Vital signs resources needed

[classicdame, MSN, EdD]

I am looking for documentation on how to monitor vital signs for "unusual" circumstances, such as the patient who is post-mastectomy BILATERALLY. Or maybe the double LLE amputee with a dialysis graft on one arm and ---- you get the idea. Any ideas? Have looked in textbooks and Lippincotts Manual of Nursing Practice. Many thanks

[MIcrunchyRN]

you can always use legs on a bil mastectomy patient.... and you can use both arms on a bil le amputation also if you have a carotid puse then you know your systolic is at least 50 or 60 (rofl i cannot remember what now.... off to see if i can find it... something along the lines if you have a radial pulse your systolic is 90, brachial is 80, femoral is 70 and carotid is 60. its a way to asses in emergent situations)

ooh i found link

palpation methods

a minimum systolic value can be roughly estimated without any equipment by palpation, most often used in emergency situations. palpation of a radial pulse indicates a minimum blood pressure of 80 mmhg (11 kpa), a femoral pulse indicates at least 70 mmhg (9.3 kpa), and a carotid a minimum of 60 mmhg (8.0

kpa). however, one study indicated that this method was not accurate enough and often overestimated patient's systolic blood pressure.[1] a more accurate value of systolic blood pressure can be obtained with a sphygmomanometer and palpating for when a radial pulse returns.[2] because a diastolic pressure cannot be obtained by this method, blood pressures obtained by palpation are noted as "/p".[3]

that quote was found here : http://en.wikipedia.org/wiki/blood_pressure

[classicdame, MSN, EdD]

MIcrunchyRN: Good info and thanks. I failed to mention that my audience is unlicensed nursing assistants. Any other advice?

[Absolutely13]

Double mastectomy BP is popliteal....I can answer that.

[pagandeva2000, LPN]

Double mastectomy BP is popliteal....I can answer that.

:up:I needed to know that. Thanks. I didn't encounter this yet, but this is a question I always meant to ask in nursing school but forgot. When I was a CNA, I just used to tell the nurse. Now it's me...and it can happen one day.