Vital signs

Question 1

List and define the four vital signs

Answer 1

1. Blood Pressure (force exerted against the walls of the blood vessels as blood flow through them)
2. Pulse (throbbing caused by the contraction and expansion of an artery as blood passes through it stated in beats per minute)
3. Temperature (degree of heat in a living body)
4. Respiration (breathing rate stated in breaths per minute)

Question 2

Explain systolic and diastolic pressure

Answer 2

• The highest pressure occurs when blood is pushed through the arteries by the contraction of the heart = “systolic pressure”
• Lower pressure occurs when heart relaxes between beats = “diastolic pressure”
• BP is recorded in millimeters of mercury (mm Hg), in a fraction where systolic is the m=numerator and diastolic is the denominator

Question 3

Explain how to correctly measure an individual’s pulse

Answer 3

How to measure pulse:
• Face patient and rest pt’s arm, palm-up, on chair armrest
• Place finger pads of middle, and ring fingers on radial artery, as shown (Do Not use your Thumb, as it has it’s own pulse)
• Feel throbbing pulse by putting light pressure on artery 4) Count pulse for a minimum of 30 seconds
• Multiply this number by 2 to calculate pulse rate for 1 minute
• Wait for second hand of watch or clock to reach the 12 or 6.
Begin counting

Question 4

Explain how to correctly measure an individual’s body temperature

Answer 4

1. Ask if patient had tobacco, hot or cold to drink within 30 minutes of assessment
2. Wash hands and explain procedure to patient
3. Shake thermometer and place sheath over thermometer
4. Place thermometer just under patient’s tongue
5. Leave in place for 3 to 5 minutes
6. Remove thermometer from mouth
7. Discard sheath
8. Read the thermometer to the nearest 10th of a degree
9. After reading, place thermometer on a barrier in a safe place
10. Wash hands
11. Record reading
12. Report abnormal findings

Question 5

Explain how to correctly measure an individual’s respiratory rate

Answer 5

1. Never let the patient know you are counting their respirations
2. Assess immediately after taking pulse, while fingers are still in place on the wrist
3. Look at your watch or clock and watch the patient’s chest out of your peripheral vision
4. Count the number of times the chest rises over 30 seconds
5. Multiply the number by 2
6. Observe for a full minute if rate seems irregular
7. Pay attention to depth and rhythm of breathing
8. Record BOTH pulse and respiratory rates

Question 6

Describe ranges associated with normal blood pressure

Answer 6

• 120/ 80 is normal
• Hypertension: abnormally high blood pressure. Blood pressure stays at or above 140/90
• Hypotension: abnormally low blood pressure under 110/70

Question 7

Describe ranges associated with normal pulse rate

Answer 7

Normal pulse range: 60- 100 beats per minute for an adult

It is lower for children

Question 8

Describe ranges associated with normal body temperature

Answer 8

• 35.5- 37.5 degrees
• Average normal 37 degrees
• Fever: over 37. 5 degrees
• A temperature above 38.3°C usually indicates an active disease process
• A temperature above 41°C is a medical emergency
• Also patients with temperatures under 35.4°C should not be treated
• In these cases, dental treatment is contraindicated

Question 9

Describe ranges associated with normal respiratory rate

Answer 9

Normal Adult respiratory rate = 14 to 20 breaths per minute (easy, quiet, regular)

It is higher for children

Question 10

Discuss some of the factors that affect blood pressure measurements

Answer 10

• Age
• Race
• Body position
• Respiration
• Emotion/ anxiety
• Temperature
• Anxiety
• Exercise
• Meals
• Tobacco
• Alcohol
• Pain
• “White Coat Syndrome” is when blood pressure rises above its usual rate when measured in a health care setting because patient is nervous

Question 11

Discuss some of the factors that affect pulse

measurements

Answer 11

1. Stress
2. Age
3. Medications
4. Exercise

Question 12

Discuss some of the factors that affect body temperature measurements

Answer 12

• Time of day - temp is lowest in the morning
• Infection / inflammation
• Stress
• Exercise
• Smoking -
• Rapid Breathing
• Age - 70 years old or above, average temperature is 36°C
• Cold / Hot liquids - alters temp accordingly within 30min Hormones - temp varies with menstrual cycle
• Environment – hot or cold outside?

Question 13

Discuss some of the factors that affect respiratory rate measurements

Answer 13

• Age
• Medications
• Stress
• Exercise
• Altitude
• Gender
• Body position
• Fever

Question 14

Describe the 5 categories used to classify blood pressure for adult patients

Answer 14

Normal: 120/ 80

Normal- high: 139/ 89

Grade 1: 140/90 159/99

Grade 2: 160/ 100 179/ 109

Grade 3: > 180/ 110

Question 15

Identify the appropriate dental management protocols associated with normal- high bp

Answer 15

• Routine dental treatment including L.A. acceptable
• Recommend lifestyle modifications
• Retake BP at continuing care appointments as a screening strategy for detection of hypertension

Question 16

Identify the appropriate dental management protocols associated with grade 1 bp

Answer 16

• Allow patient to relax; retake BP after 5 minutes
• Inform patient and recommend lifestyle modifications
• Routine dental treatment (consider procedure, LA needed??, best avoid but proceed if patient relaxed/comfortable and supervising Dentist consulted)
• Employ stress-reduction strategies
• If BP is above normal on three separate appointments and if patient is not under physician’s care for hypertension, refer to physician

Question 17

Identify the appropriate dental management protocols associated with grade 2 bp

Answer 17

• Retake BP after patient has rested for 5 minutes
• If still elevated, inform patient of readings
• Refer to physician within 1 week; delay treatment if patient cannot handle stress or if dental procedure to be performed is stressful
• Consult supervising Dentist first, Routine dental treatment can be provided if patient relaxed and wishing to proceed (No L.A or complex scaling)
• Employ stress-reduction strategies

Question 18

Identify the appropriate dental management protocols associated with grade 3 bp

Answer 18

• Retake BP after 5 minutes
• If still elevated, cancel todays treatment!
• Refer to physician for immediate evaluation
• When you next see your patient seek a written medical release form from physician prior to dental treatment
• Emergency dental treatment can be done in a “hospital dental setting”