3.01 vital signs

Vital SignsVital Signs

3.01 Understand Diagnostic and Therapeutic Services


• Provide information about body function• Include:

– temperature– pulse– respiration– blood pressure

• Changes may be the first sign of disease• Accuracy is imperative!

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Vital SignsVital SignsTemperature

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

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Normal rangesNormal ranges

– 97º - 100º F – 36.1º - 37.8º C

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Hypothermia

•Temperature below 95º F

•Death can occur if below 93º F

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HypothermiaTemperature decreases with:

– environment– exposure to cold– inactivity– sleep– starvation

Symptoms:– shivering– cold skin– confusion


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Hyperthermia

•Temperature 100-104º F

•Temperature above 104º F is life-threatening

•Prolonged hyperthermia may cause brain

injury.

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Hyperthermia

Temperature increases with: – environment– exercise– illness, infection, injury– stress

Symptoms:– hot, dry, red skin– nausea/vomiting– headache– low blood pressure


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Clinical

Non-mercury glass

ElectronicAural

Thermometers

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Sites to measure temperature:

•Aural – auditory canal

•Axillary – armpit

•Oral – mouth

•Rectal – rectum

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To record temperature:

– Oral 98.6º (O)

– Rectal 99.6º (R)

– Axillary 97.6º (ax)

– Aural 98.6º (T)

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Vital SignsVital SignsTemperature Measurement

Oral 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

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REPORT REPORT

ABNORMAL RESULTS ABNORMAL RESULTS

OF ANY VITAL SIGN OF ANY VITAL SIGN

IMMEDIATELYIMMEDIATELY

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TemperatureTemperature


Demonstrate the skillProvide for guided practice

Provide for independent practiceVerify student passing

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OralOral

Vital SignsVital SignsTemperature Measurement

• AuralAural

• Pros:– Measures core body temperature– Fast and convenient

• Con:– Inaccurate if not placed correctly in the ear

canal– Ear infection– Ear wax


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TemperatureTemperature




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AuralAural


Vital SignsVital SignsPulse

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 foot17


When would you use these pulse sites?

Temporal

Carotid

Brachial

Radial

Femoral

Popliteal

Dorsalis pedis 3.01 Understand Diagnostic and Therapeutic Services

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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


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• Pulse can be increased by:– exercise– stimulant drugs– excitement– fever– shock– nervousness

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• Pulse can be decreased by:

– sleep

– depressant drugs

– heart disease

– coma

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REPORT REPORT




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Radial PulseRadial Pulse




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Vital SignsVital SignsApical Apical Pulse

• Pulse count taken with the stethoscope.

• Use if the patient has:– Irregular heartbeat– Arteriosclerosis– Weak or rapid radial pulse– Infants and children


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Apical PulseApical Pulse




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Vital SignsVital SignsRespiration

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 characterRhythm – regular or irregularCharacter – depth, ease of breaths

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Vital SignsVital SignsRespiration

• Abnormal respiratory patternsApnea – periods of absent breathing

Cheyne-stokes – periods of apnea and dyspnea

Dyspnea – difficult breathing

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REPORT REPORT




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RespirationsRespirations




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Vital SignsVital SignsBlood pressure

Pressure of blood on the arterial walls

Recorded as a fraction: 120/80

Systolic pressure – wall of left ventricle is contractingNormal range: 100-140 mm Hg

Diastolic pressure– wall of left ventricle is restingNormal range: 60-90 mm Hg

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Factors that elevate blood pressure:– anxiety

– eating– exercise– excitement– stimulant drugs

Factors that lower blood pressure:– depressant drugs

– excessive loss of blood

– rest

– shock

Vital SignsVital SignsBlood pressure

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REPORT REPORT




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Blood PressureBlood Pressure




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Combined Vital SignsCombined Vital SignsTPR BPTPR BP




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Diagnostic Skills:Diagnostic Skills:Height and WeightHeight 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

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Diagnostic Skills:Diagnostic Skills:Daily WeightsDaily Weights

• Daily weights are used to monitor patients with chronic disease processes:– Hormone disorders– Renal disorders– Heart disease

– Cancer

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• 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.

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OBSERVE SAFETY PRECAUTONS!OBSERVE SAFETY PRECAUTONS!

Prevent injury from falls and the

protruding height lever.

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Measuring Height and WeightMeasuring Height and Weight




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Diagnostic SkillsDiagnostic Skills

Diagnostic Skills:Diagnostic Skills:Measure Measure Visual AcuityVisual Acuity

• Used to measure the ability to see

• Snellen charts: used to measure distant vision

• Ishihara method tests for color

• Tonometer measures intraocular pressure


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Diagnostic Skills:Diagnostic Skills:Measure Measure Visual AcuityVisual 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


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Measure Visual Acuity Measure Visual Acuity




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Diagnostic SkillsDiagnostic Skills

3.01 vital signs

Education

therapeutic services3

f temperature

oral temperature

f death

vital signs3

vital signsoral3

body functioninclude

heat producedheat