MEASURING & RECORDING
VITAL SIGNS
Clinical Rotations
The Four Vital Signs
Blood Pressure
Temperature ----------------------------Pulse----------------------- Respirations
Objectives:
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Students will:
 List
the 4 major vital signs
 Describe the principles for measuring and recording
oral, rectal, axillary, tympanic and temporal
temperatures
 Convert Fahrenheit to Celsius
 Define- temperature, pulse, respirations, blood pressure
and apical pulse
WHAT IS BLOOD PRESSURE?
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When your heart beats, it pumps blood around
your body to give it the energy and oxygen it
needs
As the blood moves, it pushes against the sides
of the blood vessels( arteries) –
The strength of the force exerted on your vessels
is called your blood pressure
How is blood pressure it measured?
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Measured in millimeters of mercury
A blood pressure machine is called a
sphygmomanometer
BP is read at two points:
 Systolic
 Diastolic
Systolic Blood Pressure
Blood
pressure
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Pressure that occurs in the walls of the
arteries when the LEFT VENTRICLE OF
THE HEART is contracting
Normal systolic reading is BELOW
120 mm or mercury
Normal range is 100- 120 mm or
mercury
Systolic is the FIRST sound heard
Diastolic Blood Pressure
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The constant pressure in the walls of the arteries
when the LEFT VENTRICLE is at rest (between
contractions)
Normal diastolic reading is below 80mm or mercury
Normal range is 60-80 mm of mercury
It is noted as the reading on the BP gauge when the
sound STOPS or becomes very FAINT
Recording Blood Pressure
Recorded in the form of a fraction
 Systolic is the top number
 Diastolic is the bottom number
Example:
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120/70
Pulse Pressure
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The difference between the SYSTOLIC and the
DIASTOLIC pressure
Important indicator of the health & tone of the
arterial walls
Normal pulse pressure is: 30-50 mm of mercury
Example: what is the pulse pressure of
110/80
Answer:
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The pulse pressure of 110/80 is:

30 mm of mercury
Abnormal Blood Pressure
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Pre Hypertension
 Warning
that high blood pressure is likely to develop
 This condition can harden arteries, dislodge plaque,
and block vessels that nourish the heart
 Indicated by pressure readings of:
 Systolic
–120-139 mm of mercury
 Diastolic – 80-89 mm or mercury
Hypertension
Indicated when pressures are greater than
140 mm of mercury
COMMOM CAUSES:
 Stress
 Anxiety
 High salt intake
 Advanced age
 Thyroid disease
 Vascular disease such as arteriosclerosis
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Hypotension
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Indicated when BP is less than
 90
mm of mercury
COMMOM CAUSES
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Occurs with heart failure
Dehydration
Depression
Severe burns
Hemorrhage
Shock
Orthostatic or Postural Hypotension
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Occurs when there is a sudden drop in BOTH the systolic
& diastolic pressures
Occurs when an individual moves from a lying to a
sitting or to a standing position
Blood vessels fail to compensate for the change in
position
Individual experiences- may last a few seconds
Lightheadedness
 Dizziness
 Blurred vision
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Factor affecting BLOOD PRESSURE
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Heartbeat
Condition of the arterial system
Elasticity of the arteries
Volume of circulating blood
Position
Factors which may Increase BP
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Anxiety
Nervousness
Obesity
Stimulant drugs
Exercise
Smoking
Pain
Factors which can Decrease BP
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Sleep
Depressant drugs
Shock
Dehydration
Hemorrhage
Fasting
Sphygmomanometers
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Aneroid
 Does
not have a mercury column
 It has a round gauge
 Each line equals 2 mm of mercury
 Position at eye level
 Needle must start at 0 ZERO
Electronic Sphygmomanometers
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Used in most health care facilities
Record blood pressure automatically after cuff is
placed on patient
Will show reading in a digital display
Factors to Follow When taking a BP
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American Heart Association recommends:
 Patient
should be quite for at least 5 minutes
 Take 2 separate readings
 Wait at least 30-60 seconds between readings
Continued
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Correct size and placement of the cuff
Patient should be sitting or lying down
Arm should be freely extended and free of
constricting clothes
BP cuff must be deflated and free of any air
BP cuff should be placed over directly over the
brachial artery
Edge of cuff should sit 1” above the antecubital
space
How to take a Blood Pressure
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Person should be comfortably seated or lying down
Should have rested for 10-15 minutes prior to the
reading
Arms that are paralyzed, injured, have an IV or
shunt should not be used**** never take BP the
same side as a mastectomy
Infant blood pressures can be taken on the leg
Blood Pressure Procedure
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Excess air should be squeezed out of the cuff
Cuff should be placed snugly on upper arm.
Gauge should be easily visualized
Valve should be closed, but easily able to be
opened
Blood Pressure Procedure
Two techniques for obtaining the pressure
TECHNIQUE #1
 Find radial pulse. Pump cuff till pulse no longer palpated.
 Then pump another 30 mm Hg higher
 Place diaphragm of stethoscope on brachial artery about ½ 1 inch above the elbow
 Release the valve and listen for the two measurements - slowly
deflating the cuff.
Blood Pressure Procedure
TECHNIQUE #2
 Find brachial artery and put diaphragm over the
site.
 Pump cuff to 120 mm Hg and listen for the heart
beat. If it is heard, pump another 30 mm Hg and
listen again.
 When the pulse is no longer heard, then pump
another 30 mm Hg and slowly deflate, listening for
the two measurements.
Reporting & Recording Reading
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If reading is uncertain, wait 30 seconds to 1 minute
before remeasuring
Record the reading and report any abnormalities
If the B/P reading is outside of the normal limits,
retake it before reporting the value to a supervisor
to be certain of accuracy
Blood Pressure Skills Lab
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OBJECTIVE:
 Successful
completion of Skills Check list after
demonstrating proficiency in this hands on lab
experience
1.
Students will have the opportunity to practice taking
and recording BP as recommended by the AHA
2. Successful completion of the skills check list is required
to pass this skills section of this lesson
Temperature Conversions
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Fahrenheit to Celsius
C=(F-32)/ 1.8
Celsius to Fahrenheit
F=(C X 1.8) + 32