vital signs

The nurse seems rather confused and uninformed about the procedures and devices used for the measurement of vital signs. This usually results to a lack of respect, trust, and acceptance in her abilities and may hamper the nurse-patient therapeutic relationship Ciutation. The inability of the student nurse to handle equipment such as sphygmomanometer and thermometer properly showed lack of professionalism and such type of actions are bound to make the patient anxious about the nurse’s performance. Furthermore, she presented a rough estimation of the blood-pressure measurement with the conclusion that it did not really matter neglecting the fact that slight changes in vital signs could suggest major complications.

Vital observations were carried out efficiently, they were recorded every 15 minutes and a cardiac monitor was attached to continuously monitor for any deterioration. As a student nurse I assisted by recording vital observations using NEWS and assessing consciousness by using the Glasgow coma scale to ensure there were no signs of brain trauma (Le Roux, Levine and Kofke, 2013). In line with the NMC, my mentor supervised and countersigned my observations (NMC, 2011b). I promoted good patient safety as deterioration would be recognised early and appropriate care provided. Throughout the treatment process I witnessed and provided person centred care. Nursing and medical staff continuously checked patient comfort and obtained consent for treatment being provided.

Unit 4222-335 Undertake physiological measurements 1.1 We should always check equipment which we are going to use if it is safe and working properly, we should wear PPE every time we are undertaking any task, ensure that we are trained to do the task, we should keep the working place safe and clean. When we are about to take measurement from an person we need to make sure that the person know exactly what we are going to do and asking permission for the task we are about to do. Recording the task in the chart and keep it confidential to protect personal information during the course of our work.

Pulse oximeter used to check his oxygen saturation level, which was 98% on air with no central or peripheral cyanosis. Since Mr Devi, does not seem to have any sign of abnormal respiration. The next assessment is circulation, where there are many physical signs to look for. The colour of the hand and digits, are they blue, pink, pale or mottled. Also need to measure for capillary refill time (CRT) by applying cutaneous pressure for 5 Sec on a fingertip held at heart level of Mr. Devi. The normal value of CRT is usually less than 2 second prolonged CRT suggests poor peripheral perfusion. Measure his Blood Pressure (B/P), count pulse rate by listening to the heart with a stethoscope or palpate peripheral and central pulses, assessing for the presence, rate, quality, regularity and equality. All of this assessment indicates the cardiovascular system in the patient is within the normal range or is there any emergency measures should take (Resus.org.uk 2016). However, Mr Devi’s circulation is a concern because his HR was 110bpm which is higher than normal range, the normal heart beat for adults ranges from 60-100bpm. Also his BP was 190/99mmhg with mean arterial pressure (MAP) of

As Jane was presenting with a symptom of a life threatening event it was important that treatment was immediate. Priority was initially made from assessment of the airways, breathing and circulation, level of consciousness and pain. Jane’s respirations on admission were recorded at a rate of 28 breaths per minute, she looked cyanosed. Jane’s other clinical observations recorded a heart rate of 105 beats per minute (sinus tachycardia), blood pressure (BP) of 140/85 and oxygen saturation (SPO2) on room air 87%. It is important to establish a base line so that the nurse is altered to sudden deterioration in the patient’s clinical condition. Jane’s PEWS score (Physiological Early Warning Score) was 4 and indicated a need for urgent medical attention (BTS 2006). Breathing was the most obvious issue and was the immediate priority.

The normal capillary refill time is less than 2 seconds, anything over indicates reduced skin perfusion. Ask the patient if they have any chest pain, if so begin a ECG monitoring. Take the patients temperature. The normal range for this is 36-37.5 degrees Celsius. A high temperature can be a sign of infection. The doctor may also like to re-take the patient’s Arterial Blood Gas (ABG) because previous results showed respiratory acidosis.

Patient care technicians (PCT’s), formally known as nursing assistants, are the backbone to any nursing department. They create rapport with the patients and family members, as well as the nursing and medical staff. Some of the tasks PCT’s are responsible for include: obtaining and recording vital signs, collecting and labeling specimens, blood glucose specimen, and obtaining electrocardiograms (ECG). All these tasks are important and critical in an emergency. PCT’s designated to work in medical surgical floors may not remember the steps for obtaining a good ECG reading. Like the saying goes: if you don’t use it, you lose it. The most common reason ECG’s are misinterpreted is due to incorrect lead placement. PCT’s in critical settings such

The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT

With the health care system changing so rapidly, it is important that nurses are autonomous. It is necessary, as patient advocates, that we understand the cause and effect of all entities involving our patients. Critical thinking and making the correct judgment call clinically is vital. A patient situation which comes to mind is an 86 year old female, weighing 50kg, Vital Signs: Blood Pressure: 80/50, Heart Rate: 102 (Sinus Tachycardia), Respirations:

Reflective essay: Intro: Vital signs are a fundamental component of nursing care and indicate the body’s ability to maintain blood flow, regulate temperature and regulate oxygenate the body tissue. Taking vital signs are essential in revealing any sudden changes in the body, which could potentially indicate clinical deterioration of the patient.

When checking for orthostatic changes in vital signs the nurse should measure the serial blood pressure and take the pulse of a patient in the supine, sitting, and standing positions. The nurse should first start by placing the patient in the supine position and allowing the patient to rest for 2 to 3 minutes before taking the blood pressure. Next, the nurse should place the patient in the sitting position with their legs dangling off the side of the bed. Then the nurse should allow the patient to rest for 1 to 2 minutes before measuring the blood pressure once again. Lastly, the nurse should reposition the patient to the standing position and should allow 1 to 2 minutes of rest before proceeding to the last blood pressure measurement. Orthostatic changes in the patients pulse and blood pressure need to be monitored closely because they can indicate signs of dehydration concerning the gastrointestinal system. Usually while the patient is in the standing position the systolic blood pressure will decrease 10 mm Hg, and the diastolic blood pressure will increase a bit. Now, when the systolic blood pressure decreases by 20 mm Hg, the diastolic blood pressure decreases by 10 mm Hg or higher, and there could be no change in heart rate or there could be an increase in the heart rate of 20 beats/minute or higher while reposition from the supine position to the

Running Head: QUANTITATIVE RESEARCH CRITIQUE 1

The issue of consistency is raised when discussing how to ensure assessments are comprehensive, complete and that the data is recorded using the same guidelines as other nurses. To enable consistency of assessment, the same nurse should be taking the observations of a patient for the duration of a shift (Moore, 2007). This ensure that the interpretation of results don’t differ each time the vital signs are done. It also allows the nurse to detect subtle changes in the patients state that may not have been written down. For example, in most clinical environments the respiration rate is recorded as just a number, and the rhythm, degree of effort, quality of breathing and evidence of wheezing or other abnormal breathing sounds are not recorded. The rate may stay the same over a period of time while other aspects of respiration may change, and this is something that a nurse is more likely to notice if they have assessed that patient before. During handover, a nurse should tell the next nurse looking after their patients how they took observations and detail what tools they used to ensure consistency is maintained.

Focused physical history and physical examination. Baseline observations are recorded as part of an admission assessment and documented on the patients observation chart. The vital signs include temperature, respiratory rate, heart rate, blood pressure, oxygen saturation, pain level and the level of consciousness. The

The anesthetist assessed the patient’s vitals by comparing the values to what is normal and what was normal for the patient when it was measured at the beginning of anesthesia. The vitals were taken every 10 minutes with a blood gas analysis performed every 30 minutes to monitor the electrolytes. These parameters would not only help to maintain the patient at a surgical plane of anesthesia but also help the anesthetist maintain the patient at a steady state physiologically and metabolically. In addition, the patient’s potassium levels were specially monitored throughout the anesthesia due to his HYPP status. An arterial catheter would also be placed in the patient’s metatarsal artery for measurement of direct blood pressure and would also be used for blood collection for IRMA blood gas