1. JAVERIA AMANULLAH
CRITICAL CARE (102)
ASSIGNMENT: 01
SUBMITTED TO:
DR.ALLAH NAWAZ
QAZI

2. PATIENT ASSESMENT:
 History
 Name
 Age
 sex
 Martial status
 address
 Presenting complaints
 History of present illness
 History of previous illness
 History of treatment
 Family history
 Social and occupational history
Vital signs
Vital signs include:
1. Body temperature,
2. Pulse,
3. Respiration and
4. Blood pressure.
Temperature:
Body temperature is the degree of heat maintained by the body.
 Temperature range:
An average normal Temperature is 98.6 (Fahrenheit) or
37.0 0C (Celsius).
Temperature Ranges in Centigrade and Fahrenheit
Centigrade Fahrenheit
 Normal 36.6 - 37.20C 98 – 990F
 Subnormal < 36.60C < 980F
 Febrile > 37.20C > 990F
 Hyper Pyrexia > 41.60C > 1070F
 Hypo Thermia < 350C < 950F
Method Of Measuring Body Temperature
1. Axilla
2. Orally
3. Rectal
4. Groin (commonly for children)

3. Types Of Fever Or Pyrexia:
There are three classic types of fever or Pyrexia
1. Continued: When fever does not fluctuate more than about 10C ( 1.50F ) during
24 hours but at no time touches the normal it is describe as Continued.
2. Remittent: When the daily fluctuations exceed 20C it is called remittent.
3. Intermittent: When fever is Present only for several hours during the day is
called intermittent.
Pulse
Pulse is the rhythmic expansion of the artery, which occurs with each ventricular
contraction.
Pulse rate:
Number of pulse beats per minute.
Normal pulse rate is 72 to 80 beats/minute.
The following characteristics of the pulse should be
checked:
1. Rate
2. Rhythm
3. Volume
4. Vessel wall
5. Symmetry
Pulse sites
1. Temporal
2. Facial
3. Carotid.
4. Brachial
5. Radial
6. Femoral.
7. Popliteal
8. Posterior tibialis.
9. Pedal (dorsal pedialis)
Respiration
It is the act of breathing where the exchange of gases takes place
between lung and blood.
Reparatory rate:
The rate is recorded as the number of respirations per minute. (A
single respiration is one inhalation and one exhalation) the average
respiratory rate for an adult range from 14 to 18 breaths per minute
but wide variation occurs in health.

4. BREATHING PATTERNS
 Eupnea: (Normal)
 Dyspnea : Difficulty in breathing
 Apnea: Absence of Breathing
 Orthopnea: Discomfort of Breathing- That is aggravated by lying down.
 Hypoventilation: Reduced alveolar ventilation relative to metabolic carbon-
Dioxide production so that alveolar carbon- dioxide Pressure increases above
normal (under ventilation).
 Hyperventilation: Increase alveolar ventilation relative to metabolic carbon-
dioxide production, so that alveolar Carbon-dioxide Pressure decreases to below
normal. (Over ventilation).
 Sleep apnea- Cessation of breathing during sleep
 Cyanosis- Dark bluish discoloration of the skin and mucus membrane due to
deficient oxygenation of the blood.
 Hypoxia- Decrease below normal level of oxygen in inspired gases, arterial blood
or tissue without reaching anoxia.
 Hypoxemia- Sub normal oxygenation of arterial Blood Short of Anoxia.
 Anoxia - Absence or almost complete absence of oxygen from inspired gases,
arterial blood or tissue
 Hypercapnia – Abnormally increased arterial carbon dioxide tension.
 Hypocapnia –Abnormal decreased arterial Carbon dioxide tension.
 Asphyxia- Impaired or absent exchange of oxygen and carbon dioxide on a
ventilatory basis combined hypercapnia and hypoxia or anoxia.
 Bradycardia: Slowness of the heart beat usually defined (by convention) as rate
under 60 beats per minute.
 Tachycardia: Rapid breathing is a rate above 20 breaths per minute, associated
with increased activity or a disease process.
 Cheyne-Stokes is the term for cycles of breathing characterized by deep, rapid
breaths for about 30 seconds, followed by absence of respirations for 10 to 30
seconds.
Blood pressure:
Blood pressure is a measurement of the force applied to the walls of the
arteries as the heart pumps blood through the body.
 Normal range:
The normal range of blood pressure is 120/80.
 Systolic Pressure which occurs when the ventricles
contract is the highest pressure against the walls of the blood
vessels.
 Diastolic Pressure which occurs when the ventricles are relaxed
is the lowest pressure against the walls of blood vessels.

5. BLOOD PRESSURE RANGES:
Age Blood Pressure
Systolic Diastolic
 New Born 65 mm Hg 45 mm Hg.
 1 Year 75 mm Hg. 50 mm Hg.
 4 Year 85 mm Hg 60 mm Hg.
 8 Years 96 mm Hg 65 mm Hg.
 100 mm Hg. 100 mm Hg 70 mm Hg
 Adult 130 mm Hg 84 mm Hg
CRITICAL DISORDERS
1. Ischemic Heart Disease (IHD):
Ischemic or ischemic heart disease (IHD, is a disease characterized by ischemia
(reduced blood supply) to the heart muscle, usually due to coronary artery
disease (atherosclerosis of the coronary arteries).
2. Myocardial Infarction (MI)
Myocardial infarction (MI) or acute myocardial infarction (AMI), commonly
known as a heart attack is the interruption of blood supply to a part of the heart,
causing heart cells to die. This is most commonly due to occlusion (blockage) of a
coronary artery.
3. Arrhythmias
Cardiac arrhythmia, also called dysrhythmia, is an irregularity or the loss of
normal rhythm of the heart beat.
4. Fibrillation
Fibrillation is the rapid, irregular, and unsynchronized contraction of muscle
fibers.
5. Atrial Fibrillation (A Fib)
Also known as A. Fib the atria beat faster than the Ventricles. This produces an
irregular quivering action of the atria and a very rapid ventricular heart beat.
6. Ventricular Fibrillation (V Fib)
Also known as V. Fib is the result of irregular contractions of the Ventricles and
is fatal unless reversed by electric defibrillation.
7. Congestive Cardiac Failure (CCF) OR
Congestive Heart Failure (CHF)
Congestive heart failure (CHF) is a condition in which the heart's function as a
pump is inadequate to deliver oxygen rich blood to the body.
8. Pulmonary Edema
Pulmonary edema is an abnormal build up of fluid in the air sacs of the lungs,
which leads to shortness of breath.
9. Pulmonary Embolism
A pulmonary embolism is a sudden blockage in a lung artery. The blockage
usually is due to a blood clot that traveled to the lung from a vein in the leg.
10. Acute Respiratory Distress Syndrome (ARDS)

6. ARDS, or acute respiratory distress syndrome, is a lung condition that leads to
low oxygen levels in the blood. ARDS can be life threatening. This is because
your body's organs, such as the kidneys and brain, need oxygen-rich blood to
work properly.
11. Cerebro Vascular Accident (CVA)
The sudden death of some brain cells due to lack of oxygen when the blood flow
to the brain is impaired by blockage or rupture of an artery to the brain. A CVA is
also referred to as a stroke.
12. Trauma
An injury physical or mental.

7. ARDS, or acute respiratory distress syndrome, is a lung condition that leads to
low oxygen levels in the blood. ARDS can be life threatening. This is because
your body's organs, such as the kidneys and brain, need oxygen-rich blood to
work properly.
11. Cerebro Vascular Accident (CVA)
The sudden death of some brain cells due to lack of oxygen when the blood flow
to the brain is impaired by blockage or rupture of an artery to the brain. A CVA is
also referred to as a stroke.
12. Trauma
An injury physical or mental.