{"id":532,"date":"2018-01-02T00:55:10","date_gmt":"2018-01-02T00:55:10","guid":{"rendered":"http:\/\/pressbooks.library.ryerson.ca\/vitalsign\/?post_type=chapter&#038;p=532"},"modified":"2018-02-14T15:41:39","modified_gmt":"2018-02-14T15:41:39","slug":"532","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/chapter\/532\/","title":{"raw":"Case Study 4: Older Adult Client (continued)","rendered":"Case Study 4: Older Adult Client (continued)"},"content":{"raw":"<h2><strong>Vital Sign Measurements\u00a0<\/strong><\/h2>\r\n<h4>1050 hrs, September 7, 2018<\/h4>\r\n<ul>\r\n \t<li>Sitting BP: 160\/94 mm Hg right arm<\/li>\r\n \t<li>Pulse: 72 bpm (radial), 2+, regular rhythm<\/li>\r\n<\/ul>\r\n&nbsp;\r\n\r\n<strong>1. Which findings are considered abnormal for this adult client? What medical terminology is used to define\/label these findings?<\/strong>\r\n<ul>\r\n \t<li>The blood pressure is elevated: hypertension (without diagnosis).<\/li>\r\n<\/ul>\r\n<strong>2. What factors might cause the blood pressure reading to be higher than normal in this adult client?<\/strong>\r\n<ul>\r\n \t<li>Operator error<\/li>\r\n \t<li>Anxiety, stress, or pain<\/li>\r\n \t<li>Caffeine, smoking, or nicotine in the preceding 30 minutes<\/li>\r\n \t<li>Recently took adrenergic stimulants such as phenylephrine or pseudoephedrine<\/li>\r\n \t<li>Bladder and bowel discomfort<\/li>\r\n \t<li>Tight clothing on arm or forearm<\/li>\r\n \t<li>Noisy, cold room<\/li>\r\n \t<li>Taken immediately after activity<\/li>\r\n \t<li>Movement during the pressure reading<\/li>\r\n<\/ul>\r\n<strong>3. What are the healthcare provider\u2019s next actions based on the findings of this older client?<\/strong>\r\n<ul>\r\n \t<li>Retake the blood pressure to ensure accuracy<\/li>\r\n \t<li>Take blood pressure in the other arm<\/li>\r\n \t<li>Have client sit in a room by themselves and then do the following:\r\n<ul>\r\n \t<li>ensure the room is quiet<\/li>\r\n \t<li>dim the lights<\/li>\r\n \t<li>allow the client to sit quietly for five minutes, without talking<\/li>\r\n \t<li>then take three measurements, a few minutes apart, with the automatic cuff (with an automatic cuff, the blood pressure documented is the average of the three readings).<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n&nbsp;\r\n\r\nAfter the healthcare provider followed the above procedures, the results were:\r\n\r\nSeptember 7, 2018\r\n\r\n1058 hrs \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sitting BP: 156\/92 mm Hg right arm P 70 bpm (radial)\r\n\r\n1100 hrs\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sitting BP: 148\/90 mm Hg left arm\r\n<h4><\/h4>\r\n<strong>Automatic Cuff\u00a0<\/strong>\r\n<h4><strong>5 mins later (1105 hrs)<\/strong><\/h4>\r\nSitting BP: 150\/86 mm Hg right arm P 66 bpm\r\n<h4><strong>2 mins later (1107 hrs)<\/strong><\/h4>\r\nSitting BP: 144\/84 mm Hg right arm P 68 bpm\r\n<h4><strong>2 mins later (1109 hrs)<\/strong><\/h4>\r\nSitting BP: 156\/82 mm Hg right arm P 62 bpm\r\n\r\n&nbsp;\r\n<div class=\"textbox shaded\"><strong>Print the blank vital sign record and document the adult client\u2019s vital sign readings. Then, go to the next page for a sample vital sign record of these findings.<\/strong><span><\/span><span><\/span><\/div>\r\n<a href=\"http:\/\/pressbooks.library.ryerson.ca\/vitalsign\/wp-content\/uploads\/sites\/26\/2018\/01\/Vital-Sign-Record-blank-FINAL.pdf\">Vital Sign Record \u2013 Blank (pdf)<\/a>\r\n\r\n<a href=\"http:\/\/pressbooks.library.ryerson.ca\/vitalsign\/chapter\/case-study-2-pediatric-client-continued\/vital-sign-record_blank\/\" rel=\"attachment wp-att-1188\"><img src=\"http:\/\/pressbooks.library.ryerson.ca\/vitalsign\/wp-content\/uploads\/sites\/26\/2018\/01\/Vital-Sign-Record_Blank-761x1024.jpg\" alt=\"\" class=\"alignnone size-large wp-image-1188\" width=\"761\" height=\"1024\" \/><\/a>\r\n\r\n&nbsp;","rendered":"<h2><strong>Vital Sign Measurements\u00a0<\/strong><\/h2>\n<h4>1050 hrs, September 7, 2018<\/h4>\n<ul>\n<li>Sitting BP: 160\/94 mm Hg right arm<\/li>\n<li>Pulse: 72 bpm (radial), 2+, regular rhythm<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>1. Which findings are considered abnormal for this adult client? What medical terminology is used to define\/label these findings?<\/strong><\/p>\n<ul>\n<li>The blood pressure is elevated: hypertension (without diagnosis).<\/li>\n<\/ul>\n<p><strong>2. What factors might cause the blood pressure reading to be higher than normal in this adult client?<\/strong><\/p>\n<ul>\n<li>Operator error<\/li>\n<li>Anxiety, stress, or pain<\/li>\n<li>Caffeine, smoking, or nicotine in the preceding 30 minutes<\/li>\n<li>Recently took adrenergic stimulants such as phenylephrine or pseudoephedrine<\/li>\n<li>Bladder and bowel discomfort<\/li>\n<li>Tight clothing on arm or forearm<\/li>\n<li>Noisy, cold room<\/li>\n<li>Taken immediately after activity<\/li>\n<li>Movement during the pressure reading<\/li>\n<\/ul>\n<p><strong>3. What are the healthcare provider\u2019s next actions based on the findings of this older client?<\/strong><\/p>\n<ul>\n<li>Retake the blood pressure to ensure accuracy<\/li>\n<li>Take blood pressure in the other arm<\/li>\n<li>Have client sit in a room by themselves and then do the following:\n<ul>\n<li>ensure the room is quiet<\/li>\n<li>dim the lights<\/li>\n<li>allow the client to sit quietly for five minutes, without talking<\/li>\n<li>then take three measurements, a few minutes apart, with the automatic cuff (with an automatic cuff, the blood pressure documented is the average of the three readings).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>After the healthcare provider followed the above procedures, the results were:<\/p>\n<p>September 7, 2018<\/p>\n<p>1058 hrs \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sitting BP: 156\/92 mm Hg right arm P 70 bpm (radial)<\/p>\n<p>1100 hrs\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sitting BP: 148\/90 mm Hg left arm<\/p>\n<h4><\/h4>\n<p><strong>Automatic Cuff\u00a0<\/strong><\/p>\n<h4><strong>5 mins later (1105 hrs)<\/strong><\/h4>\n<p>Sitting BP: 150\/86 mm Hg right arm P 66 bpm<\/p>\n<h4><strong>2 mins later (1107 hrs)<\/strong><\/h4>\n<p>Sitting BP: 144\/84 mm Hg right arm P 68 bpm<\/p>\n<h4><strong>2 mins later (1109 hrs)<\/strong><\/h4>\n<p>Sitting BP: 156\/82 mm Hg right arm P 62 bpm<\/p>\n<p>&nbsp;<\/p>\n<div class=\"textbox shaded\"><strong>Print the blank vital sign record and document the adult client\u2019s vital sign readings. Then, go to the next page for a sample vital sign record of these findings.<\/strong><span><\/span><span><\/span><\/div>\n<p><a href=\"http:\/\/pressbooks.library.ryerson.ca\/vitalsign\/wp-content\/uploads\/sites\/26\/2018\/01\/Vital-Sign-Record-blank-FINAL.pdf\">Vital Sign Record \u2013 Blank (pdf)<\/a><\/p>\n<p><a href=\"http:\/\/pressbooks.library.ryerson.ca\/vitalsign\/chapter\/case-study-2-pediatric-client-continued\/vital-sign-record_blank\/\" rel=\"attachment wp-att-1188\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.ryerson.ca\/vitalsign\/wp-content\/uploads\/sites\/26\/2018\/01\/Vital-Sign-Record_Blank-761x1024.jpg\" alt=\"\" class=\"alignnone size-large wp-image-1188\" width=\"761\" height=\"1024\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-content\/uploads\/sites\/26\/2018\/01\/Vital-Sign-Record_Blank-761x1024.jpg 761w, https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-content\/uploads\/sites\/26\/2018\/01\/Vital-Sign-Record_Blank-223x300.jpg 223w, https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-content\/uploads\/sites\/26\/2018\/01\/Vital-Sign-Record_Blank-768x1033.jpg 768w, https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-content\/uploads\/sites\/26\/2018\/01\/Vital-Sign-Record_Blank-65x87.jpg 65w, https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-content\/uploads\/sites\/26\/2018\/01\/Vital-Sign-Record_Blank-225x303.jpg 225w, https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-content\/uploads\/sites\/26\/2018\/01\/Vital-Sign-Record_Blank-350x471.jpg 350w\" sizes=\"auto, (max-width: 761px) 100vw, 761px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"author":36,"menu_order":16,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-532","chapter","type-chapter","status-publish","hentry"],"part":487,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/pressbooks\/v2\/chapters\/532","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/wp\/v2\/users\/36"}],"version-history":[{"count":17,"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/pressbooks\/v2\/chapters\/532\/revisions"}],"predecessor-version":[{"id":1192,"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/pressbooks\/v2\/chapters\/532\/revisions\/1192"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/pressbooks\/v2\/parts\/487"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/pressbooks\/v2\/chapters\/532\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/wp\/v2\/media?parent=532"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/pressbooks\/v2\/chapter-type?post=532"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/wp\/v2\/contributor?post=532"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/vitalsign\/wp-json\/wp\/v2\/license?post=532"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}