chapter 24 vital signs
DESCRIPTION
Vital Signs Temperature Pulse Respiration Blood pressureTRANSCRIPT
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Chapter 24Vital Signs
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Vital Signs• Temperature• Pulse• Respiration• Blood pressure
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When to Assess Vital Signs• Upon admission to any healthcare agency• Based on agency institutional policy and procedures• Any time there is a change in the patient’s condition• Before and after surgical or invasive diagnostic
procedures• Before and after activity that may increase risk• Before administering medications that affect
cardiovascular or respiratory functioning
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Maintenance of Body Temperature• Thermoregulatory center in the hypothalamus regulates
temperature• Center receives messages from cold and warm thermal
receptors in the body• Center initiates responses to produce or conserve body
heat or increase heat loss
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Heat Production• Primary source is metabolism• Hormones, muscle movements, and exercise increase
metabolism• Epinephrine and norepinephrine are released and alter
metabolism• Energy production decreases and heat production
increases
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Sources of Heat Loss• Skin (primary source)• Evaporation of sweat• Warming and humidifying inspired air • Eliminating urine and feces
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Transfer of Body Heat to External Environment• Radiation• Convection ( الحمل (بواسطة• Evaporation• Conduction
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Pulse Physiology• Regulated by the autonomic nervous system through
cardiac sinoatrial node• Parasympathetic stimulation — decrease heart rate• Sympathetic stimulation — increases heart rate• Pulse rate = number of contractions over a peripheral
artery in 1 minute
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Respirations• Pulmonary ventilation — movement of air in and out of
lungs– Inhalation: breathing in– Exhalation: breathing out
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Rate and Depth of Breathing • Changes in response to body demands• Controlled by respiratory centers in the medulla and pons• Activated by impulses from chemoreceptors • Increase in carbon dioxide is the most powerful
respiratory stimulant
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Physiology of Blood Pressure• Force of the blood against arterial walls• Controlled by a variety of mechanism to maintain
adequate tissue perfusion• Pressure rises as ventricle contracts and falls as heart
relaxes– Highest pressure is systolic– Lowest pressure is diastolic
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Factors Affecting Body Temperature• Circadian rhythms• Age and gender• Environmental temperatures
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Pulse Variations• Increased or decreased pulse rate• Pulse amplitude and quality• Regular or irregular pulse rhythm
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Factors Affecting Respirations• Exercise • Respiratory and cardiovascular disease • Alterations in fluid, electrolyte, and acid balances• Medications• Trauma• Infection• Pain• Anxiety
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Factors Affecting Blood Pressure• Age, gender, race• Circadian rhythm• Food intake• Exercise• Weight• Emotional state• Body position• Drugs/medications
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Equipment for Assessing Temperature• Electronic and digital thermometer• Tympanic membrane thermometer• Glass thermometer• Disposable single-use thermometer• Temporal artery thermometer• Automated monitoring devices
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Equipment for Assessing Blood Pressure• Stethoscope and sphygmomanometer• Doppler ultrasound• Electronic or automated devices
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Sites for Assessing Temperature• Tympanic membrane• Oral• Rectal• Axillary
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Sites for Assessing Pulse• Palpating peripheral arteries• Auscultating apical pulse with stethoscope• Assessing apical-radial pulse
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Assessing Respirations• Inspection• Listening with stethoscope• Monitoring arterial blood gas results• Using a pulse oximeter
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Assessing Blood Pressure• Listening for Korotkoff sounds with stethoscope
– First sound is systolic pressure– Change or cessation of sounds occurs - diastolic
pressure• The brachial artery and popliteal artery are commonly
used
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Normal Temperatures for Healthy Adults• Oral – 37.0ºC, 98.6ºF• Rectal – 37.5ºC, 99.5ºF• Axillary – 36.5ºC, 97.6ºF• Tympanic – 37.5ºC, 99.5ºF• Forehead – 34.4ºC, 94.0ºF
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Normal ranges for Vital Signs for Healthy Adults• Oral temperature — 37.0ºC, 98.6ºF• Pulse rate — 60 to 100 (80 average)• Respirations — 12 to 20 breaths/minute• Blood pressure — 130/85