Introduce self, The client’s chest and

identify the aware that the observe the

patient and nurse is chest movement
explain the counting the Count the
procedure respiratory rate respiratory rate
1. Wash hands could cause the for one full
before starting client to alter minute.
the procedure the respiratory
pattern. Place a 4. Observe the
2. Provide for depth, rhythm,
hand against the
client privacy and character of
clients chest to
3. Observe or respirations
feel the chest
palpate and
movements with Observe the
count the
breathing, or respirations by
respiratory rate
place the clients watching the
arm across the
 movement of respiratory rate
the breast on the clients
5. Observe for a record
regular or
irregular
rhythm Observe
the character;
the sound they 1. Introduce self,
produce and the identify the
effort they patient and
require explain the
6. Make the procedure
patient 2. Wash hands
comfortable and 3. Provide privacy
wash your for the client
hands the
4. Position the center of the Palpate the
patient bladder directly brachial artery
appropriately over the artery with fingertips
Should be sitting Place the lower Close the valve on
otherwise specified border of the cuff the bulb
Elbows must be 2.5 cm above ante Pump the cuff until
slightly flexed cubital space you no longer feel
Expose the upper 6. If this is the the brachial puls
arm client’s initial Release the
examination, pressure
5. Wrap the perform completely in the
deflated cuff preliminary cuff and wait 1 to 2
evenly around determination of minutes before
the upper arm. systolic pressure making further
Locate the
measurements
brachial artery
and apply the
7. Position the Place the where the brachial
stethoscope stethoscope on the pulse disappeared
appropriately skin Release the valve
Cleanse the Hold the so that the
earpiece with diaphragm with pressure decreases
antiseptic wipes thumb and index at the rate of 3 to 3
Insert the earpiece fingers mmHg per second
of the stethoscope 8. Auscultate the identify the
in your ears  client’s blood manometer
Ensure it hangs pressure reading at
freely Pump the cuff until Korotkoff phases
Place the bell side the Deflate the cuff
over the brachial sphygmomanomete completely
pulse site r reads 30 mmHg Wait 1 - 2 minutes
above the point before making
further 11. Clean the
determinations earpiece of the
Repeat the above stethoscope
steps to confirm 12. Do the
the accuracy of the aftercare of the
reading equipment and
wash your hands
13. Document the
9. If this is the BP reading 
client’s initial
examination
repeat the
procedure on
10. Make the
patient
comfortable
 5. Clean the
earpiece and
diaphragm
of the
stethoscope
with cotton
1. Wash your balls soaked
hands. in alcohol
2. Prepare the 6. Position the
equipment client in a
3. Identify the comfortable
patient and position
explain the (supine or
procedure sitting
4. Provide position)
privacy
7. Warm the intercostal 11.Replace the
diaphragm space and patient’s
with your place the clothing and
hands. diaphragm fix the top
Expose the 9. Auscultate linen
area of the and count 12.Make patient
chest over the comfortable
the apex of heartbeats 13.Wash your
the heart and assess hands
8. Locate the any
site, on the observable
left mid- characteristi
clavicular cs for full
line in time
between 5th 10.Record the
and 6th pulse rate
 the area is to be
procedure assessed
2. Wash hands 5. Assist the
3. Provide the client to a
client comfortable
privacy resting
4. Select the position.
pulse point. When the
Normally, radial pulse
the radial is assessed,
pulse is take with the
1. Introduce unless it palm facing
self, identity cannot be downward,
of the patient exposed or the client’s
and explain circulation to arm can rest
another body
 alongside the between pressure
body. the beats. and the
6. Palpate and Normally, pressure
count the it has is equal
pulse. equal time with each
7. Assess the periods beat
pulse rhythm between 8. Make the
and volume beats patient
 Assessing  Assessing comfortable
the pulse the pulse and wash
rhythm volume, A hands
by noting normal 9. Document
the pulse can the pulse
pattern of be felt rate, rhythm,
the with and volume
intervals moderate
in the client
record