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Observation and reflection. Measuring vital signs - Temperature, Pulse, Respiration and Blood Pressure.

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Introduction

OBSERVATIONS Temperature, Pulse, Respiration and Blood Pressure Temperature, pulse, respirations and blood pressure are the vital signs which indicate the body's ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs indicate patients' responses to the physical, environmental, and psychological stressors. Vital signs may also reveal sudden changes in a patient's condition (NICE 2007). A change in one vital sign can directly lead to a detection of a change in another vital sign. As a first year student l was allocated a new post-operative patient from the theatres to the orthopaedic ward by my mentor and to record patients' observations. The British journal of Nursing (2006) states that patient's vital signs need to be measured and recorded upon arrival to a health care facility as well as on admission to the ward. I also had the opportunity to do baseline observations. According to the Emergency Medical Service, 2006, p194, the baseline observation is used to ...."identify the patient's condition, such as the improvement, stability or deterioration." Prior to going over to the patient, l made sure that my equipment was clean and functioning well. l also had to have the MEWS Chart where l would record the vital signs data. ...read more.

Middle

The adult respiration rate varies between 12 & 20 (Marieb & Hoehn 2007). After finishing the respiratory reading l took the manual blood pressure using the sphygmomanometer (inflatable bladder and cuff) and stethoscope. I checked if the cuff was the right size for the patient to ensure that an accurate reading was taken (BHS 2006). I placed a pillow under the patient's arm to ensure that the upper arm was at heart level, for accurate measurement the arm should be supported at the level of the heart. If the arm is unsupported the muscles may contract leading to a rise in diastolic blood pressure. Raising the arm above heart level can lead to underestimation of blood pressure (Medicines and Healthcare products Regulatory Agency (MHRA) 2006).I wrapped the upper arm with the cuff, positioned the stethoscope over the brachial artery with one hand, inflated the cuff and listened through the earpiece until l could not hear any sound (Hill &Grim 1991). I then opened the valve on the pump slowly and the first tapping sound l heard was that of the systolic pressure. The sound became faint as the pressure in the cuff decreased until l could not hear any sound (diastolic pressure). ...read more.

Conclusion

Accuracy is essential and nurses should be appropriately trained in the various methods of vital signs measurement and the correct use of equipment. Reference British Journal of Nursing (2000). The Importance of Measuring and Recording Vital Signs Correctly. 15(5) Brown,S. (1990) Temperature taking-getting it right. Nurse Standard,5(12),4-5 Bogan, B., Kritzer, S. & Deane, D. (1993) Nursing Student Compliance to Standards for Blood Pressure Measurement. J Nurse Educ, 32(2), 90-2. Campbell, N.R.et al. (1990) Accurate, reproducible measurement of blood pressure. Can Med Assoc J, 143(1), 19-24. DH (2005) Saving Lives: a Delivery Programme to Reduce Healthcare Associated Infection Including MRSA: Skills for Implementation. Department of Health, London. Elkin, M.K., Perry, A.G., & Potter, P.A. (2004). Nursing Interventions & Clinical Skills (3rd ed.). Missouri: Mosby. Edwards, S. (1997) Measuring Temperature. Prof Nurse,13(2), 55-7. Jarvis, C. (2004). Physical Examination & Health Assessment (4th ed.). Missouri: Elsevier Science. Knussman HK (2006). Beyond the Basics: Interpreting Vital Signs. Emergency Medical Service 35(12). Marieb, E.M. & Hoehn, K. (2007) Human Anatomy and Physiology. Pearson Benjamin Cummings, San Francisco. Nursing and Midwifery Council (2008) The Code: Standards of Conduct, Performance and Ethics of Nursing and Midwifery .Nursing and Midwifery Council, London Nursing and Midwifery Council (2007) NMC. Record and Keeping Guidance. Place, B. (2000) Pulse oximetry: benefits and limitations. Nursing Times, 96 (26), 42. Weber, J., & Kelly, J., (2003). Health Assessment in Nursing (2nd ed) Philadelphia: Lippincott Williams &Wilkins. ?? ?? ?? ?? 1 ...read more.

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