Vital signs are very important measurements that should be done with little to no errors. As humans, we often make silly mistakes here and there, but as a medical assistant we must pay close attention to every detail. When we first meet a patient, start with small talk to see how the person is feeling. If we can tell that the patient is angry, or seems to be in a bad mood we could expect to see an elevated pulse, respiration, and blood pressure. If we can calm the patient down, their new vitals would be more accurate. Errors happen all the time with anything in life. Contributing factors in inaccurate vital sign readings include:
• Checking a patient’s height and weight with shoes still on
• Forgetting to ask if a patient has eaten, drank,
There are several different heart problems that show up as an abnormal EKG reading. For example, a heart block can occur when there is a delay in the signals coming from the SA node, AV node, or the Purkinje fibers. However, clinically the term heart block is used to refer to an AV block. This delays or completely stops communication between the atria and the ventricles. AV block is shown on the EKG as a delayed or prolonged PR interval. The P wave represents the activity in the atria, and the QRS complex represents ventricular activity. This is why the PR interval shows the signal delay from the AV node. There are three degrees of severity, and if the delay is greater than .2 seconds it is classified as first degree. Second degree is classified by several regularly spaced P waves before each QRS complex. Third degree can be shown by P waves that have no spacing relationship to the QRS complex. Another type of blockage is bundle branch block. This is caused by a blockage in the bundle of His, creating a delay in the electrical signals traveling down the bundle branches to reach the ventricles. This results in a slowed heart beat, or brachycardia. On an EKG reading this is shown as a prolonged QRS complex. A normal QRS is about .8-.12 seconds, and anything longer is considered bundle branch block. Another type of abnormal EKG reading is atrial fibrillation, when the atria contracts very quickly. On the EKG this is shown by no clear P waves, only many small fibrillating waves, and no PR interval to measure. This results in a rapid and irregular heartbeat. On the other hand, ventricular fibrillation is much more serious and can cause sudden death if not treated by electrical defibrillation.
In this lab, I took two recordings of my heart using an electrocardiogram. An electrocardiogram, EKG pg. 628 Y and pg. 688 D, is a recording of the heart's electrical impulses, action potentials, going through the heart. The different phases of the EKG are referred to as waves; the P wave, QRS Complex, and the T wave. These waves each signify the different things that are occurring in the heart. For example, the P wave occurs when the sinoatrial (SA) node, aka the pacemaker, fires an action potential. This causes the atria, which is currently full of blood, to depolarize and to contract, aka atrial systole. The signal travels from the SA node to the atrioventricular (AV) node during the P-Q segment of the EKG. The AV node purposefully delays
Nurses also refer to vital signs when assessing for deterioration but findings showed omissions were apparent in observation charts, lacking empirical evidence preferred by doctors to assess and advice further action. The review also highlighted ineffective communication between nursing and medical staff with problems experienced communicating complex information between different disciplines (NPSA
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
JB McKenzie, et al. "STRATEGIES USED BY CRITICAL CARE NURSES TO IDENTIFY, INTERRUPT, AND CORRECT MEDICAL ERRORS." American Journal of Critical Care 19.6 (2010): 500-509. CINAHL Plus with Full Text. EBSCO. Web. 7 Mar. 2011.
The purpose of this paper is to identify a quality safety issue. I will summarize the impact that this issue has on health care delivery. In addition, I will identify quality improvement strategies. Finally, I will share a plan to effectively implement this quality improvement strategy.
The research problem is clearly stated in the introduction and various times during the literature review. While it is known that automatic sphygmomanometers are not as accurate when compared to the gold standard of manual sphygmomanometer during single blood pressure readings they are still being used a triage instruments in emergency departments (Dind, Short, Ekholm, & Holdgate, 2011, p. 526). Triage is an essential step in the emergency department and instruments used in triage need to be accurate. Little is known about the accuracy of automatic devices when assessing postural blood pressures. It is shown in this study that orthostatic hypotension is a direct link to what triage category the patient is assigned, which can affect variables such as wait time and care received, so accurate measurement of this is an important factor in the emergency setting (Dind et al., 2011, p. 531).
His story of how they thought he had a heart problem, but it really was just a communication problem is baffling, however, it is not uncommon. “About 80% of all serious medical errors involve miscommunication during care transitions (to different care settings)” (Govette, 2016). Health care facilities always talk about how working as a team and communication is important to the facilities success, but it is often overlooked. I believe the reason for this, is that most facilities use text as a way to communicate and often don’t use any other methods. However, the miscommunication problem could be solved if they met with other health care professionals, or even talked to them over the phone to discuss the problems with a particular patient. Even just double checking with someone to make sure they read the patients file would help the situation
AIM: - the aim of this experiment is to find out what the effects of exercise are on the heart rate. And to record these results in various formats. VARIABLES: - * Type of exercise * Duration of exercise * Intensity of exercise * Stage of respiration
However, after my instructor left from the room, I reintroduced myself, and started a conversation, stating my objectives for the day. As I began to speak my actions while I administer vital sign, I was promptly damped by an expectedly attitude from my patient. Whenever I attempt speaking, I...
Anesthesiologists have many responsibilities. 3They measure the patient’s temperature, pulse, heart rate, and breathing rate while under the sedative. They have...
D. standing near her room, breathing sharply. While asked what has just happened, she answered, ‘I feel dizzy and can faint!’ Mrs. D. then explained that she rose up from her chair in the television room and felt lightheaded. I decided to bring her to the room hoping she would feel less dizziness if she could sit. After consultation with my mentor and third year unit nursing student, I decided to perform measurement of her vital signs. Since only electronic sphygmomanometer was available for me that time, I had to use it for my procedure. Gladly, I discovered that I have already used such equipment in my previous nursing practice. Using the standard sized calf, I found that her blood pressure was 135/85, respirations were 16, and her pulse was 96 beats per minute (bpm). However, I decided to recheck the pulse manually, founding that it was irregular (78 bpm). The patient stated that she felt better after rest. Immediately after the incident I made a decision to explore carefully the medical chart of Mrs. D., along with her nursing care plan. That helped me to discover multiple medical diagnoses influencing her
It is shocking to know that every year 98000 patients die from medical errors that can be prevented(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.), 2000). Medical errors are not a new issue in our healthcare system; these have been around for a long time. Hospitals have been trying to improve quality care and patients safety by implementing different strategies to prevent and reduce medical errors for past thirty years. Medical errors are the third leading cause of death after heart disease and cancer in America (Allen, 2013). In addition medical errors are costing our healthcare system an estimated $735 billion to $980 billion (Andel, Davidow, Hollander, & Moreno, 2012).
Vital signs are an important factor in the nursing process. Nurses every day assess a patient’s vital signs every hour, sometimes even every fifteen minutes depending on the situation. These vital signs include: heart rate, respirations, blood pressure, and temperature. Today, nurses also treat pain as the fifth vital sign because of its importance to the nursing process as a whole. Pain is an undesirable side effect that arises from many disease processes and surgical procedures. It is not the same to every person that experiences it. Many things can affect how a patient perceives their own pain. Some aspects that alter a patient’s way of perceiving pain are culture, past experiences with pain, age, gender, and the ability to
This reflection of vital signs will go into discussion about the strengths and weaknesses of each vital sign and the importance of each of them. Vital signs should be assessed many different times such as on admission to a health care facility, before and after something substantial has happened to the patient such as surgery and so forth (ref inter). I learned to assess blood pressure (BP), pulse (P), temperature (T) and respiration (R) and I will reflect and discuss which aspects were more difficult and ways to improve on them. While pulse, respiration and temperature were fairly easy to become skilled at, it was blood pressure which was a bit more difficult to understand.