BASIC PATIENT CARE: VITAL
• Body temperature is controlled by a small
SIGNS
▪Also called CARDINAL SIGNS
▪Vital signs are measurements of the
Body's most basic functions
.The four main vital signs routinely
Monitored by medical professionals
And health care providers include the
Following:
1. Body temperature
2.Pulse rate
3.Respiration Rate(rate of breathing)
4.Blood Pressure(Blood Pressure Is Not
Considered A Vital Sign but is Often
Measured along with the Vital signs.)
•TAKE NOTE:
1.A Physician’s order is not
Required for Vital signs To be measured.
2.Unless REGISTERED NURSE is present
to do so,vital signs should be taken by the
RADIOGRAPHER when a Patient is
brought into
The diagnostic imaging department for
Invasive diagnostic procedure Or treatment,
before
And after the patient receives
Medication, or anytime the patient’s general
condition Suddenly changes
▪ It is the responsibility of the radiographer
to make certain that there is a functioning
sphygmomanometer, a stethoscope and the
equipment necessary to administer oxygen
in each diagnostic imaging room at the
beginning of each shift.
▪ Emergencies requiring these items arise,
and there is no time to look for this
equipment.
BODY TEMPERATURE
structure in the basal region of the
diencephalon of the brain called the
HYPOTHALAMUS, sometimes referred to
as the body’s thermostat.
• The normal body temperature of a person
varies depending on gender, recent activity,
food and fluid consumption, time of day,
and, in women, the stage of the menstrual
cycle.
.• When the body's metabolism increases,
more heat is produced.
\• The environment, time of the day, age,
hormone level, emotions, physical exercise,
digestion of food, disease, and injury are
some factors that influence body
temperature.
• When the body's metabolism increases,
more heat is produced.
• The environment, time of the day, age,
hormone level, emotions, physical exercise,
digestion of food, disease, and injury are
some factors that influence body
temperature.
MEASURING BODY TEMPERATURE
THERE ARE FIVE AREAS OF THE BODY
IN WHICH TEMPERATURE IS USUALLY
MEASURED:
1. THE ORAL SITE
2. THE TYMPANIC SITE
3. THE RECTAL SITE
4. THE AXILLARY SITE
5. THE SKIN
1. ORAL TEMPERATURE
is taken by mouth under the tongue; the
average oral temperature reading is 98.6
(37ºC)
2. AXILLARY TEMPERATURE
is taken in the axilla or armpit. The average
axillary temperature is 97.6º to 98 º F (36.4
ºC to 36.7 ºC)
3. RECTAL TEMPERATURE is taken at the
anal opening to the rectum. The average
rectal temperature is 99.6 ºF (37.5 ºC)
4. TYMPANIC TEMPERATURE is taken
inside the ear. An ear (tympanic)
temperature is 0.3°C (0.5°F) to 0.6°C (1°F)
higher than an oral temperature.
• The site selected for measuring body
temperature must be chosen with care
depending on the patient’s age, state of
mind, and ability to cooperate in the
procedure.
• Because the reading will vary depending
on where it is measured, be sure to specify
the site used when reporting the reading.
Example:
• A rectal temperature of 99.6 º F is written
99.6 R.
• An oral temp of 98.6 º F is written 98.6 O.
• An axillary temp of 97.6 º F is written 97.6
Ax.
• A tympanic temp of 97.6 º F is written
97.6 T.
INSTRUMENT USED TO MONITOR BODY
TEMPERATURE
1. TYMPANIC MEMBRANE
THERMOMETER(ALSO CALLED AS AN
AURAL THERMOMETER)
- Is a small, hand-held device that
measures the temperature of the blood
vessels in the tympanic membrane of the
ear.
2. ORAL TEMPERATURE
- The probe is under the tongue and held in
place until the instrument signals that it has
registered temperature.
3. AXILLARY THERMOMETER
-Safest method of measuring body
temperature because it is non- invasive.
4. RECTAL THERMOMETER
- Considered to provide the most reliable
measurement of the body temperature
because factors that can alter the results
are minimized.
- Normally, a rectal temperature is taken
only on infant patients and not on adults.
- For rectal temperature, use a thermometer
with a blunt tip. - Never use an oral
thermometer to take a rectal temperature.
- Probe covers are often colored red for
rectal temperature.
OTHER INSTRUMENT USED:
• TEMPERATURE- SENSITIVE PATCHES It
is place on the abdomen or forehead of
infants or children to measure temperature
• A newer method obtaining a temperature
is done by “scanning” the forehead and the
back of the ear with a probe.
• They are a quick and reliable method for
obtaining a baseline temperature.
PULSE RATE
• As the heart beats, blood is pumped in a
pulsating fashion into the arteries. This
results in a throb, or pulsation, of the artery.
• At areas of the body in which arteries are
superficial, the pulse can be felt by gently
pushing the artery lying beneath the skin
against a solid surface such as a bone.
• The pulse can be detected most easily in
the following areas of the body:
• Apical pulse: over the apex of the heart
(heard with a stethoscope).
• Radial pulse: over the radial artery at the
wrists at the base of the thumb.
• Carotid pulse: over the carotid artery at
the front of the neck .
• Femoral pulse: over the femoral artery in
the groin
• Popliteal pulse: at the posterior surface of
the knee
• Temporal pulse: over the temporal artery in • Respiration is also quicker in newborns
front of the ear and infants. When assessing respiration,
• Dorsalis pedis pulse (pedal): at the top of observe the rate, depth, quality, and pattern.
the feet in line with the groove between the
extensor tendons of the great and the
second
• Posterior tibial pulse: on the inner side of
the ankles.
• Brachial pulse: in the groove between the
biceps and the triceps muscles above the
elbow at the antecubital fossa.

BLOOD PRESSURE

• Blood pressure is the force of the blood

▪ Tachycardia- is an abnormally rapid heart
rate (over 100 beats per minute).
▪ Bradycardia- is an abnormally slow heart
rate (below 60 beats per minute).
pushing against the artery walls during
contraction and relaxation of the heart.
• Each time the heart beats, it pumps blood
into the arteries, resulting in the highest
blood pressure as the heart contracts.
When the heart relaxes, the blood pressure
falls.

• For infants and children, the apical pulse is

the most accurate for cardiovascular
assessment.
• Equipment needed to assess the pulse
includes a watch with a second hand and a
pad and pencil to record findings. For
monitoring apical pulse, a stethoscope that
has been cleaned will be needed.

RESPIRATION RATE
• As with other vital signs, it is important to
establish a baseline respiratory rate
because changes in respiration are often an
early sign of threatened physiologic state.
Remember, however, that the rate of
respiration increases with physical exercise
or emotion.
• Both the systolic and diastolic pressures
are recorded as "mm Hg" (millimeters of
mercury).
• This recording represents how high the
mercury column in an old-fashioned manual
blood pressure device (called a mercury
manometer or sphygmomanometer) is
raised by the pressure of the blood.
• High blood pressure, or hypertension,
directly increases the risk of heart attack,
heart failure, and stroke.
• With high blood pressure, the arteries may
have an increased resistance against the
flow of blood, causing the heart to pump
harder to circulate the blood.

Blood pressure is categorized as normal,

elevated, stage 1 or stage 2 high blood
pressure:
• Normal blood pressure is systolic of less
than 120 and diastolic of less than 80
(120/80)
• Elevated blood pressure is systolic of 120
to 129 and diastolic less than 80
• Stage 1 high blood pressure is systolic is
130 to 139 or diastolic between 80 to 89
• Stage 2 high blood pressure is when
systolic is 140 or higher or the diastolic is 90
or higher
WHY WE NEED TO MONITOR BLOOD
PRESSURE?
• For people with hypertension, home
monitoring allows the doctor to monitor how
much the blood pressure changes during
the day, and from day to day.
• This may also help the doctor determine
how effectively the blood pressure
medication is working.
BEFORE YOU MEASURE YOUR BLOOD
PRESSURE:
The American Heart Association
recommends the following guidelines before
performing blood pressure monitoring:
1. Don't smoke or drink coffee for 30
minutes before taking your blood pressure.
2. Go to the bathroom before the test.
3. Relax for 5 minutes before taking the
measurement.

PROCEDURE FOR PATIENT
ASSESSMENT
What is Patient Assessment?
1. Can the patient tolerate the stresses of
the procedure?
2. Are modifications to the treatment plan
necessary based upon the patient's history
and physical?
3. Is premedication/ other procedure is
really required for the patient?
PATIENT ASSESSMENT DEFINITIONS
1. Scene Size-Up : Steps taken by
healthcare providers when approaching the
scene of an emergency call.
2. Initial Assessment: The process used to
identify and treat life-threatening problems,
concentrating on Level of Consciousness,
Cervical Spinal Stabilization, Airway,
Breathing, and Circulation.
3. Focused History and Physical
Examination: The components of this step
may be altered based on the patient’s
presentation.
4. Rapid Trauma Assessment: This is
performed on patients with a significant
mechanism of injury to determine potential
life -threatening injuries.
5. Rapid Medical Assessment: This is
performed on medical patients who are
unconscious, confused, or unable to
adequately relate their chief complaint.
6. Focused History and Physical
Examination – Trauma: This is used for
patients, with no significant mechanism of
injury, that have been determined to have
no life-threatening injuries.
7. Focused History and Physical
Examination – Medical: This is used for
patients with a medical complaint who are
conscious, able to adequately relate their
chief complaint to you, and have no life-
threatening conditions.
8. Detailed Physical Examination - This
assessment will only be performed while
enroute to the hospital or if there is time on-
scene while waiting for an ambulance to
arrive.
9. Ongoing Assessment - This assessment
is performed during transport on all patients.
• Many patients come to the diagnostic
imaging department in poor physical
condition. This may be due to illness, injury,
or lengthy preparation for a diagnostic
examination.
• When a person is in a weakened physical
condition, physiologic reactions occur
quickly and without warning and may be life
threatening if not recognized and treated
immediately.
ACRONYMS USED DURING PATIENT
ASSESSMENT
The nontrauma-related medical
emergencies that occur while the patient
is undergoing diagnostic imaging are:
1. Shock
2. Anaphylaxis (a type of shock)
3. Pulmonary embolus
4. Reaction related to diabetes mellitus
5. Cerebral Vascular Accident (CVA)
6. Cardiac and Respiratory Failure
7. Syncope
8. Seizures
• Neurologic assessment can be highly
technical and complex and is not within the
scope of a RT’s practice. However, a rapid
neurologic assessment tool that is used
frequently in health care institutions is the
GLASGOW COMA SCALE.
• This scale addresses the three areas of
neurologic functioning and quickly gives an
overview of the patient’s level of
responsiveness. It is simple, reliable and
convenient to use

• As a radiologic technologist, you may be

the first member of the health care team to
observe these reactions, you must be able
to recognize the symptoms and initiate the
correct treatment.
• The technologist must be able to assess
the behaviors that determine a patient’s
level of neurologic and cognitive functioning
on admission for a diagnostic procedure. If
this initial assessment is performed, the
technologist will be able to recognize
changes in the patient’s mental status if
they occur in the imaging department.

ASSESSMENT OF NEUROLOGIC AND

COGNITIVE FUNCTIONING

.SKIN COLOR ASSESSEMENT
• The skin is an easily observed indicator of
the peripheral circulation and perfusion,
blood oxygen levels, and body temperature.
• The skin color, temperature, and condition
are good indicators of the patient’s condition
and circulatory status.
• They may also be good initial indicators of
heat or cold injuries. This initial indicator
should always be confirmed, when time
permits, with a core body temperature.
Vitiligo
• In this condition, which may be hereditary,
melanocytes (cells that produce melanin)
die or stop forming melanin.
• Depigmented patches of milky-white skin
appear in various regions, typically the face,
hands, feet, and extensor surfaces and may
coalesce into extensive areas.
Cyanosis
• It refers to a bluish cast to the skin and
mucous membranes.
• Peripheral cyanosis is when there is a
bluish discoloration to the hands or feet.
• It's usually caused by low oxygen levels in
the red blood cells or problems getting
oxygenated blood to the body.
Jaundice
• Jaundice is a condition in which the skin,
whites of the eyes and mucous membranes
turn yellow because of a high level of
bilirubin, a yellow-orange bile pigment.
• Jaundice has many causes, including
hepatitis, gallstones and tumors.
• In adults, jaundice usually does not need
to be treated.
Erythema
• It is the redness of the skin or mucous
membranes, caused by hyperemia
(increased blood flow) in superficial
capillaries.
• It occurs with any skin injury, infection, or
inflammation.
BLEEDING ASSESSMENT
Bleeding, also called HEMORRHAGE, is
the name used to describe blood loss.
Blood loss can occur in almost any area of
the body.
1.Internal bleeding occurs when blood leaks
out through a damaged blood vessel or
organ.
2.External bleeding happens when blood
exits through a break in the skin
1. ARTERIAL With this type of bleeding, the
blood is typically bright red to yellowish in
colour, due to the high degree of
oxygenation. A wound to a major artery
could result in blood ‘spurting’ in time with
the heartbeat, several meters and the blood
volume will rapidly reduce.
2. VENOUS This blood is flowing from a
damaged vein. As a result, it is blackish in
color (due to the lack of oxygen it
transports) and flows in a steady manner.
Caution is still indicated: while the blood
loss may not be arterial, it can still be quite
substantial, and can occur with surprising
speed without intervention.
3. CAPILLARY Bleeding from capillaries
occurs in all wounds. Although the flow may
appear fast at first, blood loss is usually
slight and is easily controlled. Bleeding from
a capillary could be described as a ‘trickle’
of blood.
*The key first aid treatment for all these
types of bleeding is DIRECT PRESSURE
over the wound.
What is the most serious type of bleeding?
• Blood in the arteries is rich in oxygen and
is said to be bright red', however, this can
be difficult to assess.
• This is the most serious type of bleeding
because a large amount of blood can be
lost in a very short period.
SENSORY EVALUATION AND PAIN
The Sensory Exam
• The sensory exam involves evaluation of
pain (or temperature), light touch, position
sense, vibration, and discriminative
sensations.
• This portion of the exam is very subjective
and may become unreliable if repeated in
quick succession.
• Therefore, this exam should not be
rushed, but must proceed efficiently.
Compare symmetrical areas on both sides
of the body and compare proximal to distal
areas.
CLINICAL ASSESSMENT OF
MUSCULOSKELETAL INTEGRITY AND
PATIENT’S MOBILITY
• The musculoskeletal system provides
form, support, stability, and movement to
the body
• It is made up of the bones of the skeleton,
muscles, cartilage, tendons, ligaments,
joints, and other connective tissue that
supports and binds tissues and organs
together.
MUSCULOSKELETAL EVALUATION
• The musculoskeletal examination should
include assessments of strength and of
active and passive range of motion and
evaluation for warmth, tenderness, or
swelling of joints.
Why is musculoskeletal evaluation
important?
• Defects in function can be most rapidly
perceived by having the patient perform
active functions with each region of the
musculoskeletal system.
This reduces examination time and helps
the examiner to identify areas in which there
is poor function for more careful evaluation.