Adult Health Assessment

Normal Temperature Range

35.8 - 37.3

Normal Pulse Range

60-100 bpm

Normal Blood Pressure

95 - 135 systolic
60 - 85 - diastolic

Normal Resperiations

10 - 20 breaths per minute

Normal Oxygen Saturation

+95%

Pain scale

1 - 10

OPQRSTUV Pain Assessment

Onset - When did it begin?
Provoke - What makes it better/worse?
Quality - What does it feel like?
Radiate - does it radiate anywhere?
Severity - Rate 1/10
Treatment - what treatment have you tried?
Understanding - what do you think caused it?
Value - wha

Nursing Process

Assessment
Diagnosis
Planning
Implementation
Evaluation

medical diagnosis

the identification of a disease or condition by a doctor

Nursing Diagnosis

used to evaluate the response of the whole person to actual or potential health problems

Describe the four qualities considered when assessing the pulse

Rate (bpm)
Rhythm (regular/irregular)
Force (0-3+)
0 - abssent
+1 - weak
+2 - normal
+3 - full bounding
Equality - same both sides?

Describe various routes of temperature measurement and special considerations for each route

Rectal - only when other routes are not practical
Tympanic Membrane Temp - infrared emissions of eardrum
Temporal Artery Temp - infrared emissions from the temporal artery. More accurate than TMT (but conflicting reports)

Describe the appropriate procedure for assessing respiration and oxygen saturation

Don't mention taking respiratiatons. Maintain position of counting pulse. Count 30 sec if normal. 1min if abnormal.

Discuss the importance of using an appropriately sized blood pressure cuff

Width: 40% circumfrence of patients arm
Length: 80% circumfrence arm
Too narrow yields a falsely high BP - takes extra pressure to compress the artery