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!

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

Normal rangesNormal ranges

– 97º - 100º F – 36.1º - 37.8º C

Hypothermia

•Temperature below 95º F

•Death can occur if below 93º F

HypothermiaTemperature decreases with:

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

Symptoms:– shivering– cold skin– confusion

Hyperthermia

•Temperature 100-104º F

•Temperature above 104º F is life-threatening

•Prolonged hyperthermia may cause brain

injury.

Hyperthermia

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

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

Clinical

Non-mercury glass

ElectronicAural

Thermometers

Sites to measure temperature:

•Aural – auditory canal

•Axillary – armpit

•Oral – mouth

•Rectal – rectum

To record temperature:

– Oral 98.6º (O)

– Rectal 99.6º (R)

– Axillary 97.6º (ax)

– Aural 98.6º (T)

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

REPORT REPORT

ABNORMAL RESULTS ABNORMAL RESULTS

OF ANY VITAL SIGN OF ANY VITAL SIGN

IMMEDIATELYIMMEDIATELY

TemperatureTemperature

Demonstrate the skillProvide for guided practice

Provide for independent practiceVerify student passing

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

TemperatureTemperature

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

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

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

• Pulse can be decreased by:

– sleep

– depressant drugs

– heart disease

– coma

REPORT REPORT

Radial PulseRadial Pulse

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

Apical PulseApical Pulse

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

Vital SignsVital SignsRespiration

• Abnormal respiratory patternsApnea – periods of absent breathing

Cheyne-stokes – periods of apnea and dyspnea

Dyspnea – difficult breathing

REPORT REPORT

RespirationsRespirations

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

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

REPORT REPORT

Blood PressureBlood Pressure

Combined Vital SignsCombined Vital SignsTPR BPTPR BP

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

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

• 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.

OBSERVE SAFETY PRECAUTONS!OBSERVE SAFETY PRECAUTONS!

Prevent injury from falls and the

protruding height lever.

Measuring Height and WeightMeasuring Height and Weight

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

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

Measure Visual Acuity Measure Visual Acuity

Diagnostic SkillsDiagnostic Skills

3.01 vital signs

therapeutic services3

f temperature

oral temperature

f death

vital signs3

vital signsoral3

body functioninclude

heat producedheat

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