Vital Signs
Vital Signs
• Provide information about body function
• Include:
– temperature
– pulse
– respiration
– blood pressure
• Changes may be the first
sign of disease
• Accuracy is imperative!
3.01 Understand Diagnostic and
Therapeutic Services
2
Vital Signs
Temperature
Measurement of the balance between heat
lost and heat produced
Heat lost through:
•
•
•
Perspiration
Respiration
Excretion
Heat produced by:
• Metabolism of food
• Muscle and gland activity
3.01 Understand Diagnostic and
Therapeutic Services
3
Vital Signs
Temperature
Normal ranges
– 97º - 100º F
– 36.1º - 37.8º C
3.01 Understand Diagnostic and
Therapeutic Services
4
Vital Signs
Temperature
Hypothermia
• Temperature below 95º F
• Death can occur if below 93º F
3.01 Understand Diagnostic and
Therapeutic Services
5
Vital Signs
Temperature
Hypothermia
Temperature decreases with:
–
–
–
–
–
environment
exposure to cold
inactivity
sleep
starvation
Symptoms:
– shivering
– cold skin
– confusion
3.01 Understand Diagnostic and
Therapeutic Services
6
Vital Signs
Temperature
Hyperthermia
• Temperature 100-104º F
• Temperature above 104º F is life-threatening
• Prolonged hyperthermia may cause
brain injury.
3.01 Understand Diagnostic and
Therapeutic Services
7
Vital Signs
Temperature
Hyperthermia
Temperature increases with:
–
–
–
–
environment
exercise
illness, infection, injury
stress
Symptoms:
–
–
–
–
hot, dry, red skin
nausea/vomiting
headache
low blood pressure
3.01 Understand Diagnostic and
Therapeutic Services
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Vital Signs
Temperature
Thermometers
Clinical
Non-mercury glass
Aural
Electronic
3.01 Understand Diagnostic and
Therapeutic Services
9
Vital Signs
Temperature
Sites to measure temperature:
• Aural – auditory canal
• Axillary – armpit
• Oral – mouth
• Rectal – rectum
3.01 Understand Diagnostic and
Therapeutic Services
10
Vital Signs
Temperature
To record temperature:
– Oral 98.6º (O)
– Rectal 99.6º (R)
– Axillary 97.6º (ax)
– Aural 98.6º (T)
3.01 Understand Diagnostic and
Therapeutic Services
11
Vital Signs
Temperature Measurement
Oral
• Ask the patient if they have ingested hot or
cold food or drink, or smoked within the
last ½ hour
• If yes, wait at least 15 minutes before
measuring the oral temperature
3.01 Understand Diagnostic and
Therapeutic Services
12
Vital Signs
REPORT
ABNORMAL RESULTS
OF ANY VITAL SIGN
IMMEDIATELY
3.01 Understand Diagnostic and
Therapeutic Services
13
Vital Signs
Oral
Temperature
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
14
Vital Signs
Temperature Measurement
• Aural
• Pros:
– Measures core body temperature
– Fast and convenient
• Con:
– Inaccurate if not placed correctly in the ear
canal
– Ear infection
– Ear wax
3.01 Understand Diagnostic and
Therapeutic Services
15
Vital Signs
Aural
Temperature
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
16
Vital Signs
Pulse
Pressure of blood on artery walls as the heart
beats and relaxes
• Sites:
Temporal – side of the forehead
Carotid – side of the neck
Brachial – inner elbow
Radial – above the thumb at radius
Femoral – upper thigh
Popliteal – behind the knee
Dorsalis pedis – top of the arch of the foot
3.01 Understand Diagnostic and
Therapeutic Services
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Vital Signs
Pulse
When would you use these pulse sites?
Temporal
Carotid
Brachial
Radial
Femoral
Popliteal
Dorsalis pedis
3.01 Understand Diagnostic and
Therapeutic Services
18
Vital Signs
Pulse
Normal rate adult (male) 60 – 70 beats per minute
adult (female) 65 – 80 beats per minute
children (over 7) 70 – 100 beats per minute
children (1 – 7) 80 – 110 beats per minute
infants (less than 1 year) 100 – 160 beats per
minute
Rhythm regular or irregular
Volume strength of the pulse
3.01 Understand Diagnostic and
Therapeutic Services
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Vital Signs
Pulse
• Pulse can be increased by:
– exercise
– stimulant drugs
– excitement
– fever
– shock
– nervousness
3.01 Understand Diagnostic and
Therapeutic Services
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Vital Signs
Pulse
• Pulse can be decreased by:
– sleep
– depressant drugs
– heart disease
– coma
3.01 Understand Diagnostic and
Therapeutic Services
21
Vital Signs
REPORT
ABNORMAL RESULTS
OF ANY VITAL SIGN
IMMEDIATELY
3.01 Understand Diagnostic and
Therapeutic Services
22
Vital Signs
Radial Pulse
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
23
Vital Signs
Apical Pulse
• Pulse count taken with the stethoscope.
• Use if the patient has:
– Irregular heartbeat
– Arteriosclerosis
– Weak or rapid radial pulse
– Infants and children
3.01 Understand Diagnostic and
Therapeutic Services
24
Vital Signs
Apical Pulse
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
25
Vital Signs
Respiration
Process of taking in oxygen and expelling
carbon dioxide
1 inspiration + 1 expiration = respiration
Normal rate:
adults – 12 – 20 breaths per minute
children – 16 – 30 breaths per minute
Evaluate for rhythm and character
Rhythm – regular or irregular
Character – depth, ease of breaths
3.01 Understand Diagnostic and
Therapeutic Services
26
Vital Signs
Respiration
• Abnormal respiratory patterns
Apnea – periods of absent breathing
Cheyne-stokes – periods of apnea and
dyspnea
Dyspnea – difficult breathing
3.01 Understand Diagnostic and
Therapeutic Services
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Vital Signs
REPORT
ABNORMAL RESULTS
OF ANY VITAL SIGN
IMMEDIATELY
3.01 Understand Diagnostic and
Therapeutic Services
28
Vital Signs
Respirations
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
29
Vital Signs
Blood pressure
Pressure of blood on the arterial walls
Recorded as a fraction: 120/80
Systolic pressure – wall of left ventricle
is contracting
Normal range: 100-140 mm Hg
Diastolic pressure– wall of left ventricle
is resting
Normal range: 60-90 mm Hg
3.01 Understand Diagnostic and
Therapeutic Services
30
Vital Signs
Blood pressure
Factors that elevate blood pressure:
– anxiety
–
–
–
–
eating
exercise
excitement
stimulant drugs
Factors that lower blood pressure:
–
–
–
–
depressant drugs
excessive loss of blood
rest
shock
3.01 Understand Diagnostic and
Therapeutic Services
31
Vital Signs
REPORT
ABNORMAL RESULTS
OF ANY VITAL SIGN
IMMEDIATELY
3.01 Understand Diagnostic and
Therapeutic Services
32
Vital Signs
Blood Pressure
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
33
Vital Signs
Combined Vital Signs
TPR BP
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
34
Diagnostic Skills:
Height and Weight
Measured if warranted by patient’s age and physical
condition
• Measured routinely:
– on admission to health care facility
– as part of annual physical examination
– each provider visit for children
• Important for evaluation of laboratory tests
and calculation of medications
3.01 Understand Diagnostic and
Therapeutic Services
35
Diagnostic Skills:
Daily Weights
• Daily weights are used to monitor patients with
chronic disease processes:
–
–
–
–
Hormone disorders
Renal disorders
Heart disease
Cancer
3.01 Understand Diagnostic and
Therapeutic Services
36
Diagnostic Skills:
Daily Weights
• Guidelines for daily weights:
use the same scales
at the same time
wearing the same type of clothing
patient voids to empty bladder
• Make sure to balance the scales before
weighing the patient.
3.01 Understand Diagnostic and
Therapeutic Services
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Diagnostic Skills:
Daily Weights
OBSERVE SAFETY PRECAUTONS!
Prevent injury from falls and the
protruding height lever.
3.01 Understand Diagnostic and
Therapeutic Services
38
Diagnostic Skills
Measuring Height and Weight
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
39
Diagnostic Skills:
Measure Visual Acuity
• Used to measure the ability to see
• Snellen charts: used to measure
distant vision
• Ishihara method tests for color
• Tonometer measures intraocular
pressure
3.01 Understand Diagnostic and
Therapeutic Services
40
Diagnostic Skills:
Measure Visual Acuity
• OD – right eye (oculus dexter)
• OS – left eye (oculus sinister)
• OU – both eyes (oculus uterque)
• Myopia – nearsightedness, defect in
distant vision
• Hyperopia – farsightedness, defect in
near vision
3.01 Understand Diagnostic and
Therapeutic Services
41
Diagnostic Skills
Measure Visual Acuity
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
42