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Through your nursing assessment accurate measurements of your patient's vital signs provide crucial information about body functions . Even if these have been carried out by another practitioner it is important to reassess pulse and respiratory rate as a minimum, as you need to judge the quality (such as rhythm and depth) as well as rate, and be alert to any changes or deterioration. No matter whether you plan to write up your notes as you go along or later, chart or make a note of vital signs as you record them, as they are very easily forgotten.

Interpreting level of consciousness and vital signs through your nursing assessment


A rapid determination of level of consciousness can be achieved using the AVPU scale. This scale is applicable to all age groups. The practitioner assesses the patient as fitting into one of four categories:

• Alert

• Responds to Voice

• Responds to Pain

• Unconscious.

Any concerns following this initial nursing assessment should be followed up with a full Glasgow Coma Score assessment.

Track and trigge

NICE (2007b) recommends that a physiological 'track and trigger system' (in the form of a multiparameter or aggregate weighted scoring system) should be used to determine deterioration or to grade the risk of deterioration in all adult patients in acute hospital settings. A variety of different systems exist, with weighted systems such as an Early Warning Score (EWS) or a Modified Early Warning System (MEWS) being amongst the most commonly used. Such systems consider vital signs and other findings such as urine output and AVPU to determine deterioration or risk. Choice of tools and parameters vary from one setting to the next, so it is important to familiarise yourself with the tool(s) used in your care setting. Scoring systems are also being developed for use with children – Paediatric Early Warning Systems (PEWS). For more information on EWS, see Baines and Kanagasunduram (2008).


If you obtain an isolated abnormal value when monitoring vital signs, firstly look at the whole patient and other findings. If the value seems unexpected and the patient seems otherwise well, it may be appropriate to recheck the reading again, but don't automatically assume the reading is inaccurate. Electronic devices in particular MAY give inaccurate readings for a variety of reasons, but on the other hand patients with concerning abnormal fi ndings may not look obviously unwell. Remember also that normal readings vary with the patient's age – for example, blood pressure increases as you get older. But don't make assumptions that such abnormal readings are 'normal in the elderly'; any such abnormalities should still be reported and explored further.


Also remember that an abnormal value for one patient may be a normal value for another. Each patient has their own baseline values, which is what makes recording baseline vital signs so important wherever this is possible.

Repeat vital sign recordings

Afterwards, take or request measurements of vital signs at regular intervals, with frequency depending on the patient's condition. A series of readings invariably provides more valuable information than a single set.

MEWSing on the problem

If the patient is acutely unwell or deteriorating, repeat initial observations and AVPU scoring at frequent intervals. Consider findings in relation to a 'track and trigger system' such as an Early Warning Scoring system (EWS) or a Modified Early Warning Scoring system (MEWS), which uses vital signs and other findings to predict risk of deterioration.

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florence freeman Sep 27 '14 · Comments: 1
NEW ORLEANS -- By necessity, the Pelicans keep heaping more responsibility in Tyreke Evans lap -- and he keeps coming through. Wholesale Jerseys US . Evans had 22 points and a career-high 15 assists, and the short-handed Pelicans overcame the loss of Anthony Davis to extend their winning streak to a season-high five games, 102-95 victory over Utah on Friday night. The performance came with Evans starting at point guard, a role Evans occupied in stints with Sacramento earlier in his career, but not with New Orleans until this week, beginning with an upset victory over the Los Angeles Clippers on Wednesday. "I always seem to make it work. Im a basketball player," Evans said. "So, just trying to make the best of it, you know, for me and my teammates and the coaching staff and the organization. Just trying to finish the season out strong and win as many games as possible." Davis left with a left ankle injury less than four minutes in, further depleting New Orleans already injury-riddled roster. But the 6-foot-6 Evans simply looked for other teammates when the Jazzs defence collapsed on him, and the offence flowed. "Hes so big, he can see over the other guards and that gives him the ability to find guys," Pelicans coach Monty Williams said. "Hes always a threat to score at the basket, so that helps." Anthony Morrow scored 20 points, Al-Farouq Aminu added 13, and Austin Rivers and Darius Miller each had 12. Alexis Ajinca, playing 28 minutes in Davis absence, had 10 rebounds, nine points and three blocks. Derrick Favours had 18 points and 11 rebounds for the Jazz, who lost their third straight. Gordon Hayward added 21 points. "We just have to continue to fight and close those games out," said Trey Burke, who had 12 points. "We definitely had a chance to win this game tonight. "We arent going to get discouraged," Burke continued. "Were all good players and we know we are capable. No matter what, were sticking together." Before the game, the Jazz ruled out reserve guard Alec Burks with a left ankle sprain. The Pelicans, meanwhile, scratched guards Eric Gordon (left knee tendinitis) and Brian Roberts (left knee bone bruise). Davis started grimacing during the opening minutes. With 8:17 left in the first quarter, Ajinca was subbed into the game and Davis headed for the locker room. Williams did not update Davis condition after the game. Still, the Pelicans managed to maintain the lead for most of the way. Evans pushed the ball in transition and routinely slashed to the hoop to convert short floaters or layups in traffic. Otherwise, he found players such as Morrow and Miller on the perimeter. "Hes been doing a great job in that role change, but thats what great players do," Morrow said of Evans. "Im proud of him, glad hes stepped it up. Obviously he does a lot of things for us on both ends of the floor, and obviously hes adjusted his game and hes been great for us." Evans layup put the Pelicans up 72-66 heading into the fourth quarter, and his weaving dribble drive for a reverse scoop made it 87-81 with 1:52 left. Morrow hit three of his four 3-point attempts, the last giving the Pelicans an 85-79 lead with 3:05 left. Ajincas three-point play on an 8-foot jumper as he was fouled by Favours made it 90-83 with less than a minute left, but the teams traded a slew of free throws before it was over. Marvin Williams finished with 12 points for Utah, but the Jazz committed 19 turnovers, leading to 33 Pelicans points. Evans normally plays shooting guard or small forward, but once again looked comfortable at the point while scoring 13 first-half points. The Pelicans 39-31 when Morrows consecutive jumpers capped an 8-0 run, and New Orleans lead was 43-38 at halftime. NOTES: The Pelicans and Jazz split their previous two meetings. They meet once more on April 4 in Utah. ... The Jazz are 8-29 on the road. ... Utah next plays on Sunday in Oklahoma City. ... Evans has hit 20 points 15 times this season and has nine double-doubles. ... The Pelicans shot 50.7 per cent (36 of 71), marking the third time during their current winning streak they eclipsed the 50 per cent mark. Wholesale Jerseys USA . Owens was roughed up in Torontos 20-9 defeat to Montreal on Tuesday, needing treatment twice after hurting his neck and taking a hard shot to the abdomen. In other news from Fridays practice, Jerious Norwood took most of the snaps at running back for Curtis Steele. Norwood also did some returning, although Milanovich said returns would likely be done by committee. Wholesale Jerseys Supply . -- Whenever a Royals pitcher has issued a walk lately, the runner has usually scored.TORONTO -- CFL players have started voting on their tentative agreement with the league. The CFL Players Association and CFL agreed in principle on a five-year contract Saturday. The players have until 8 p.m. ET to vote. The CFL board of governors will hold its ratification vote Friday afternoon. A majority of players -- 50 per cent plus one -- on six of the nine CFL teams must support the deal for it to be accepted. If the agreement is rejected, the union will notify the CFL and try resuming talks. A strike is also a possibility given the tentative deal wasnt well received by some players. Many were unhappy that the agreement calls for a $5-million salary cap in the first year after the CFLPA had originally sought a $6.24-million cap. Last year, the CFL salary cap was $4.4 million. The CFL also got the players to agree to its gross revenue formula that would trigger the renegotiation of the cap or entire collective agreement. The players, who initially wanted the CBA to include revenue sharing, wanted the cap or entire agreement renegotiated if league revenues increased by more thhan $18 million -- excluding the Grey Cup -- in the third year of the deal. Wholesale Jerseys From China. . But the union ultimately agreed to the CFLs figure of $27 million. The union did get the option year on CFL contracts eliminated, excluding rookies. Also, the players practice day, for the most part, remains at 4.5 hours but can be increased to a maximum of six hours while teams will hold just one padded practice a week during the season. Toronto Argonauts players met Wednesday night to discuss the agreement and centre Jeff Keeping, a member of the union executive, said good questions were asked. "Im happy the guys have all the facts," Keeping said. "I feel at the end of the day the guys are more informed than they were prior to that. "The mood is mixed. Guys are entitled to their own opinion and every man is going to make his own choice." Keeping said players will be able to vote electronically until 8 p.m. ET, after which the ballots will be tabulated. He added the results are expected later Thursday evening with the union releasing them sometime Friday. ' ' '
sunshine0727 Sep 22 '14 · Comments: 1
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Estelle Murakami Sep 18 '14 · Comments: 1 · Tags: |sep|stemologica, stemologica
Vapors that contain nicotine but without the 4,000 plus chemicals that are found in tobacco cigarettes. Electronic Cigarettes are a healthier substitute for smoking and are modifying the way that people smoke. Remember that the benefits of smokeless cigarettes are many and varied. With cigarette prices soaring rapidly, many people are finding that the smokeless cigarette is a great alternative to traditional cigarettes. It's a simple but high-tech solution that relies on refill cartridges to give you everything you need. The smokeless e-juice is formulated to be very similar to the popular cigarette flavors. These cigarettes contain the best e-juice which is the liquid that creates the vapor smoke. It does not require a lighter to start smoking; it only needs the included rechargeable battery to power up the micro technology process that makes it function - reducing any risk of fire hazard.

By danwilders : A how to tutorial about Smokeless Cigarettes, Best E-Juice, Buy E Cigarettes, Technology with step by step guide from danwilders. By danwilders : A how to tutorial about Buy Electric Cigarettes, Best E Juice, E-cigarette cartridges, Technology with step by step guide from danwilders. Smokers looking to switch over, ecigs are ideal replacement with its simple functioning and stylish design. I guess if my friends used smokeless cigarettes that's one pesky problem eliminated but I'm a bit disappointed I can't play video games on a console they can hold in their mouths while they get their oral fix. When the smoker inhales, the heating element heats up the solution and releases steam. You may also get e-juice that enhances the ecigs taste just like your favorite tobacco brand.

The concept behind electronic cigarettes or e cigarettes is very simple. The smoker inhales and exhales the steam and gets the relaxing feeling they normally get from tobacco cigarettes. The E cigarette has helped thousands of people to quit smoking tobacco cigarettes by allowing them to get the feeling of smoking without the dangers of tobacco. E-juice or e-liquid is a water based solution that does contain some nicotine. E-juice is the fluid that is used to fill blank cartridges for the smokeless cigarette. Like the name implies this popular flavor tastes like coffee and is very successful with people. E-Cigarette kits are a social life booster for anyone who finds themselves outside without their friends nearby smoking a cigarette. An electronic cigarette store is often the best place to get these cigarettes since they are typically low cost there.


The e-juice is a combination of water, flavoring, propylene glycol or glycerin and in some cases nicotine. Even if you are trying to quit smoking the electric cigarettes are a great alternative, as you can gradually reduce the amount of the nicotine in the e-juice. The best e-juice container is easily accessible along with sticks out of the finish of the cart. Immediately, the image that came to mind of Electronic Cigarettes was of someone with a device like a video game console joystick poking out of someone's mouth, cord trailing from the end to the wall socket. All over the world people are buying e-cigarette kits and weaning themselves off tobacco. E-juice is a solution of water and several types of flavorings, one of which can be nicotine.

There are a lot of varieties and flavors when it comes to e-juice, making it hard to determine what the best e-juice is.
Monte Mace Sep 13 '14 · Comments: 1 · Tags: |sep|e-juice, e cig juice, e juice

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anything Apr 23 '17 · Comments: 1

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qqqq Jun 29 '17 · Comments: 1

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qqqq May 5 '17 · Comments: 1
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