TPR

Temperature is the balance between heat produced and heat lost is measured by a clinical thermometer (mercury, glass, electronic or tape thermometer)

Pulse is the force of blood from the left ventricle as it flows into the arterial circulation.

Respiration is the continued process of drawing in and expelling of air from the lungs; taking of O2 and elimination of CO2, H2O and other products of oxidation.



Equipments to be Used:

1. Oral Thermometer
2. A box of tissue wipes
3. Wastes receptacle
4. Medicine tray
5. Watch with a second hand




Procedure:

1. Read patient's chart.

2. Do medical hand-washing.

3. Gather equipment and inspect.

4. Bring needed materials to patient's bedside to save time and energy.

5. Explain the procedure to the patient as to its nature, purpose, what to expect and what is expected of him.

6. Ask permission from the patient to use his bathroom.

7. Wash the thermometer with soap and water and dry from the bulb to the stem in a rotating fashion with a tissue paper.

8. Check the level of mercury on the thermometer. Shake mercury down to 35C with a sharp snappy jerk of the hand away from the patient and any hard objects.

9. Place mercury bulb under the patient's tongue in a slanting position. Instruct patient to keep mouth closed and not to bite the thermometer. Leave thermometer for 3 minutes.

10. Draw patient's arm to rest on abdomen. Bend elbow. If patient prefers to sit, support arms comfortably.

11. Press patient's wrist lightly with 3 finger-tips, since fingertips are most sensitive to vibrations, over padial artery (thumb should not be used to palpate artery since it disrupts pulse). Note the rhythm, volume and tension of the pulse for the first 30 seconds. Then count the pulse beat for 1 full minute.

12. After counting the pulse, without changing the patients position, watch the rise and fall of the chest.


13. Count the inspiration and expiration as one respiration. Count for 1 full minute.

14. Remove the thermometer. Wipe with friction from stem to bulb in a fast 1 direction motion to avoid contamination of microorganisms. Discard 1 tissue wipe to the waste receptacle.

15. Read thermometer at eye level, against the light. Write down results in jot down notebook.

16. Ask permission again to use the patient's bathroom to wash the thermometer.

17. Wash the thermometer from the stem to bulb in a rotating fashion. Dry with a clean tissue wipe.

18. Place back the thermometer to its container.

19. Record results in patient's chart.