Basic Obs Quiz - October 2010

1)What are the normal pulse values for a healthy adult and a healthy neonate?
Adult: 60-100bpm
Neonate: 110-160 bpm

2)Name two sites used to measure pulse rate in a neonate:
Brachial ; Apex (heart); Base of umbilical cord

3)Name three indications for taking a pulse measurement in an adult:
• On admission to provide a baseline
• Signs of deviation from norm/ signs of illness
• When auscultating the fetal heart
• During labour
• Prior to transfer of care i.e. from delivery suite to postnatal ward
• During and following surgery
• Postnatally if indicated (i.e. signs of illness or post-operatively)
• Prelabour SROM
• Use of tocolytic drugs

4) Describe the units of measurement used in relation to BP:
mmHg – millimetres of mercury

5)A BP reading consists of measurements for systolic and diastolic pressure. What is the difference between these?
These are the pressures exerted by the blood on the walls of the blood vessels at different stages of the heartbeat ‘cycle’. Systolic = the maximum pressure exterted, measured when the heart is pumping, Diastolic = the minimum pressure exerted, measured when the heart is at rest.

6)It is important to always use the correct equipment for any job. When measuring BP, why is it vital to ensure that you use the correct size cuff?:
Too small causes falsely high readings. Too large causes falsely low readings – either of which can affect care/treatment required/given.

7)You are caring for Gina, who had an emergency caesarean section several hours ago. You arrive on shift and go to take her observations. Upon plotting her obs on the chart, you notice the portsmouth sign.
Describe the features of the Portsmouth sign, and explain why this is significant.
Portsmouth sign: Pulse rate higher than systolic BP – on obs chart looks like seagull pooing on its own head (LOL).
Significance: Tachycardia and hypotension are indications of severe haemorrhage and/or cardiopulmonary compromise.

8)Describe the normal limits of body temperature:
35.8 – 37.3 deg C

9)Name two sites for taking a temperature measurement:
Oral/Buccal; Tympanic (ear); Axilla (armpit)

10)You’re caring for a woman in labour. Upon taking her routine observations, you discover that her temperature is 38 deg C. All other obs are stable. Over the next hour, her pulse rises to 120bpm. BP is stable. The fetal heart rate also rises to 168 bpm.
Explain why you would be concerned. What could these changes indicate?
Raised temp in labour can indicate infection. A raised maternal temp can cause FH to rise, when combined with maternal tachycardia an infection is indicated and treatment is necessary.

BONUS Describe the process of taking a temperature measurement on a newborn – what are the considerations?
• Parental consent
• Baby in a safe place
• Baby kept warm
• Loosen clothing, do not allow baby to get cold
• Place thermometer into axilla
• Hold arm gently across chest to secure thermometer
• Wait specified time (dependent on thermometer)
• Remove thermometer and read
• Document findings
• Act upon findings if outside of normal limits

lol on second thoughts don't bother pm'ing my results not to mention that i misunderstood one of the questions and missed another one out completely! Plus was totally wrong haha!