immediately
what is the normal respiration rate?
- 12 to 20 breaths per minute
how is respiration rate measured?
- assess rise and fall of the chest wall
how do you take respiratory rate manually?
- count for 60 seconds
- one full rise and fall is counted as one breath
what should you observe from respiratory rate?
- rate
- depth
- rhythm
- any abnormal movements
- work of breathing
where is the control centre located?
- medulla oblongata
what is the respiration rate controlled by?
- chemical control> chemoreceptors
- nervous control- phrenic and intercostal nerves
what is tachypnoea?
- increase in respiratory rate
what is bradypnoea?
- reduction of respiratory rate
what are the causes of tachypnoea?
- respiratory pathologies
- asthma
- COPD
- heart failure
- fever
- pain
- distress
- PE
- pneumonia
- anxiety
- acute respiratory distress syndrome
what are the causes of bradypnoea?
- medications
- opioid
- head injury
- complications in respiratory failures
what do you do with the cuff when measuring BP? what should you ensure?
- wrap the cuff around the upper arm bicep
- arrow should be in line with the brachial artery
what position should the model be in for taking blood pressure?
- sitting or in a lying position
what can assess postural hypertension?
- lying to standing blood pressure readings
what is the systolic BP?
- measure of the peak pressure in which blood hits the artery
- top number
what is the diastolic BP?
- lower lowest point
- bottom number
what is the normal BP systolic rate?
- 90mmhg
what are the precautions for measuring blood pressure?
- fistulas > avoid taking from that side
- cannulas
- open wounds
- fractures/ trauma
- lymphedema
- any surgical procedures that affect access to arm
- skin integrity compromise
what is low blood pressure called?
- hypotension
what is a high blood pressure called?
- hypertension
what are the causes of hypotension?
- hypovolaemia (loss of fluids, blood, diarrhoea, vomiting)
- sepsis
- anaphylaxis
- medications
- PE
what are the causes of hypertension?
- agitation and anxiety
- MI
- heart failure
- asthma
- stroke
- infection
- sepsis
- PE
what is oxygen saturation?
- measure of the percentage of hemoglobin binding with oxygen
what is the normal oxygenation?
- normally 94-100%
what device do you use to measure oxygen saturation?
- electronic pulse oximeter device
what do you do with the device to measure sp02?
- place the device on finger with screen pointing up
- concentration of 02 given as a percentage
what are the precautions of oxygen saturation?
- nail polish, false nails
- history of hypoxia
- fractures
- trauma
what is oxygen saturation driven by?
- hypercapnic drive
what does low sp02 indicate?
- respiratory compromise
- cardiovascular compromise
what are the causes of low sp02?
- asthma
- heart failure
- PE
- MI
- sepsis
- acute respiratory distress syndrome pneumothorax
- post surgery
what is the normal heart beat?
- normally between 50-100 beats per min
how do you measure heart beat?
- measured by assessing palpating the radial artery and counting the number of beats per min
what fingers should you use while palpating the radial artery?
- index and middle finger
how can you take pulse rate using a device?
- pulse oximeter
what should you assess from the pulse rate? (3)
- rate
- strength
- depth of pulse
what are the precautions of taking heart rate?
- open wounds
- fractures
- skin integrity compromise
- arterial lines
what can provide abnormal readings/ no reading of HR?
- nail polish
what is heart rate controlled by? where is it located?
- controlled by autonomic nervous centre
- in medulla oblongata
what are the two different responses of HR?
- sympathetic
- parasympathetic
what does the sympathetic nerve do?
- increases HR
- fight or flight response
what does the parasympathetic nerve do?
- reduces the HR
what is a high heart rate called? - what number
- tachycardia
- over 100
what is a low heart rate called? - what number?
- bradycardia
- under 50
what are the causes of tachycardia?
- anxiety
- medication
- heart failure
- PE
- anaphylaxis
- acute respiratory distress syndrome
what is a sign of deterioration?
- increase or decrease in temperature
what response is temperature?
- homeostatic response
where is the control centre of temperature?
- hypothalamus
what is the normal temperature? what is it called?
- 36 to 37.5 degrees
- apyrexial
what is low grade temperature? - when does this happen?
- 38 degrees
- mild inflammation, infection or allergy
what is moderate to high grade temp?
- 38 to 40 degrees
- infection possible wound or soft tissue injury
what is hyperpyrexia?
- high temperature
- bacterial infections
- or injury to the hypothalamus
what is hypothermia?
- temperature below 35
what is hypothermia the result of?
- infection
- serious sign of potential organ compromise
what is the A-G of imaging ?
- alignment
- bones
- cardiac
- diaphragm
- expansion
- fields
- gadgets
what is the alignment in imaging?
- spinous process are in the centre of the trachea
what are the bones for breathing?
- clavicle
- spinous process
- scapula
- ribs
what is the cardiac aspect of imaging?
- heart takes up 3rd of the distance of the angle, aortic arch, cardio- phrenic angle
what is the diaphragm aspect of imaging?
- costophrenic right shoulder should be higher than the left due to the position of the liver
what does expansion go to?
- goes to the 6th rib
what is the field aspect of imaging?
- hilum blood vessels
what is the gadgets aspects of imaging?
- identify any objects to rule out pathology
