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Case Study – Vital Signs                               Glen Glines

Learning Objectives:
  1. Identify abnormal vital signs (T, P, RR, BP, O2Sat, Pain)
  2. Identify factors that affect body temperature, pulse, and respirations
  3. Discuss possible rationales for altered vital signs (T, P, RR, BP, O2Sat, Pain)
  4. Identify sites where a pulse may be taken in the hospitalized patient
  5. Discuss common errors in blood pressure assessment

Timothy Smith is a 46 year old male patient. He has returned to the unit from the recovery room for post-op hernia repair under general anesthesia. You take his vital signs 99F, P/80, RR/18, BP-120/84, O2Sat 94% RA, 3/10 pain abdomen.
Focused Questions:
  1. Are Timothy’s vital signs within normal ranges? List normal adult vital signs for T/P/RR/BP/O2/Pain
The vital signs as provided are all with normal range for a general population.
The pain level is subjective and to be believed.
Normal ranges are   T 35.8-37.3c (96.4-99.1f) / P 60-100 / RR 12-20 /
BP 120/80   with variance for assessment of up to 10 mmHg      
The sensation of pain is not normal should be 0/10.  

  2. What factors might affect body temperature?

A current infection, a CVA, cerebral enema, tumor or trauma that would affect the functioning of the hypothalamus.   Skin or tissue necrosis, trauma and MI can cause temperature elevation.
Excessive cooling caused by external environment, as in surgery or accidental causes Hypothermia.  

  3. List all of the sites the nurse could check a patients pulse. Which sites are most commonly used?
A arterial pulse can be palpated at   the following arterial points Temporal, Carotid, Apical, Brachial, Radial, Ulnar, Femoral, Popliteal, Posterior Tibial and (pedal)   Common sites used are Carotid, Apical, Brachial, Radial and Dorsalis Pedis

  4. What factors might influence the respiratory rate? (List factors that could cause an increase or decrease)
Increase: exercise, sympathetic nervous...

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