PPT - Physiological Monitoring and Readiness for OT Flashcards
Baseline vitals needed for all clients, but in particular:
- Clients suffering from recent trauma, hospitalization, etc.
- Current or previous cardiovascular/cardiopulmonary conditions
- Clients who are not active have limited aerobic activities for many weeks/months
- Client’s with general fatigue
- Very young and very old (65+ years)
Factors that Influence a Client’s Vital Signs
- Level or amount of activity
- Emotional status
- Physiological status
- Environmental Temperature
- Client’s age
- What are some things contributing to the physiological status of the client?
Disease, illness, use of medication, trauma - What are some possible adverse and potentially dangerous responses to activity and exercise?
Confusion, slow reactions of movement/response to directions, lethargy, fatigue, loss of consciousness, etc.
Blood Pressure
- Pressure exerted by circulating blood on walls of blood vessels
- Usually refers to brachial arterial pressure
- Pressure of circulating blood decreases as it moves further away from the heart
- Composed of Systolic and Diastolic pressures
Systolic: BP at the contraction of the left ventricle of the heart
Diastolic: BP at the time of rest period of the heart
Blood Pressure – Korotkoff’s Sounds
Sounds are described in phases
Listen using a stethoscope and blood pressure cuff
- Phase 1: first, faint, clear tapping sound which gradually increases (first indication of systolic BP in adults)
- Phase 2: murmur or swishing quality present
- Phase 3: sounds become crisp and louder than before
- Phase 4: distinct and abrupt muffling sounds until a soft, blowing sound is heard (initial indicator of diastolic BP)
- Phase 5: muted sound, disappearance of sound, also known as “second diastolic pressure phase”
We are concerned with two specific Korotkoff sounds: the 2nd Korotkoff sound and the first faint/muted sound…that is the BP to record
Blood Pressure “Norms”
Normal
120/80
Pre-Hypertension
120 – 139/80 -89
Stage I Hypertension
140 – 159/90 – 99
Stage 2 Hypertension
≥ 160/≥ 100
Monitor BP for abnormal responses to activity and/or occupation. Abnormal Responses include:
- Systolic pressure rapidly increasing or does not increase during activity
- Systolic pressure continues to increase or decrease even when the activity has leveled off (plateau)
- Systolic pressure rapidly declines or does not decline as the intensity of the activity declines/terminates
- Systolic pressure declines significantly below resting level when activity is terminated
- Systolic pressure declines during the exercise before the activity intensity declines
- Systolic pressure rate or the amount of systolic pressure increase is excessive** during the exercise or activity period
- Diastolic pressure increases more than 10-15 mmHg during the activity
Respiration
Inspiration and Expiration of air between the lungs and the environment through muscle contraction and relaxation
Respiration rate
number of breaths per minute
Respiration rhythm
regularity of the pattern
Respiration depth
amount of air exchanged with each respiration
Respiration character
deviations from normal, resting or quiet respiration
Accepted normal range for respiration at rest
Adults – 12 -18 respirations per minute
Infants – 30 – 50 respirations per minute
Resting values above 20 respirations per minute or below 10 respirations per minute are considered abnormal for adults
Upper Chest Breather
thorax rises and expands during inhalation and abdomen remains somewhat motionless
Abdominal Breather
expansion of the abdomen with inspiration and there is basically no movement in the thorax
Factors affecting respiration
Age, emotional status, physical activity, air quality, altitude, disease/illness
