Module 6 – Section 3 DSP Notebook BHS Vital Signs and Symptoms

OJT Activity #17: Measuring a Radial Pulse

Steps Partner Check Instructor Check
Assemble materials (clock/watch with second hand or
digital second counter).
Wash hands.

Identify person.

Greet person.

Provide for person's privacy.

Explain to the person how you will be taking the vital
signs.
Obtain permission to take the person's pulse.
Grasp the right/left wrist between your thumb and four
fingers.
Place your 2nd & 3rd fingers on the wrist, palm side of
hand up, closest to the thumb.
Count pulse for 15 seconds and multiply by four.
Assess the strength and rhythm of the pulse. (see NOTE
below).
Write down the results.

Attend to person's comfort and safety.

Thank individual for cooperating.

Wash hands.

Follow this example when documenting the pulse rate in

the progress notes: Radial pulse-76, strong & regular.
Note: The average pulse rate for an adult is 72-80 beats per minute. The rhythm is routinely
described as follows:
Strong - normal rhythm
Bounding - unusually strong rhythm
Thready - pulse beats are weak
Irregular - pulse beats do not have a regular rhythm.
Regular - regular rhythm

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OJT Activity #17: Measuring a Carotid Pulse

Steps Partner Check Instructor Check
Assemble materials (clock/watch with second hand or
digital second counter).
Wash hands.

Identify person.

Greet person.

Provide for person's privacy.

Explain to the person how you will be taking the vital
signs.
Obtain permission to take the person's pulse.
Run your four fingers down the Adam's apple on the
front side of the neck.
Slide your first three fingers into the crevice next to the
Adam's apple.
Count pulse for 15 seconds and multiply by four.
Assess the strength and rhythm of the pulse. (see NOTE
below).
Write down the results.

Attend to person's comfort and safety.

Thank individual for cooperating.

Wash hands.

Follow this example when documenting the pulse rate in

the progress notes: Radial pulse-76, strong & regular.

Note: The normal pulse rate for an adult is 72-80 beats per
minute. The rhythm is routinely described as follows:
Strong - normal rhythm
Bounding - unusually strong rhythm
Thready - pulse beats are weak
Irregular - pulse beats do not have a regular rhythm.
Regular - regular rhythm
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Module 6 – Section 3 DSP Notebook BHS Vital Signs and Symptoms

OJT Activity #17: Measuring a Brachial Pulse

Steps Partner Check Instructor Check
Assemble materials (clock/watch with second hand or
digital second counter).
Wash hands.

Identify person.

Greet person.

Provide for person's privacy.

Explain to the person how you will be taking the vital
signs.
Obtain permission to take the person's pulse.
Place your first three fingers on the inner surface of the
upper arm.
Count pulse for 15 seconds and multiply by four.
Assess the strength and rhythm of the pulse. (see NOTE
below).
Write down the rate and rhythm.

Attend to person's comfort and safety.

Thank individual for cooperating.

Wash hands.

Report anything abnormal to supervisor or nurse.

Follow this example when documenting the pulse rate in

the progress notes: Radial pulse-76, strong & regular.

Note: The normal pulse rate for an adult is 72-80 beats per minute. The rhythm is
routinely described as follows:
Strong - normal rhythm
Bounding - unusually strong rhythm
Thready - pulse beats are weak
Irregular - pulse beats do not have a regular rhythm.
Regular - regular rhythm
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OJT Activity #18: Measuring the Respiratory Rate

Steps Partner Check Instructor Check
Assemble materials (clock/watch with second hand or
digital second counter).
Wash hands.

Identify person.

Greet person.

Provide for person's privacy.

Explain to the person how you will be taking the vital
signs.
Obtain permission to take the person's pulse.
Appear to be taking the person's pulse, begin counting
respirations.
Count the rise and fall of the chest as one respiration.
Count rate for 30 seconds and multiply by 2. (see NOTE
below)

Write down the rate and rhythm.

Attend to person's comfort and safety.

Thank individual for cooperating.

Wash hands.

Report anything abnormal to supervisor or nurse.

Follow this example when documenting the respiration

rate in the progress notes: Respiration - 16.

Note: The average normal respiratory rate for an adult is 16-20 respirations per
minute.

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OJT Activity #19: Taking a Manual Blood Pressure

Equipment needed: Blood pressure cuff that is the right size for the individual,
stethoscope, alcohol wipes, and watch/clock with second hand.

Steps Partner Check Instructor Check

Locate blood pressure cuff, stethoscope and alcohol
wipes.
Wash hands.

Identify and greet person.

Explain to the person how you will be taking the vital
signs.
Obtain permission to take the person's pulse.

Provide for the person's privacy.

Open the alcohol wipes and wipe off the ear pieces of the
stethoscope.
Discard used wipes.

Ask individual to sit or lie down. Uncover either upper

arm of individual. (Do not use an arm that has an injury
or paralysis, etc.) Do not constrict blood flow to arm.

Place stethoscope ear pieces in your ears.

Support the person's forearm on a firm surface near heart

level. Position the palm up.

Verify that the cuff is deflated and reading at zero.

Wrap cuff around person's arm so lower edge of cuff is at

least one inch above bend of inside elbow. Place rubber
cushion of cuff so the center is over artery in center of
inner arm.
Place flat side of stethoscope diaphragm over individual's
brachial pulse.
Tighten the valve (screw attached to the bulb at the end
of the tube) on the blood pressure cuff inflation
mechanism until it is closed.
Grasp the bulb in the palm of your hand.

Position yourself so that your eyes are level with the

mercury or the dial.

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Steps Partner Check Instructor Check

Using a pumping action, inflate the blood pressure cuff
(while feeling the pulse) up to 30-40 mm past where you
feel the pulse disappear using bulb.

Observe pressure dial.

Do not touch cuff or tubes. Hold firmly so there is not

space between stethoscope and skin, but with as little
pressure as possible.
Release the valve by loosening the screw slowly while
carefully observing the dial attached to the bulb.
Not the dial reading when you first hear a regular
thumping sound through the ear pieces of the
stethoscope. This is the systolic reading.
Continue to let air out slowly. The sounds will become
dull and disappear.
Note the number when you hear the last sound. This is
the diastolic reading. (see NOTE below)

Deflate cuff completely.

Repeat after 1-2 minutes.

Completely deflate cuff. Remove ear pieces of

stethoscope from ears.

Remove cuff from individual's arm.

Attend to person's comfort & safety.

Thank the person for cooperating.

Open the alcohol wipes and wipe off ear pieces of

stethoscope.

Wash hands.

Follow this example when documenting the blood

pressure reading in the progress notes: B/P-120/80.

Note: Normal systolic (top number) is 110-120. Normal diastolic (bottom number) is 60-80.

Please determine if a specific arm should not be used for blood pressure (broken arm,
mastectomy, etc)

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OJT Activity #20: Taking an Oral Temperature

Equipment needed: Disposable plastic probe cover
Electronic thermometer*
Probe attachment
Pen and paper

Steps Partner Check Instructor Check

Assemble materials (electronic thermometer, disposable
plastic probe cover, probe attachment, pen and paper).

Wash hands.

Identify and greet the person.

Provide for person's privacy

Explain to the person how you will be taking their

temperature.

Obtain permission to take the person's temperature with

the electronic thermometer.
Ask if the person has eaten, drank, or smoked in the last
ten minutes. If so, wait tem minutes before taking the
temperature.

Plug the probe into the base of the thermometer.

Check the connection of the probe to the base of the

thermometer.
Explain to the person you are about to insert the
thermometer into their mouth, under the tongue, and
then do so. Instruct the individual to close their mouth.

Wait for buzzer to sound.

Remove probe.

Read the thermometer. (see NOTE below)

Write down the temperature.

Discard used probe cover.

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Return probe to proper storage place.

Attend to person's comfort and safety.

Thank the person for cooperating.

Wash hands.

Report abnormal temperatures to the supervisor/nurse.

Follow this example when documenting the electronic

temperature in the progress notes: Oral Temp- 98.60

Note: Normal oral temperature is 98.6o (37o C), but may vary by individual.

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OJT Activity #22: Taking an Axillary (Armpit) Temperature

Equipment needed: Electronic thermometer

Probe cover
Probe attachment
Pen and paper

Steps Partner Check Instructor Check

Locate the electronic thermometer and plastic probe
cover sheaths.
Wash hands.

Identify and greet the person.

Provide for person's privacy

Explain to the person how you will be taking their
temperature.
Obtain permission to take the person's temperature with
the electronic thermometer.
Plug the oral probe into the base of the thermometer.

Cover the probe with the plastic probe cover sheath.

Assist the person in loosening their clothing around the
armpit.
Using a paper towel, pat dry the axilla where the
thermometer will be placed.
Place the end of the probe in the center of the person's
armpit.
Once the thermometer has been put into place, have the
person hold their arm tightly against the chest.
Leave the thermometer in place until the thermometer
buzzer sounds or temperature registers.
Remove the thermometer from the person's armpit.

Read the thermometer.

Discard the plastic sheath.

Write down temperature. (see NOTE below)

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Assist the person with clothing adjustment.

Attend to the person's comfort & safety.

Thank the person for cooperating.

Return the probe to its stored position.

Wash hands.

Store thermometer.
Report any abnormal temperature to the
supervisor/nurse.

Follow this example when documenting the electronic

temperature in the progress notes: Axillary Temp- 98.6o

Note: Normal axillary (armpit) temperature is 97.6o (36o C), but may vary by individual.

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OJT Activity #61: Measuring Weight

Attention: Recording of weight may be requested by physician or dietitian.

Always explain what you will be doing with individual, ask permission and
discuss steps as you are doing them.
Ensure privacy and confidentiality for this procedure.
Discuss what you are going to do with consumer. Use the least prompting
necessary.
Record results in agency-preferred location.
Weigh at the same time of the day to ensure accurate comparison.

Equipment needed: Scale

Steps Partner Check Instructor Check

Determine which person you will be weighing.

Ensure privacy.
When charting measurements assure that weights are
taken at the same time each day.
Have the person take off heavy shoes or outer clothing.
Train or assist person to place scale on flat surface, if not
already there.
Train or assist individual to step on scale. Verify that
he/she is not holding onto anything.
Train or assist individual to read number on scale.

Train or assist individual to step off scale.

Train or assist individual to return scale to the proper
storage location.
Record the results and give them to your OJT trainer.

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