Nursing Formal Lesson 1
Subject: General Nursing
Topic: Haemodynamic monitoring
SANC R 2598 (h) Taking vital signs
Date: 04 August 2015
Time / period: 40 min
Number of students in the group: 6
Emfuleni Mediclinic Lecture Room
Target group
First year, second semester. For education and training as Auxiliary Nurses leading to registration (R169), 22 February 1985, as amended. This qualification is developed in terms of category as prescribed in the Nursing Act, 2005 (Act No 33 of 2005).
Learning outcomes:
At the end of this session the student nurse must:
Have knowledge of what are haemodynamic monitoring and vital signs of the patient
What is vital signs and what is the importance thereof
Be familiar with the normal ranges…
Ask the students if they are aware that even today vital signs are not being done and acted on correctly. Stress the importance of the writing the findings of the machine and not a guestimation of what you think the value must be.
Thus, very important to write the right findings, and report any abnormalities. Also stress the importance off taking vital signs post operatively and those abnormal findings can indicate bleeding and is therefore very important.
Tell the students that a very important part of vital signs is observing the patient, asking the patients how they feel and if they experience any pain for this has an effect on the vital…
Guidelines when taking temperature
Do not do orally if:
< 6 years old
Unconscious
Surgery to the neck or mouth
On O2 therapy
Confused
Paralyzed on one side
If smoke, eat or drink wait at least 15 ? 20 minutes (John Hopkins Medicine, 2015).
What is the pulse rate?
The pulse rate is a measurement of the heart rate, or the number of times the heart beats per minute. As the heart pushes blood through the arteries, the arteries expand and contract with the flow of the blood. Pulses can easily be felt in arteries close to skin surfaces and are the same anywhere in the body.
Pulse sites to use
Temporal
Carotid
Apical
Brachial
Radial
Femoral
Dorsalis pedis
Popliteal
Posterior tibialis (Booysen, et al. 2008:127).
Normal limits for the pulse
Adults 60 ? 100 beats per minute
Adolescent 55 ? 90 bpm
2 ? 10 years old 60 ? 110 bpm
Newborn baby 120 ? 160 bpm
Tachycardia > 100 bpm
Bradycardia < 60 bpm
Pulse rate has to be described by its characteristics such as rhythm or regularity and volume or fullness (Booysen, et al….
