Vital Signs

Vital Signs

Vital Signs: Various determinations that provide

info about basic body functions

Four main V.S.• Temperature• Pulse• Respiration• Blood Pressure

Vital Signs cont… Accuracy is essential

• Abnormal v.s. may indicate disease• Never guess or report an inaccurate reading

A health assistant may not reveal this information to the pt• The physician will tell the pt

Measurement of the balance btwn heat lost & heat produced in the body

Heat lost by• Perspiration• Respiration• Excretion

Heat produced by• Metabolism• Muscle activity• Gland activity

Temperature

Homeostasis: state of constant fluid balance (good thing)

• If temp is too high or too low, fluid balance is affected

• Body temp regulates chem reaction in body

Temperature cont…

Normal 97.0 —100.0 F (36.1— 37.8 C)

Fever >101.0 F (38.3 C)

Hyperthermia >104.0 F (40.0 C)

Hypothermia <95.0 F (35 C)

Variations in Body Temp

Reading a Thermomete

r

Normal variations in temp caused by

• Individual differences High/low metabolism

• Time of day Usually lower in AM Higher in PM after eating & activity

• Part of body where temp is taken Oral Rectal Axillary

Variations in Body Temp cont…

Oral temp• Thermometer in place 3-5 min• Most convenient & comfortable

Rectal temp• Thermometer in place 3-5 min• Most accurate

Axillary/Groin temp • Thermometer in place 10 min• Both are less accurate because they are external

Variations in Body Temp cont…

Sites for Taking Temperature

Glass• Contains mercury• Must be shaken down below 98.0 F• Soak in alcohol for 30 min

Electronic • Used in most facilities• Has a plastic cover to prevent x-contamination

Paper• Contains special chemical to change colors

Types of Thermometers

Fahrenheit to Celsius

• Subtract 32 from F

• Multiply result by 5/9 or 0.5556

• Example:

C = (212 – 32) x 0.5556

180 x 0.5556

C = 100

Conversions

Celsius to Fahrenheit

• Multiply C by 9/5 or 1.8

• Add 32 to total

• Example:

F = (37 x 1.8) + 32

66.6 + 32

F = 98.6

Conversions

Illness and/or infection

Exercise and/or excitement

High temperatures in the environment

Factors that cause increase in body temperatures…

Starvation or fasting

Decrease muscle activity

Cold temperatures in the environment

Factors that cause decrease in body temperatures…

Eating/drinking (hot or cold)

Smoking

Make sure pt. has not had anything to eat, drink or smoke for at least 15 min.

Avoid factor that could alter or change temperatures

The pressure of the blood pushing against the walls of an artery as the heart beats & rests

• Felt as throbbing of an artery caused by contraction of the heart

Pulse

Temporal: side of head

Carotid: side of neck

Brachial: inside crease of elbow • (antecubital space)

Radial: inside of wrist, above thumb

Femoral: inside of upper thigh

Popliteal: behind knee

Dorsalis Pedis: top of foot arch

Major Pulse Sites

Major Pulse Sites

Noted as # beat per min

Cary with age, sex & body size

• All adults — 60-90 B/M

• Adult men — 60-70 B/M

• Adult women — 65-80 B/M

• Children >7 — 72-90 B/M

• Children 1-7 — 80-120 B/M

• Infants — 90-140 B/M

Pulse Rate

Bradycardia: pulse rate <60

Tachycardia: pulse rate >100• Except children

Pulse rhythm: refers to spacing or regularity of beats

• Regular or irregular

Pulse volume: refers to strength or intensity of pulse• Strong, weak, thready, bounding etc…

RECORD ALL INFORMATION: RHYTHM, RATE, VOLUME

Pulse Rate cont…

Volume

Rate

Rhythm

Increased by:• Exercise• Stimulants• Excitement• Fever• Shock • Nervous tension

Decreased by:• Sleep • Depressant drugs• Heart disease• Coma

Factors that will change rate:

Count taken at apex of the heart with a stethoscope

Special pulse taken for pt’s with• Irregular heart beats• Arteriosclerosis• Weak or rapid pulse• Infants or children

Sound resembles a “Lubb-Dubb” Each “Lubb-Dubb” is counted as one

Apical Pulse

When apical pulse is higher than other pulse sites

Heart beat is weak or rapid & doesn’t produce a pulse each time

Apical pulse – radial pulse= pulse deficit

Pulse Deficit

Measures breathing, one inspiration & one exhalation

Normal respiratory rates

• Adults: 12-20 breaths per min• Adults >25 are accelerated• Children: 16-25 breaths per min• Infants: 30-50 breaths per min

Respirations

Character of respirations refers to the depth & quality

Described as:• Deep• Shallow• Labored• Moist• Difficult• Stertorous (like snoring)

Rhythm of respirations refers to regularity or spacing• Regular or irregular

Respirations

Dyspnea: difficult or labored

Apnea: absence of respirations

Cheyne Stokes: period of dyspnea followed by periods of apnea (dying pt’s)

Rales: bubbling or noisy sounds caused by fluid or mucus

Abnormal Respirations

Respirations are under partially voluntary control

Pt’s may tend to breath faster if they know you are counting

Keep your hand on the pulse site and count respirations when pt is unaware

Record all info: rate, character, rhythm

Ex: 11 June 2010 4:30 pm R18 Deep & Reg. L. Wall R.D.H.

Abnormal Respirations etc…

Measurement of the pressure that the blood exerts on the walls of the arteries during the various stages of heart activity

Measured in millimeters of mercury (mmHg)

Measurements read at two points

• Systolic and diastolic

Blood Pressure

Systolic pressure• Pressure that occurs in walls of arteries when

heart is contracting• Normal = 120 mmHg• Range = 100 - 140 mmHg

Diastolic pressure• Constant pressure what occurs in walls of

arteries when heart is at rest or btwn contractions

• Normal = 80 mmHg• Range= 60 – 90 mmHg

Blood Pressure cont…

Factors that influence BP• Force of heartbeat• Resistance of the arteries• Elasticity of the arteries• Volume of blood

Factors that increase BP• Excitement, anxiety• Stimulants• Exercise • Eating• Standing up

Factors that decrease BP• Sleep/Rest• Depressant drugs• Excessive loss of blood• Lying down

Blood Pressure cont…

BP is recorded as a fraction• Systolic/Diastolic (EX: 120/80)

Equipment needed to take BP

• Sphygmomanometers Mercury or aneroid

• Stethoscope

Blood Pressure cont…