Vital Signs

What instruments are used to take a patient's blood pressure?

A sphygmomanometer and a stethoscope.

What instrument is used to amplify sounds that occur within the artery?

A stethoscope.

What is one of the newest techniques in taking a patient temperature by means of the ear canal?

A tympanic reading.

Describe the following five phases of Korotkoff sounds in blood pressure measurement. Phase V:

The artery will be fully opened; the sound will disappear; this is the diastolic reading.

After reviewing Ms. Stewart's medical history, you notice that she checked "yes" next to hypertension. You take her blood pressure, and your reading is 143/95. Is this considered hypertensive? If so, what stage is her hypertension?

143/95 is considered Stage 1 hypertension.

What is the normal respiration rate for a young child through the teenage years?

18 to 30 breaths per minute.

What is used to measure the body's temperature?

A thermometer.

What does the systolic pressure reflect?

The amount of pressure that is required for the left ventricle of the heart to compress or push oxygenated blood out into the blood vessels.

Describe the following five phases of Korotkoff sounds in blood pressure measurement. Phase II:

The cuff deflates, and more blood flows; a swishing sound may be heard; this sound is softened and becomes prolonged into a murmur.

Which dental team member is usually responsible for obtaining a patient's vital signs?

The dental assistant.

What may affect the function of the pulse oximeter?

Sunlight, low temperature, abnormal pulse rate and rhythm, vaso constriction, and cardiac function.

What range would be considered hypertension, stage 1 for an adult?

140-159 systolic and 90-99 diastolic.

What term describes the process of physical and chemical change that takes place in the production of the body's heat?

Metabolism.

Describe the basic functioning of the ECG.

Amplifies the natural electric currents generated by the electrical impulses of the heart, and the pattern of the heartbeat is traced on graph paper.

What term describes an irregularity in the heartbeat?

An arrhythmia.

What should be the first priority of every health care provider?

Attention toward a patient's immediate health.

What range would be considered hypertension, stage 2 for an adult?

Greater than or equal to 160 systolic and greater than or equal to 100 diastolic.

You have a patient with Parkinson's disease. Describe how you would take the patient's pulse while they are continuously moving in the chair.

I would have them concentrate on something, whether it be an object or on the sound of my voice.

When is the pulse taken using the radial artery?

In the dental office.

What happen to a person's temperature during illness?

It increases to fight bacteria and viruses and to produce internal heat for warmth.

What will simplify the process of taking a patient's pulse?

Observing a watch or a clock with a second hand while palpating the pulse.

How is the respiration rate obtained?

Observing the numbers of times the patient's chest rises and falls for 30 seconds; then double the count to conclude the number of breaths for 1 minute.

Where is the brachial artery located?

On the inner fold of the arm.

Where is the radial artery located?

On the inner surface of the wrist.

The carotid artery is used for which procedure(s)?

Performing CPR.

Describe the process of obtaining a pulse using the carotid artery.

Place two fingers alongside the patient's larynx on the side of the neck nearest you; move your fingers slowly down the groove to the soft area above the clavicle, and then palpate this area gently to determine a pulse. (30 x2)

What vital sign is described as the process of inhaling and exhaling, or breathing?

Respiration.

What provides a minimum level for determining a patient's health status?

Taking a patient's vital signs.

What does a pulse oximeter measure?

The concentration of oxygen in the blood.

Which body system controls breathing?

The nervous system.

Why are glass thermometers not recommended?

They contain mercury which can be harmful to humans and wildlife.

What may the dentist choose to do if there is a concern about the patient's medical status based on the blood pressure reading?

They may choose to reschedule the appointment until after he/she has had the chance to speak directly to the patient's physician.

The brachial artery is used for which procedure?

To take a patient's blood pressure.

How is the blood pressure reading recorded?

Using a sphygmomanometer and a stethoscope.

What may lead to an inaccurate reading when using an automated electronic blood pressure device?

Weak batteries.

Describe the three types of characteristics you are looking for when taking a patient's pulse.

When taking a patient's pulse, you are looking for the rate, which is the number of beats that occur during the counting period, the rhythm, which describes the pattern of the beats, and the volume, which is the force of the beat.

When may an ECG/EKG be required for dentistry?

When a patient is undergoing general anesthesia or IV sedation in a hospital or outpatient setting as a preventative measure. This can allow the dentist to follow the patient's cardiac activity throughout a procedure.

How should the patient be positioned to taking the radial pulse?

With their arm at the same level as or lower than the heart; the arm should be well supported and extended straight out.

What range would be considered prehypertension for an adult?

120-139 systolic and 80-89 diastolic.

What type of thermometer has become popular because of the convenience?

Digital thermometers.

What is the normal respiration rate for a relaxed adult?

10 to 20 breaths per minute.

How long is a glass thermometer left in place before reading the results?

3 minutes.

What is the normal pulse rate in a resting adult?

60 to 100 beats per minute.

What is the normal pulse rate in a resting child?

70 to 120 beats per minute.

What is the average range of the body's oral temperature for a resting person?

97.6 degrees F to 99 degrees F.

What is the average oral and tympanic (ear) temperature?

98.6 degrees F.

What test measures the electrical activity of the heart?

A electrocardiogram.

Which type of thermometer is a long glass tube with a small mercury bulb at the end that expands when touched by warm tissue of the body?

A glass thermometer.

Describe the following five phases of Korotkoff sounds in blood pressure measurement. Phase III:

A large amount of blood is flowing into the artery; a distinct, sharp tapping sound returns and continues rhythmically.

If taking a blood pressure more than one time, how much time should elapse before it is taken again?

A minimum of 10 minutes.

When is a person's body temperature the lowest and when is it the highest?

A person's lowest body temperature occurs in the early morning hours, and the highest temperature occurs in the evening.

Which vital sign is described as the rhythmical expansion of the artery every time the heart beats?

A pulse.

What are Korotkoff sounds?

A series of sounds produced by the blood rushing back into the brachial artery.

Is respiration voluntary or involuntary?

An involuntary response and a voluntary function.

Where is the carotid artery located?

Alongside the patient's larynx.

What device is used in many practices to simplify and speed the recording of a blood pressure?

An automated electronic blood pressure device.

What does a record of the patient's vitals signs provide the dental team?

Assurance regarding the patient's well-being and health status.

Describe the following five phases of Korotkoff sounds in blood pressure measurement. Phase I:

Blood is beginning to flow back into the artery and can be heard as a sharp tapping sound; this is the systolic blood pressure reading.

Describe the following five phases of Korotkoff sounds in blood pressure measurement. Phase IV:

Blood is flowing easily, and the sound changes to a soft tapping; the sound becomes distinctly muffled and fainter.

Which vital sign is described as the amount of labor the heart has to exert to pump blood throughout the body?

Blood pressure.

Describe the sphygmomanometer.

Consists of the cuff, which is a cloth wrap that holds an inflatable rubber bladder, the rubber bulb, which is attached to the cuff with rubber tubing.

What factors may affect a patient's vital signs, and how?

Hot or cold beverages which can alter a patient's oral temperature, fear of a procedure which can increase blood pressure and respiration, and exercise which can elevate temperature, pulse, respiration, and blood pressure.

When should vital signs routinely be taken?

If this is the patient's first visit, 6-month recall, or a medical emergency.

What characteristics are noted during the taking and recording of respiration?

Include rate, which is the total number of breaths per minute, rhythm, which refers to the breathing pattern, and depth, which is the amount of air that is inhaled and exhaled during a breath.

What characteristics should be noted when obtaining and recording the patient's pulse?

Include rate, which is the number of beats that occur during the counting period, rhythm, which describes the pattern of beats, and volume, which is the force of the beat.

What are the advantages of using a tympanic thermometer?

Include the fact that the ear canal is a protected cavity so the reading is not affected by an open mouth, hot or cold drinks, or nose congestion; it also has a much smaller probe and can provide a reading within 2 seconds; in addition, the risk of spreading communicable diseases is greatly reduced because the covered probe of the thermometer does not actually touch the eardrum.

How does the average temperature for an infant and young child compare to an adult?

It is higher in infants and younger children than in adults.

Why might the tympanic method be more accurate?

Its rapid measurement causes less patient movement to occur.

What is the normal range of blood pressure of adults?

Less than 120 systolic and less than 80 diastolic.

Ms. Stewart is a new patient to your clinic, and you have just reviewed her medical-dental history. Where would you take Ms. Stewart to take her vital signs? In what order would you take them for optimum time efficiency?

Mrs.Stewart's vital signs would be taken inside one of the treatment rooms while she is sitting down. I would begin by taking her temperature, blood pressure, checking her pule, and then observing her respiration in order to be time efficient.

What happens during respiration?

Oxygen is taken into the body, and carbon dioxide is released as a waste product.

Describe the process of taking the radial pulse.

Place your index finger and middle fingers lightly on the patient's wrist between the radius and the tendon. (30 sec x2)

Since patients may consciously change their breathing pattern if they know their breaths are being monitored, what is the best technique when taking a patient's respiration?

Refocus your attention to their chest while you still have your fingers positioned on their wrist.

What care needs to be taken when using a digital thermometer?

Remember the timed feature of the digital thermometer because you may attain an inaccurate reading if the battery is low.

What is included in vital signs?

Taking and recording a person's temperature, pulse, respiration, and blood pressure.

What may be necessary to obtain an accurate reading of vital signs?

Taking measurements multiple times.

What may be necessary to obtain an accurate or average blood pressure reading?

Taking several blood pressure readings.

What term describes the degree of hotness or coldness of the body's internal environment?

Temperature.

Describe the systolic pressure?

The first sound which is a sharp tapping sound and is the first and larger number recorded.

What does the diastolic pressure reflect?

The heart muscle at rest, allowing the heart to take in blood to be oxygenated before the next contraction occurs.

Describe the diastolic pressure.

The last sound which is a soft tapping sound and is the second and lower number recorded.

Which of these instruments is the blood pressure cuff and meter, and is used to measure the blood pressure?

The sphygmomanometer.

Your next patient would be classified as obese. As you seat him in the dental chair, you do not feel comfortable about taking his vital signs. What are some of the obstacles that should be considered when taking vital signs on an obese patient?

With obese patients, you should be aware that you have to manipulate the skin occasionally to get a correct reading. You may have to take several readings.