Nursing Care Plan : Nursing Diagnosis Nanda

An Electronic Vital Signs Monitor

An electronic vital signs monitor allows you to track a patient's vital signs continually, without having to reapply a blood pressure cuff each time. In addition, the patient won't need an invasive arterial line to gather similar data.

Some automated vital signs monitors are lightweight and battery-operated and can be attached to an I.V. pole for continual monitoring, even during patient transfers. Newer models can also display patient temperature and pulse oximetry as well as blood pressure. A built in printer is also available on certain models. Make sure that you know the capacity of the monitor's battery, and plug the machine in whenever possible to keep it charged.

Before using any monitor, check its accuracy. Determine the patient's pulse rate and blood pressure manually, using the same arm you'll use for the monitor cuff. Compare your results when you get initial readings from the monitor. If the results differ, call your supply department or the manufacturer's representative.

Preparing the device

Explain the procedure to the patient. Describe the alarm system so he won't be frightened if it's triggered.

Make sure that the power switch is off. Then plug the monitor into a properly grounded wall outlet. Secure the dual air hose to the front of the monitor.

Connect the pressure cuff's tubing into the other ends of the dual air hose, and tighten connections to prevent air leaks. Keep the air hose away from the patient to avoid accidental dislodgment.

Squeeze all air from the cuff, and wrap the cuff loosely around the patient's arm or leg, allowing 2 fingerbreadths between cuff and arm or leg. Never apply the cuff to a limb that has an I.V. line in place. Position the cuff's “artery” arrow over the palpated brachial artery. Then secure the cuff for a snug fit.

Selecting parameters

When you turn on the monitor, it will default to a manual mode. (In this mode, you can obtain vital signs yourself before switching to the automatic mode.) Press the AUTO/MANUAL button to select the automatic mode. The monitor will give you baseline data for the pulse rate, systolic and diastolic pressures, and mean arterial pressure.

Compare your previous manual results with these baseline data. If they match, you're ready to set the alarm parameters. Press the SELECT button to blank out all displays except systolic pressure.

Use the HIGH and LOW limit buttons to set the specific parameters for systolic pressure. (These limits range from a high of 240 to a low of 0.) You'll also do this three more times for mean arterial pressure, pulse rate, and diastolic pressure. After you've set the parameters for diastolic pressure, press the SELECT button again to display all current data. Even if you forget to do this last step, the monitor will automatically display current data 10 seconds after you set the last parameters.

Collecting data

You also need to tell the monitor how often to obtain data. Press the SET button until you reach the desired time interval in minutes. If you've chosen the automatic mode, the monitor will display a default cycle time of 3 minutes. You can override the default cycle time to set the interval you prefer.

You can obtain a set of vital signs at any time by pressing the START button. Also, pressing the CANCEL button will stop the interval and deflate the cuff. You can retrieve stored data by pressing the PRIOR DATA button. The monitor will display the last data obtained along with the time elapsed since then. Scrolling backward, you can retrieve data from the previous 99 minutes.




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