Temperature, Pulse, Respiration and Blood Pressure Flashcards
Why should temperature, pulse, respiration and blood pressure be monitored?
to pick up any abnormal readings
helps to identify any trends or changes which could lead to interventions
What are the normal temperature ranges for a dog?
38.3 - 39.2 C
What are normal temperature ranges for a cat?
38.2 - 38.6 C
What are normal temperature ranges for a horse?
38 - 38.2 C
What are the 6 types of thermometer?
digital mercury biotherm oesphegeal rectal aural
What must you ensure happens before a mercury thermometer is used?
mercury is shaken down to the end
What is an issue with mercury thermometers?
easily broken, presents health and safety issue to staff and patient
Why is a digital thermometer preferable to a mercury one?
safer, quicker, more pleasant for patient and easier to read
What is a biotherm thermometer?
thermometer inserted into microchip and placed at the time of micro-chipping patient. Placed in the scruff.
patient is scanned for chip with biotherm scanner and temperature shown at the same time
Why should you take a patients temperature?
determine the presence of abnormailities
guide as to patients health status
Which patients should have their temperatures monitored?
all
what is pyrexia?
increase in body temperature due to fever
What is hypothermia?
low body temperature
What is hyperthermia?
raised body temperature due to environmental factors
What is the proper procedure for restraint of patient for temperature and pulse recording?
arm under patients neck, hold head close to your chest
other arm under patients abdomen to lift into standing position
hold patients body close to your chest
do not allow to sit down
Describe how to take a rectal temperature
have a colleague restrain the patient correctly
if using a mercury thermometer shake down mercury or if using a digital thermometer turn it on
lubricate the thermometer
insert the thermometer into the rectum with a twisting motion
with thermometer flat, push it towards the dorsal aspect of the rectum to avoid being in faeces
hold thermometer in place for 30 secs to 1 minute (digital thermometer will usually beep when finished)
gently remove and wipe with cotton wool
hold the thermometer horizontal and read off figure
record figure on patient records
clean and disinfect end of thermometer
shake down mercury or reset digital thermometer
replace thermometer in storage location
Which patients should thermometers never be shared between even with disinfecting inbetween?
infectious
What is the problem with single use thermometer covers?
may reduce accuracy of reading
What are the potential causes of hyperthermia?
infection, heatstroke, convulsions, pain, excitement, clinical conditions, diseases
What are potential causes of hypothermia?
shock, circulatory collapse, impending parturition, general anesthesia
What is diphasic temperature?
fluctuating or spiking
What is pulse the overall evaluation of?
efficiency and condition of animals cardiovascular system
What is pulse the basic measurement of?
the heart rate
How can pulse be detected?
use a stethoscope to auscultate the thorax or palpate pulsations in the artery
What does a pulse correspond to?
expansion of an artery, corresponds with contraction of left ventricle of the heart as it pumps blood into the aorta and around the body
What is the normal pulse rate of a dog?
70 - 140 bpm
What is the normal pulse are of a cat?
100 - 200 bpm
What is the normal pulse rate of a horse?
32 - 44 bpm
Why is there such large variation in pulse rates within species?
larger animals will have slower pulse rates
Where can a central pulse be felt?
the femoral artery
what are the 3 types of peripheral pulses?
digital, tarsal and lingual
Where can the femoral pulse be found on an animal?
medial aspect of the femur
Where can the digital pulse be found?
palmar aspect of carpus
where can the tarsal pulse be found?
medial aspect of tarsus
where can the lingual pulse be found?
ventral aspect of the tongue
when should the lingual pulse only be used?
during anesthesia
what are peripheral pulses useful for?
early indication of peripheral shutdown
describe the process of taking a patients pulse
ask colleague to restrain patient locate artery of choice with fingers count pulsations for 15 seconds and times by 4 or count for one minute record on patients notes take note of pulse character and quality
what is sinus arrhythmia?
normal variation in rate, pulse increases with inspiration and decreases with expiration
what do weak pulses indicate?
reduced circulating blood volume or shock
what do strong and jerky pulses indicate?
reduced circulatory volume or other cardiac abnormalities but there is a temporary compensatory mechanism in place
What is tachycardia?
increased heart and pulse rates
what is bradycardia?
decreased heart and pulse rates
what causes tachycardia?
excitement, exercise, pain, fear, shock, pyrexia, hypoxia
what causes bradycardia?
unconsciousness, anesthesia, debilitating disease and sleep
What is important to ensure when taking a patients heart pate with a stethoscope?
that the patient is as relaxed as possible and stress is reduced
Describe how to take a heart rate with a stethoscope
patient is restrained in a standing position
place stethoscope head on lower left chest between 3rd and 6th ribs
listen to rhythm of heart and count heart beats for 15 seconds and multiply by 4
record heart rate on patient records
How can you use the patients forelimb to show the correct position for the stethoscope on the chest?
correct position will be under the point of the elbow when the leg is flexed
What does a pulseoximiter measure?
pulse rate and oxygen saturation
How does a pulseoximiter work?
sensors are placed on skin or mucous membranes
light is emitted from pulseoximiter and passes through blood in tissues
the sensor measures changes in light absorption of oxygenated and de-oxygenated blood
Why would a pulseoximiter not be suitable for a patient with severe circulatory failure?
requires peripheral circulation in order to work
Where may you see a pulseoximiter placed during surgery?
the tongue
Why may a pulseoximiter not be reliable in animal patients?
pigmented skin or mucous membranes and fur can interfere
under what circumstances may you use an oesphegeal stethoscope?
when the patient is under anesthetic
describe how to use an oesphegeal stethoscope
pre-measure approximate length for insertion by laying tube alongside the mouth neck and chest
note the length from level of canine teeth to point of the olecranon
with stethoscope earpieces in ears advance the oesphegeal stethoscope into the oesphegus
when you hear heart rate stop advancing
do not advance further than your measured area
tape in place to avoid movement
how is the rhythm and rate of respiration assessed?
watching the chest moving up and down or placing your hands on either side of the chest or by auscultating the chest
When is respiration best assessed?
when the patient is at rest and relaxed
what should be counted when assessing respiration?
either inspiration or expiration
What should be recorded alongside respiration rate on the patients record?
effort
How should respiration be calculated?
count breaths for 15 seconds and multiply by 4 or count for 1 minute
what is dysponea?
difficulty breathing
what could cause inspiratory dysponea?
obstruction or narrowing of trachea
what could cause expiratory dysponea?
bronchitis or pleural effusions
what can cause mixed dysponea?
pneumonia, pneumothorax, hydrothorax, pyothorax (pleural effusion)
what is orthoponea?
patient changes position to assist with respiration
what is stridor?
breathing associated with a shrill, harsh inspiratory sound
what is stertor?
snoring
What is paradoxical breathing?
abnormal respiratory pattern in which the diaphragm moves upwards during inspiration and downwards during expiration
What is a wheeze?
high pitched whistling sound usually on exhalation
what happens to mucous membranes if the patient is cyanotic?
turn blue
what is rhoncus?
horse rattling sound when breathing
what is flail chest?
occurs when segment of the rib cage breaks due to trauma and becomes detached form the rest of the chest wall. The damaged area moves slightly on inspiration and expiration
what is abdominal respiration?
the abdomen moves up and down during respiration
What is tachypnoea?
increased respiration rate
What can cause tachypnoea?
heat, exercise, pain, poisons, excitement
what is bradypnoea?
decreased respiration rate
what can cause bradypnoea?
poisons (narcotic or hypnotic), sleep, anesthesia
what are cheyne stokes?
respiratory pattern that occurs shortly before death (either natural or PTS) characterised by deep and shallow breathing
what is apnoea?
cessation of breathing
what does blood pressure provide information about?
cardiovascular function and an indirect measurement of cardiac output and tissue blood flow
what is the equation that can be used to work out blood pressure?
blood pressure=cardiac output x total peripheral resistance
what effect would vasoconstriction have on BP?
increased blood pressure as more resistance
what effect would vasodilation have on BP?
decreased blood pressure as less resistance
what is total peripheral resistance?
blood pressure created by systemic vasculature
what is systolic blood pressure?
peak pressure in arteries when ventricles are contracting
what is diastolic blood pressure?
minimum pressure in arteries when ventricles have filled with blood
what is mean blood pressure?
average arterial blood pressure during cardiac cycle
What does systolic blood pressure give information about?
peripheral vascular resistance, stroke volume and intravascular volume
what does diastolic blood pressure show?
peripheral vascular resistance
what does mean blood pressure give information about?
tissue perfusion
when measuring blood pressure what needs to be considered relating to the method of measuring BP?
direct or indirect
invasive or non-invasive
What are normal blood pressure values for a dog?
systolic: 131 - 154 mmHg
diastolic: 75 mmHg
what are normal blood pressure values for a cat?
systolic: 115 - 162 mmHg
diastolic: 83 mmHg
What are the 3 main methods for blood pressure measurement?
direct arterial blood pressure
indirect arterial blood pressure (oscillometric technique)
indirect arterial blood pressure (Doppler technique)
How does direct arterial blood pressure measure blood pressure?
Electronic transducer converts signal into waveform and blood pressure. The transducer must be placed at the level of the right atrium and zeroed relative to atmospheric air before use
What is the advantage of direct arterial blood pressure?
Gold standard method
Most accurate
Gives a beat-to-beat assessment
Useful for assessing the cardiovascular consequences of cardiac arrythmia
what are the disadvantages of direct arterial blood pressure?
Technically demanding
Requires placement of an arterial catheter (usually in dorsal pedal artery)
Failure to place catheter correctly can result in haematoma
Risk of sepsis or infection if the catheter is not placed aseptically.
how does indirect blood pressure (oscillometric technique) measure blood pressure?
Same principle as doppler technique but the cuff is automatically inflated and deflated by a machine.
The presence of pulsatile changes within the cuff signals blood pressure
what are the advantages of indirect blood pressure (oscillometric technique)?
Non-invasive
Simple to use
Automated (can be set to monitor blood pressure every 3-5 mins)
Systolic, diastolic and mean blood pressures are measured and calculated
what are the disadvantages of indirect blood pressure (oscillometric technique)?
Less accurate than Doppler in small patients
Difficult to know if the measurement is accurate because the process is automated
Selection of cuff size/width important (approx. 40% circumference of limb)-too large and reading will be artificially lowered too small and reading will be artificially raised
how does indirect blood pressure (Doppler technique) measure blood pressure?
Cuff is placed around the distal limb or tail and inflated manually to stop blood flow. Pressure in the cuff is released until the blood flow can be detected by the Doppler probe that is positioned over the peripheral artery. Systolic blood pressure is read from a pressure manometer that measures the pressure in the cuff.
what are the advantages of indirect blood pressure (Doppler technique)?
Non-invasive
More accurate than oscillometric technique in smaller patients
Useful for monitoring blood flow in other situations (e.g. CPR)
What are the disadvantages of indirect blood pressure (Doppler technique)?
Less accurate than direct measurement
Does not give a continuous reading
Must be measured manually
Most accurate measurement taken by this method is systolic pressure, diastolic pressure is not reliable.
Selection of cuff size/width important (approx. 40% circumference of limb)-too large and reading will be artificially lowered too small and reading will be artificially raised
