By Stacy Heim
Nicole Walz
Lisa Anderson
Amy Lindgren
In this chapter we will discuss the basics of patient
care including the patients basic needs and how we
can meet them. It is important to have a history of the
care of the patient and to obtain one when a new
patient is being given medical care. We can help the
patient more effectively if we have a history of
illnesses and care that they have had. When you first
help a patient it is important to establish a bases of the
patients condition this includes an evaluation of the
patients physical condition and their vital signs. We
also discussed how important it is to know what to do
and how to use the equipment necessary in various
acute/emergency situations.
 Observation
 Evaluation
 Assessment
(Page 488)
 Fear
 Anger
 Anxiety
 Need
to talk constantly
 Become quiet and withdrawn
 Fidgeting
 Physical Discomfort
(Page 488)
 Dry
mouth can result from anxiety or
medication
 Offering water may be comforting to the
patient
 Make sure water is permitted
(Page 488)
 Urgent
need to void can be distressing to a
patient
 Full bladder can cause discomfort,
irritability, and difficulty remaining still
 If incontinence results, it would cause
embarrassment
 Before patient uses bathroom, make sure
no specimen is needed
 Use bedpan if needed
(Page 488 to 489)
 Make
sure you know where sanitary
napkins are kept
 Direct patient to properly dispose of the
sanitary napkin
(Page 489)
 Provide
complete and accurate
information about patient’s history and
condition
 Introduce yourself, call patient by their
name, and deal with their concerns right
away
 Gain patient’s confidence
(Page 489 to 490)
 How
did it start?
 What happened?
 When did it first trouble you?
 Was it sudden or a complaint that
gradually got worse?
(Page 490)
 Have
you ever had it before?
 If so, when?
 Has it been continuous?
 Does it bother you al the time?
 How long has this attack been bothering
you?
(Page 490)
 Where
does it hurt?
 Where is the problem?
 Can you put your finger on where it hurts
the most?
 Does it hurt anywhere else?
(Page 490)
 What
does it feel like?
 Sharp, stabbing, dull ache, throbbing pain?
 How severe is it?
 Mild, moderate, severe? (you could use a
scale from 1 to 10, 1 being no pain and 10
being the worst pain you could ever feel)
 Does it wake you up at night?
(Page 490)
 When
is it worse?
 What seems to aggravate it?
 Is it worse after meals, at night, when you
walk?
(Page 490)
 What
has helped in the past?
 Does that still help?
 What seems to help now?
 Does the time of day, amount of rest or
change is position make a difference?
(Page 490)
 Anxious
patients may read too much into
your questions
 Taking a history may seem complex and
confusing, but this skill improves with
practice
 Use role play with other students to
improve your ability to take histories
 They will become accurate and pertinent
(Page 490)
 Review
 Read
Requisition
Diagnosis and progress notes
 Allergies
 Patient
(Page 490)
history
 Observation
• Six methods of observation
 Inspection
 Palpation
 Percussion
 Auscultation
 Mensuration
 Manipulation
 Assessment
 Measurement
 Changes
in patient condition
(Beaman & Fleming-McPhillips, 2007)
(Page 490 and 491)


Normal body temperature is 98.6 degrees F
Hyperthermia
• Over 105. 8 Degrees F

Hypothermia
• Below 97 Degrees F



Methods of taking a temperature
•
•
•
•
Oral
Axillary
Rectal
Ear (aural)
•
•
•
•
Non-mercury glass
Electronic or digital
Tympanic
Disposable
•
•
•
•
Intermittent Fever
Remittent Fever
Relapsing Fever
Constant Fever
Thermometer types
Fever types
(Beaman & Fleming-McPhillips, 2007)

Normal Pulse rate for adults
• 60 – 80 bpm
• 50 – 65 bpm for older adults


Normal pulse rate for children
•
•
•
•
120 – 160 bpm for 1 year or younger
80 – 120 bpm for 2 – 6 years
80 – 100 bpm for 6 – 10 years
70 – 90 bpm for 11 – 16 years
•
•
•
•
Rate
Volume
Rhythm
Compliance
Characteristics of pulse
(Beaman & Fleming-McPhillips, 2007)

The 9 Pulse Sites
• Temporal
• Carotid
• Apical
• Brachial
• Radial
• Femoral
• Popiteal
• Posterior Tibial
• Dorsalis Pedis
(Beaman & Fleming-McPhillips, 2007)

Normal range for Adults
• 14 – 20 Cycles per minute

Normal range for Children
• Average of 30 – 50 cycles per
minute

Characteristics of
Respiration
• Rate
• Rhythm
• Depth
• Quality
(Beaman & Fleming-McPhillips, 2007)

Breathing Sound
• Stridor
• Stertorous
• Crackles
• Rhonchi
• Wheezes
• Cheyne-Stokes
• Bubbling

Normal reading for Adults
• 120/80 or below

Normal readings for children
•
•
•
•

Newborn 75/55
6 – 9 years 90/55
10 – 15 years 100/65
16 years 118/76
Hypertension
• 140/90 or above

Prehypertension
• 120/80 to 139/89

Hypotension
• Systolic less than 50 mm Hg

Tools used to take blood pressure
• Stethoscope
• Sphygmomanometer

Korotkoff Sounds
(Beaman & Fleming-McPhillips, 2007)
(Page 496)
 Considered
the fifth vital sign
• Not easy to see or measure
 Types
of pain
• Acute
• Chronic
• Radiating
• Referred
• Intractable
• Phantom
(Beaman & Fleming-McPhillips, 2007)

Not considered one of the vital signs
• Is included when doing vital signs

Pulse Oximeter
• Has sensor that attaches to finger or earlobe
• Measures oxygen saturation in blood
• Measures pulse rate

Normal Oxygen Saturation levels
• Ranges between 95% and 100%
(Page 497)

It is important to be able to evaluate a patients condition
in a short amount of time.

Notice the changes in their symptoms and conditions is
crucial.

Knowing what equipment and supplies is
needed in a emergency can help save a
persons life.

Every situation is different and must be
handled in a carefully and remain calm
under pressure.
(Page 497)

Basic supplies emergency that should be kept in a clinic :
-Airways, Emergency Medications, BP cuff, and
Stethoscope. Some clinics have a more extensive
emergency supplies.

It is important to know what is apart of the emergency
supplies and to never use them for routine use.
(Page 497 to 499)

Oxygen
-It is important to know how to effectively operate
Oxygen and Suction systems in the Facility.

Oxygen Administration
- Face Mask: Oxygen concentrations
30%-50%
-Portable tank with nasal cannula: Delivers
a constant rate of Oxygen flow for Long-term
Oxygen Therapy.
(Page 499 to 500)

Suction
-Suction is used when a patient is unable to clear the
mouth and throat of secretions, blood, or vomit.
- Ensure that the suction system is in operational
condition.
- Help place the patient into the recovery
position once their airway is clear and stand
to the side.
(Page 499 to 500)

Asthma
- Bronchospasm that causes difficulty in breathing.
- Treatments include a nebulizer with bronchodilating
medication for chronic asthmas and epinephrine for
asthma attacks.
(Page 500 to 501)

Bronchial Obstruction
- Occurs when food or other objects lodge in the larynx
blocking the airway.
- Signs include: unable to talk, cough, become agitated,
and make the universal choking sign.
- Heimlich Maneuver or Abdominal
thrusts should be used to dislodge the
object.
(Page 501)

Angina Pectoris
-Chest pain that occurs when the coronary arteries are
unable to supply the heart with sufficient Oxygen.
-Precipitated by stress or exertion.
-Relieved by rest and/or nitroglycerin tablets.
(Page 501 to 502)

Heart Attack
- A portion of the heart starts lacking oxygen.
- Sudden intense chest pain that can radiate to the left
arm, shoulder, and neck. Can appear pale.
- Prevent exertion.
- Assist them with oxygen administration
and help them to a comfortable position.
Call 911 or emergency help.
(Page 502)

Cardiac Arrest
- If you are certified in CPR and the person is not
breathing and has no pulse call for help and start CPR.
-If an AED is near and you are able to use it do so. It will
guide you and help monitor the
persons’ vitals.
- Stay with the patient until help
arrives and can take over.
(Page 502)
 Head
injuries
• Four levels of consciousness
 Extremity
fractures
• Eight common types of fractures
• Special care required and to observe
 Wounds
• Control the bleeding and maintain dressing
• hemorrhaging
(Page 502 to 503)
 Drug
Reactions
• Allergic reactions and anaphylaxis
• Early symptoms of anaphylaxis
 Diabetic
Emergencies
• Disease
• What does the body do to compensate?
• How is it diagnosed?
(Page 503 to 504)
 Cerebrovascular
Accident
• Warning signs
• Three questions to test for a stroke
• How to respond to a stroke
 Seizure
Disorders
• Why do they occur and what are the different
types?
• What to do if someone is having a seizure
(Page 504 to 505)
 Hyperventilation
• What happens during hyperventilation?
• What can be done to prevent it?
 Vertigo
and Postural Hypotension
• What is vertigo?
• What is postural hypotension?
• How can they be avoided?
(Page 505)
 Epistaxis
• Usually not serious
• How to stop epistaxis
• When to inform the physician
 Nausea
and vomiting
• What do you do if your patient is nauseated or
vomiting and how to control it?
• loss consciousness
(Page 506)
 Shock
• What is shock?
 Potentially fatal
• What is syncope?
• Dorsal recumbent position
• Symptoms of shock
• The role of the limited operator if shock is
suspected.
(Page 506)
A
limited operator must be able to assess
and respond to situations in a proper and
concise manner. They also must be able to
recognize signs and symptoms that are
emergent and life threatening.
 When one is trained well they will be more
alert and have a more positive outcome.
Beaman, N. & Fleming-McPhillips, L. (2007)Pearson’s
Comprehensive Medical Assisting. New Jersey:
Person Education, Inc.
Long, B., Frank, E. D., & Ehrlich, R. A. (2010) Radiography
Essentials For Limited Practice. Missouri: Saunders
Elsevier Inc.