Vital Signs: Temperature, Pulse, Respirations & Blood Pressure - Clinical Skills | @LevelUpRN

Summary

In this Level Up RN video, Ellis demonstrates the proper technique for taking vital signs, including respirations, pulse, and temperature. Key points include using a watch with a sweeping second hand for accurate timing, avoiding distractions while counting, and ensuring stethoscopes touch bare skin for clear auscultation. Ellis covers various methods for temperature measurement, from oral and axillary to temporal and tympanic, as well as how to measure pulse and respirations discreetly. The video also instructs on blood pressure monitoring, emphasizing the importance of proper cuff placement and listening for systolic and diastolic sounds.

Takeaways

• 🕒 Use a watch with a sweeping second hand for more accurate timing when taking vital signs.
• ⏱️ Wait for the second hand to reach a comfortable number before starting your count to avoid miscalculations.
• 👀 Avoid constantly looking at the watch while counting to prevent being influenced by its ticking.
• 👂 When auscultating sounds, ensure the stethoscope is on bare skin to avoid artifacts from clothing.
• 🌡️ For oral temperature, insert the thermometer into the posterior sublingual pocket and ensure the patient seals their lips around the probe.
• 💪 For axillary temperature, create a seal with the arm against the body to get an accurate reading.
• 🔍 Temporal temperature can be taken by placing the thermometer cap on the forehead and dragging it along the hairline.
• 👂 To take tympanic temperature, pull the pinna up and back for adults and insert the probe towards the jawline.
• 🌡️ Rectal temperature requires lubricant and insertion approximately one inch towards the umbilicus.
• 💓 To find the radial pulse, press firmly enough to feel the bounce without occluding it, and assess rate, strength, and equality.
• 🫁 For apical pulse, listen at the fifth intercostal space in the left midclavicular line, and adjust your technique for irregular heartbeats.
• 😮‍💨 To measure respirations, be discreet to avoid altering the patient's breathing pattern, and assess rate, pattern, and depth.

Q & A

What are the vital signs demonstrated in the video?

The video demonstrates how to measure respirations, pulse, and temperature.

Why is a watch with a sweeping second hand recommended for taking vital signs?

A watch with a sweeping second hand is recommended because it doesn't create a compelling sensation to start counting the ticking, which can lead to miscalculations, unlike a ticking second hand.

What is the significance of starting the count at a comfortable number on the second hand?

Starting the count at a comfortable number, like 12 or 6, makes it easier to track 30 seconds without additional mental effort, setting oneself up for success in accurate counting.

Why should one not stare continuously at the watch while taking vital signs?

Staring continuously at the watch can be confusing and lead to miscounting, as it becomes compelling to count the watch's movements rather than the patient's vital signs.

How does the presenter ensure an accurate sound when auscultating on a patient?

The presenter ensures accuracy by placing the stethoscope directly on the patient's bare skin, avoiding clothing, which can produce artifact sounds.

What is the correct method for taking an oral temperature with the thermometer demonstrated?

The correct method involves placing the probe into the posterior sublingual pocket, ensuring the patient seals their lips around the metal probe, and waiting for the monitor to beep before removing the probe.

How does the presenter differentiate between thermometers for oral/axillary and rectal temperatures?

The presenter uses different colored probe covers to differentiate between thermometers for oral/axillary (blue) and rectal (red) temperatures.

What is the proper technique for taking a tympanic temperature?

The proper technique involves grasping the pinna, pulling it up and back for adults, inserting the probe towards the jawline, and waiting for the device to beep before withdrawing it.

How does the presenter recommend taking a patient's pulse, and what factors should be assessed?

The presenter recommends finding the radial pulse proximal to the thumb, pressing firmly enough to feel the bounce without occluding it, and assessing the rate, strength, and equality of the pulse between both arms.

What is the sneaky method for taking a patient's respirations without their awareness?

The presenter suggests taking respirations covertly, often after taking the pulse, by gently resting a hand on the patient's shoulder or using the patient's arm to feel the breathing movements.

What are the key points to consider when taking a patient's blood pressure?

Key points include ensuring the patient is relaxed with their arm supported, applying the cuff one inch above the brachial artery, and using either a step-by-step or one-step approach to inflate the cuff and listen for the systolic and diastolic sounds.