pemeriksaan tanda vital-kuliah pengantar.ppt

8/14/2019 Pemeriksaan tanda Vital-kuliah pengantar.ppt

1/22


2/22

Vital Signs

Temperature, pulse, respiration, blood pressure (B/P)

& oxygen saturation are the most freuent

measurements ta!en by "#P$

Be%ause of the importan%e of these measurements

they are referred to as Vital Signs. They are

important indi%ators of the bodys response to

physi%al, en'ironmental, and psy%hologi%al stressors$


3/22

Vital SignsVital Signs

Pro'ide information about body fun%tion

n%lude*temperature

*pulse

*respiration

*blood pressure

#hanges may be the firstsign of disease

+%%ura%y is imperati'e!

3


4/22

Body Teer"#$re

% Core #eer"#$re & #eer"#$re o' #(e )ody #*++$e+, *+co#ro--ed )y #(e (yo#("-"$+ co#ro- ce#er * #(e)r"*/ & "*#"*ed 0*#(* " "rro0 r"1e.

% S2* #eer"#$re r*+e+ '"--+ * re+o+e #oe4*roe#"- cod*#*o+ deed+ o )-ood '-o0 #o+2* "#. o' (e"# -o+# #o e5#er"- e4*roe#

% T(e )ody6+ #*++$e+ ce--+ '$c#*o )e+# )e#0ee #(er"1e 'ro 37 de1 C #o 38 de1 C

% Teer"#$re *+ -o0e+# * #(e or*1, (*1(e+# d$r*1 #(ee4e*1 c*rc"rd*" cyc-e/


5/22

T(eroe#er+ & 3 #ye+

% G-"++ erc$ry & erc$ry e5"d+ or co#r"c#+ *re+o+e #o (e"#. 9$+# rece#-y o erc$ry/

% E-ec#ro*c & (e"# +e+*#*4e ro)e, re"d+ * +ecod+/

#(ere *+ " ro)e 'or or"-:"5*--"ry $+e red/ " ro)e 'orrec#"- $+e )-$e/. T(ere "re d*+o+")-e -"+#*c co4er 'ore"c( $+e. Re-*e+ o )"##ery o0er & re#$r #o c("r1*1$*# "'#er $+e.

% I'r"red Ty"*c E"r/ & +e+or ro)e +("ed -*2e "o#o+coe * e5#er"- oe*1 o' e"r c""-. E"r c""-$+# )e +e"-ed ro)e +e+or "*ed "# #y"*ce)r"e & re#6 #o c("r1*1 $*# "'#er $+e.


6/22

Clinical

erc$ry 1-"++

ElectronicAural

Thermometers

7


7/22

S*#e+

ralPosterior sublingual po%!et *under tongue (%lose to %arotidartery)

-o hot or %old drin!s or smo!ing. min prior to temp$ 0ust bea1a!e & alert$

-ot for small %hildren (bitedo1n)

2ea'e in pla%e 3 min

+xillary

Bulb in %enter of axilla

2o1er arm position a%ross %hest

-on in'asi'e * good for%hildren$ 2ess a%%urate (no

ma4or blood 'essels nearby)

2ea'e in pla%e 567 min$

0easures $5 # lo1er than oral

temp$

8e%tal

Side lying 1ith upper leg flexed,insert lubri%ated bulb (7677/.in%h adult) (7/. in%h infant)

9hen unsafe or ina%%urate bymouth (un%ons%ious, disorientedor irrational)

Side lying position * leg flexed

2ea'e in pla%e .63 min$

0easures $5 # higher than oral

:ar

#lose to hypothalmus * sensiti'eto %ore temp$ %hanges

+dult 6 Pull pinna up & ba%!

#hild * pull pinna do1n & ba%!

8apid measurement

:asy assessibility

#erumen impa%tion distortsreading

titis media %an distort reading

.63 se%onds


8/22

A++e++*1 P$-+e

% Le'# 4e#r*c-e co#r"c#+ c"$+*1 " 0"4e o' )-ood #o +$r1e #(ro$1(

"r#er*e+ & c"--ed " $-+e. Fe-# )y "-"#*1 "r#ery -*1(#-y "1"*+#

$der-y*1 )oe or $+c-e.

% C"ro#*d, )r"c(*"-, r"d*"-, 'eor"-, o-*#e"-, o+#er*or #*)*"-,

dor+"-*+ ed*+

% A++e++; r"#e, r(y#(, +#re1#( & c" "++e++ )y $+*1 "-"#*o

"$+c$-#"#*o.

% P$-+e de'*c*# & #(e d*''erece )e#0ee #(e r"d*"- $-+e "d #(e "*c"-$-+e & *d*c"#e+ " decre"+e * er*(er"- er'$+*o 'ro +oe

(e"r# cod*#*o+ *e. A#r*"- '*)r*--"#*o.


9/22

Proced$re 'or A++e++*1 P$-+e+

% Per*(er"- & -"ce ? +ecod+ @ =, *'

*rre1$-"r & co$# r"d*"- 'or > *. "d #(e "*c"--y 'or '$-- *$#e.

% A*c"- & )e"# o' #(e (e"r# "# *#6+ "e5 or PMI o*# o' "5*$

*$-+e/ & ?#(*#erco+#"- +"ce, *dc-"4*c$-"r -*e, 9$+# )e-o0 -#.

*-e & -*+#e 'or " '$-- *$#e L$)D$)

% L$) & c-o+e o' "#r*o4e#r*c$-"r AV/ 4"-$e+ & #r*c$+*d *#r"-

4"-4e+% D$) & c-o+e o' +e*-$"r 4"-4e+ & "or#*c $-o*c 4"-4e+


10/22

A, Po*# o' "5*$ *$-+e *+ "# '*'#( *#erco+#"- +"ce. B,

A++e++*1 "*c"- $-+e.


11/22

A++e++; r"#e, r(y#(, +#re1#(

#e+*o

% R"#e & N & 7>, "4er"1e 8 )

% T"c(yc"rd*" & 1re"#er #(" > )

% Br"dyc"rd*" & -e++ #(" 7 )

% R(y#( & #(e "##er o' #(e )e"#+ re1$-"r or *rre1$-"r/

% S#re1#( or +*e & or "-*#$de, #(e 4o-$e o' )-ood $+(ed "1"*+# #(e 0"-- o' "

"r#ery d$r*1 #(e 4e#r*c$-"r co#r"c#*o

% 0e"2 or #(re"dy -"c2+ '$--e++/

% F$--, )o$d*1 4o-$e (*1(er #(" or"-/

%Ierce#*)-e c"o# )e 'e-# or (e"rd/

>


12/22

Nor"- He"r# R"#e

+ge "eart 8ate (Beats/min)

nfants 7.67;

Toddlers 677

S%hool agers ?567

+doles%ent ;6


13/22

Pulse can be increasedby

Pulse can be decreasedby

exer%ise

stimulant drugsex%itementfe'ersho%!

ner'ousness

sleep

depressant drugs

heart disease

%oma

>3


14/22

Re+*r"#*o+

% A++e++ )y o)+er4*1 r"#e, r(y#( de#(

& I+*r"#*o & *("-"#*o )re"#(*1 */

& E5*r"#*o & e5("-"#*o )re"#(*1 o$#/

% IE *+ "$#o"#*c co#ro--ed )y #(e ed$--" o)-o1"#"re+*r"#ory ce#er o' )r"*/

% Nor"- )re"#(*1 *+ "c#*4e "++*4e

% A++e+ "'#er #"2*1 $-+e, 0(*-e +#*-- (o-d*1 ("d, +o "#*e# *+

$"0"re yo$ "re co$#*1 re+*r"#o+


15/22

A++e++*1 Re+*r"#*o

8ate @ of breathing %y%les/minute (inhale/exhale67%y%le)- * 7.6. breaths/min * adult 6 :upnea * normal rate & depth breathing

+bnormal in%rease * ta%hypnea

+bnormal de%rease * bradypnea

+bsen%e of breathing * apnea

Aepth +mount of air inhaled/exhalednormal (deep & e'en mo'ements of %hest)

shallo1 (rise & fall of %hest is minimal)

SB shortness of breath (shallo1 & rapid)

8hythm 8egularity of inhalation/exhalation

-ormal ('ery little 'ariation in length of pauses b/1 &: )

#hara%ter Aigressions from normal effortless breathing

Ayspnea * diffi%ult or labored breathing

#heyne6Sto!es * alternating periods of apnea and hyper'entilation, gradualin%rease & de%rease in rate & depth of resp$ 1ith period of apnea at the end ofea%h %y%le$


16/22

B-ood Pre++$re

% Force e5er#ed )y #(e )-ood "1"*+# 4e++e- 0"--+.

% Pre++$re o' )-ood 0*#(* #(e "r#er*e+ o' #(e )ody & -e'# 4e#r*c-e co#r"c#+ &)-ood *+ 'orced o$# *#o #(e "or#" #o #(e "r#er*e+, +"--er "r#er*e+ c"*--"r*e+

% Sy+#o-*c 'orce e5er#ed "1"*+# #(e "r#er*"- 0"-- "+ -e'# 4e#r*c-eco#r"c#+ $+ )-ood *#o #(e "or#" & "5. re++$re e5er#ed o

4e++e- 0"--.% D*"+#o-*c & "r#er*"- re++$re d$r*1 4e#r*c$-"r re-"5"#*o, 0(e #(e(e"r# *+ '*--*1, **$ re++$re * "r#er*e+.

& F"c#or+ "''ec#*1 B:P

& -o0er d$r*1 +-ee

& Lo0er 0*#( )-ood -o++& Po+*#*o c("1e+ B:P

& Ay#(*1 c"$+*1 4e++e-+ #o d*-"#e or co+#r*c# ed*c"#*o+


17/22

B-ood Pre+$re

% Me"+$red * H1 & *--*e#er+ o' erc$ry

% BP C-"++*'*c"#*o NCVII/

% No *4"+*4e e#(od o' B:P e"+$ree#

% S(y1o"oe#er, +#e#(o+coe

% 3 #ye+ o' +(y1o"oe#er+

Aero*d & 1-"++ ec-o+ed c*rc$-"r 1"$1e 0*#( eed-e #("# re1*+#er+#(e B:P "+ *# de+ced+ #(e c"-*)r"#*o+ o #(e d*"-.

Merc$ry & erc$ry * 1-"++ #$)e ore re-*")-e & re"d "# eye-e4e-.

E-ec#ro*c & c$'' 0*#( )$*-# * re++$re #r"+d$cer re"d+ +y+#o-*c d*"+#o-*c B:P

BP ClassificationSystolic pressure

(mmHg)Diastolic Pressure

(mmHg)

Normal J>


18/22

B-ood re+$re

% C$'' & *'-"#")-e r$))er )-"dder, #$)e coec#+ #o #(e "oe#er, "o#(er #o#(e )$-), *or#"# #o ("4e correc# c$'' +*e 9$d1e )y c*rc$'erece o' #(e"r o# "1e/& S$or# "r "# (e"r# -e4e-, "- #$red $0"rd ")o4e (e"r# c"$+e+ '"-+e -o0

re"d*1% C$'' #oo 0*de & '"-+e -o0 re"d*1

% C$'' #oo "rro0 & '"-+e (*1( re"d*1% C$'' #oo -oo+e & '"-+e (*1( re"d*1

% L*+#e 'or &orot'off souns +er*e+ o' +o$d+ cre"#ed "+ )-ood '-o0+#(ro$1( " "r#ery "'#er *# ("+ )ee occ-$ded 0*#( " c$'' #(e c$'' re++$re *+1r"d$"--y re-e"+ed.

% Do o# #"2e B:P *

% Ar 0*#( c"+#

% Ar 0*#( "r#er*o4eo$+ AV/ '*+#$-"

% Ar o #(e +*de o' " "+#ec#oy


19/22


20/22

Position

% R"*+e "#*e# "r +o #("# #(e )r"c(*"- "r#ery *+ ro$1(-y "# #(e +"e(e*1(# "+ #(e (e"r#. I' #(e "r *+ (e-d #oo (*1(, #(e re"d*1 0*-- )e"r#*'"c#$"--y -o0ered, "d 4*ce 4er+".


21/22

I order #o e"+$re #(e BP

% Sy+#o-*c )-ood re++$re *+ #(e re++$re "# 0(*c( yo$ c" '*r+# (e"r#(e $-+e.

% D*"+#o-*c )-ood re++$re *+ #(e -"+# re++$re "# 0(*c( yo$ c" +#*--(e"r #(e $-+e


22/22

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