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ASO Vital Signs

Vital Sign Skills test (Prep., Pulse., Resp., 2-Step BP, and Post Procedure)

StepsDetail
Step 1 Perform hand hygiene.
Step 2 Introduce self to patient.
Step 3 Identify patient with confirmation of full first and last name and D.O.B.
Step 4 Explain that you will take their vitals but first need to know if they have consumed or participated in any nicotine use or smoking, caffeine consumption, or any exercise/strenuous activity in the last 30 minutes.
Step 5 To find the pulse rate, determine which arm the patient wants to use and position them in a comfortable sitting or lying position, with arm relaxed and wrist extended
Step 6 Palpate radial (wrist) artery – if weak or hard to locate, switch to the other arm and notate that switch was needed
Step 7 If pulse is regular, count the beat for 30 seconds and multiply the number by 2 to get the rate. If irregular, count for a full minute.
Step 8 Determine if the pulse is regular or irregular in rhythm, weak, normal, or bounding in strength, and note it
Step 9 ***Identify the pulse rate within 4 beats of the monitor to pass*** Ex: if the beats the monitor records is 72, I must be between 70 and 74
Step 10 For respiration rate, observe rise and fall of chest or upper abdomen (one full respiratory cycle is 1 inhalation and 1 exhalation)
Step 11 ***If respirations are regular, count for 30 seconds then multiply by 2 for rate. If irregular, count for a full minute to get the rate. (Regular = 12-20 per minute, Irregular = <12 per minute or >20 per minute)
Step 12 Determine rhythm and depth of respiration (shallow depth = high rate, deep depth = low rate)
Step 13 ***Identify respiratory rate within 4 respirations of monitor to pass. Ex: if the rate the monitor records is 16, I must be between 14 and 18
Step 14 To find a baseline systolic reading, determine which arm the patient wants to use
Step 15 Position the patient with arm supported at heart level, legs uncrossed, and feet flat on the floor
Step 16 ***Measure to find appropriate cuff size – 40% of the circumference of upper arm covered by the cuff width-wise, and two-thirds length of the upper arm covered when wrapped.
Step 17 ***Palpate brachial artery (to locate)
Step 18 ***Squeeze excess air from cuff and center the cuff bladder over the brachial artery at one inch above antecubital space
Step 19 ***Wrap deflated cuff snugly and evenly over exposed upper arm – no clothing on the arm
Step 20 Position the manometer at eye level
Step 21 ***Palpate the radial artery with fingertips of the non-dominant hand and slowly inflate until the pulse disappears. Note the number where pulse disappears! Continue to inflate by 30mm Hg above where the pulse disappeared.
Step 22 ***Deflate the cuff at 2-3mm Hg per second while feeling for the pulse’ return. Note the number where pulse returns! The number reading for appearance should be the same as disappearance. If numbers differ, use the higher number.
Step 23 ***Now that the baseline systolic pressure is found, deflate the cuff fully and wait 30 seconds before measuring the BP reading
Step 24 ***Place the stethoscope ear pieces in your ears (pointed towards the nose to follow the angle of the ear canal) and place the diaphragm over the brachial artery
Step 25 ***Close the pump valve and inflate the cuff to 30mm Hg over the established palpated systolic reading. The first sound heard is the systolic number
Step 26 ***Gradually deflate the cuff at a constant rate of 2-3 mm Hg per second, to 30 mm Hg past the last sound heard. The very last sound heard is the diastolic number
Step 27 If unable to get an accurate reading, rapidly and fully deflate the cuff and wait 30 seconds before trying again
Step 28 Remove the cuff from the patient
Step 29 ***Accurately identify blood pressure reading within 6 mm Hg of monitor to pass
Step 30 Perform hand hygiene
Step 31 Document procedure in patient chart
Created by: MrsLaceUp
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