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Vital SignsVital Signs“signs of life”“signs of life”
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What are vital signs?What are vital signs?
**TemperatureTemperature- body temp- body temp
**Pulse RatePulse Rate- wave of blood,from - wave of blood,from contraction of heart.contraction of heart.
**Respiratory RateRespiratory Rate- number of breaths - number of breaths (respirations) per minute.(respirations) per minute.
**Blood PressureBlood Pressure- amount of pressure exerted on - amount of pressure exerted on vessel walls as blood pulsates. 2 pressures vessel walls as blood pulsates. 2 pressures
measured. measured.
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Vital SignsVital Signs
Abbreviations for documenting (charting)
“T”- temperature
“P”- pulse
“R”- respirations
“BP”- blood pressure
Abbreviations for documenting (charting)
“T”- temperature
“P”- pulse
“R”- respirations
“BP”- blood pressure
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TemperatureTemperature
Reading Sites:
Oral- within mouth, under tongue
Axillary- in armpit, aka axilla
Tympanic- in ear canal
Rectal- through anus, in rectum
Reading Sites:
Oral- within mouth, under tongue
Axillary- in armpit, aka axilla
Tympanic- in ear canal
Rectal- through anus, in rectum
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TemperatureTemperature
Thermometer types:
Electronic- measure temperature through probe at end of device (or) infrared capture.
Glass- contains mercury which rises to appropriate level to indicate reading temperature.
Thermometer types:
Electronic- measure temperature through probe at end of device (or) infrared capture.
Glass- contains mercury which rises to appropriate level to indicate reading temperature.
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TemperatureTemperature
Fahrenheit to Celsius conversion
C°= Degrees Celsius
Water freezes at 0°C
F°= Degrees Fahrenheit
Water freezes at 32°F
Fahrenheit to Celsius conversion
C°= Degrees Celsius
Water freezes at 0°C
F°= Degrees Fahrenheit
Water freezes at 32°F
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TemperatureTemperature
°F to °C- Deduct 32, then multiply by 5, then divide by 9
°C to °F- Multiply by 9, then divide by 5, then add 32
°F to °C- Deduct 32, then multiply by 5, then divide by 9
°C to °F- Multiply by 9, then divide by 5, then add 32
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Temp-Conversion EX.Temp-Conversion EX.
96.8°F-32*5÷9= 36°C
36°C*9÷5+32= 96.8°F
96.8°F-32*5÷9= 36°C
36°C*9÷5+32= 96.8°F
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TemperatureTemperature
Normal adult temperature range considered 98.6°F
Most range from 96.8°F to 100.4°F (36.0°C to 38.0°C).
Normal adult temperature range considered 98.6°F
Most range from 96.8°F to 100.4°F (36.0°C to 38.0°C).
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TemperatureTemperature
Many factors affect body temperature:
Exposure to (heat/cold)
Time of day- normally cooler in AM
Illness, Stress, Allergic Reaction,etc.
Many factors affect body temperature:
Exposure to (heat/cold)
Time of day- normally cooler in AM
Illness, Stress, Allergic Reaction,etc.
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TemperatureTemperature
When temperature is above 100.4F (38.0C), the patient is febrile- “with fever”.
When temperature is within normal range (96.8F to 100.4) the patient is afebrile- “without fever”
When temperature is above 100.4F (38.0C), the patient is febrile- “with fever”.
When temperature is within normal range (96.8F to 100.4) the patient is afebrile- “without fever”
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Pulse RatePulse Rate
Pulse- wave of blood flow created by contraction of the heart
Pulse Rate- number of times the heart beats in one minute (60 seconds).
BPM-beats per minute
Pulse- wave of blood flow created by contraction of the heart
Pulse Rate- number of times the heart beats in one minute (60 seconds).
BPM-beats per minute
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Pulse SitesPulse Sites
TextText
*Table 9-1 on page 326*Table 9-1 on page 326
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Pulse SitesPulse Sites
TemporalTemporal-side of head-side of headCarotidCarotid-neck-neckApicalApical-just below left nipple (listen)-just below left nipple (listen)BrachialBrachial-inside elbow-inside elbowRadialRadial-wrist-wristFemoralFemoral-groin-groinPoplitealPopliteal- behind knee- behind kneePedalPedal-top of foot-top of foot
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Pulse RhythmPulse Rhythm
Pulse Rhythm- should be regular, “evenly paced”. Can be irregular- “dysrhythmia”
If irregular, pulse should always be counted entire minute for average pulse rate.
Irregular heart (pulse) rate is sometimes normal condition in infants, through young adulthood.
Pulse Rhythm- should be regular, “evenly paced”. Can be irregular- “dysrhythmia”
If irregular, pulse should always be counted entire minute for average pulse rate.
Irregular heart (pulse) rate is sometimes normal condition in infants, through young adulthood.
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Pulse- Bilateral?Pulse- Bilateral?
Bilateral- “both sides”
pulses should be found “equal bilaterally”
If found only on one side of body at a pulse point it is referred to as “unilateral”.
Bilateral- “both sides”
pulses should be found “equal bilaterally”
If found only on one side of body at a pulse point it is referred to as “unilateral”.
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Pulse Volume“Strength of Pulse”
Pulse Volume“Strength of Pulse”
Measure of the force against the arterial wall and your fingertips as you palpate.
See Chart on next slide
Described often as:
Absent, Thready/Weak, Strong/Normal, Bounding/Full
Measure of the force against the arterial wall and your fingertips as you palpate.
See Chart on next slide
Described often as:
Absent, Thready/Weak, Strong/Normal, Bounding/Full
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Pulse Volume“Chart”
Pulse Volume“Chart”
0 Absent, Unable to detect
1 Thready/Weak, difficult to palpate; easy to obliterate
2 Strong/Normal, easily found; obliterated by pressure
3 Bounding/Full, difficult to obliterate with fingertips
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PulsePulse
Normal Pulse Ranges:
Newborn 120-160
1 month to 1 year 80-140
1-6 years 80-120
6 to adolescence 75-110
Adulthood 72-80
Late Adult 60-80
Normal Pulse Ranges:
Newborn 120-160
1 month to 1 year 80-140
1-6 years 80-120
6 to adolescence 75-110
Adulthood 72-80
Late Adult 60-80
Table 9-2 p.327Table 9-2 p.327
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Pulse Rates“outside of normal range”Pulse Rates
“outside of normal range”
Lower than normal= Bradycardia
Higher than normal= Tachycardia
Lower than normal= Bradycardia
Higher than normal= Tachycardia
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Pulse Rates“Factors that affect pulse rate”
Pulse Rates“Factors that affect pulse rate”
Age-slows with age
Sex- women tend to have faster rates
Level of fitness
Physical/mental stress-elevates
Lack of Oxygen or low BP-elevates
Medications/Alcohol
Age-slows with age
Sex- women tend to have faster rates
Level of fitness
Physical/mental stress-elevates
Lack of Oxygen or low BP-elevates
Medications/Alcohol
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Respiratory RateRespiratory Rate
Respiration (ventilation):the act or process of inhaling and exhaling; breathing. Also called ventilation.
Respiration (ventilation):the act or process of inhaling and exhaling; breathing. Also called ventilation.
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Respiratory RateRespiratory Rate
Like the pulse rate, the normal respiratory rate decreases as a person becomes older.
Apnea-absent respirations
Like the pulse rate, the normal respiratory rate decreases as a person becomes older.
Apnea-absent respirations
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Respiratory Rates “Ranges (per minute) by Age”
Respiratory Rates “Ranges (per minute) by Age”
Infant 30-60
Toddler 24-40
Preschool 22-34
Shool-aged 18-30
Adolescent/Adult 12-20
Infant 30-60
Toddler 24-40
Preschool 22-34
Shool-aged 18-30
Adolescent/Adult 12-20
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Respiratory“Observing chest movement”
Respiratory“Observing chest movement”
Adults and Older Children- chest movement outward/upward in.
Under 7 years old- use combined chest and abdominal breathing.
Abdominal breathing in adults= sign of difficulty breathing (dyspnea)
Adults and Older Children- chest movement outward/upward in.
Under 7 years old- use combined chest and abdominal breathing.
Abdominal breathing in adults= sign of difficulty breathing (dyspnea)
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Respiratory Rate“Assessing”
Respiratory Rate“Assessing”
Most common- observe chest movement for one minute
Auscultation- with stethoscope on chest wall. Best in infants whose rate is difficult to observe and adults who may be aware you are observing.
*warm stethoscope in hands
Most common- observe chest movement for one minute
Auscultation- with stethoscope on chest wall. Best in infants whose rate is difficult to observe and adults who may be aware you are observing.
*warm stethoscope in hands
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Respiratory Rate Respiratory Rate
Hyperventilation- increase in respiratory rate; beyond normal range.
Causes: Physical/mental stress, fever (pyrexia), lack of oxygen, low blood pressure.
Hyperventilation- increase in respiratory rate; beyond normal range.
Causes: Physical/mental stress, fever (pyrexia), lack of oxygen, low blood pressure.
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Respiratory Rate Respiratory Rate
Hypoventilation- decrease in respiratory rate; below normal range.
Causes: Pain Meds, Alcohol, Hypothermia, severe lack of oxygen, No blood pressure
Hypoventilation- decrease in respiratory rate; below normal range.
Causes: Pain Meds, Alcohol, Hypothermia, severe lack of oxygen, No blood pressure
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Respiration Rhythm Respiration Rhythm
Respirations should be regular (evenly spaced).Respirations should be regular (evenly spaced).
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Respiration QualityRespiration Quality
Volume and effort of each respiration should be comparable throughout the observation.
Dyspnea- labored/difficult breathing; accessory muscle use seen in neck,chest, and abdomen
Volume and effort of each respiration should be comparable throughout the observation.
Dyspnea- labored/difficult breathing; accessory muscle use seen in neck,chest, and abdomen
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Blood PressureBlood Pressure
BP-measurement of the pressure exerted on the arterial walls as blood pulsates. Two pressures are measured.(Systolic and Diastolic)
BP is measured in mmhg= millimeters of mercury
BP-measurement of the pressure exerted on the arterial walls as blood pulsates. Two pressures are measured.(Systolic and Diastolic)
BP is measured in mmhg= millimeters of mercury
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Blood PressureBlood Pressure
Systolic Blood Pressure (SBP)- pressure exerted on arterial walls during contraction phase of the heart .
highest pressure
120/70 - Systolic is 120 mmhg
Systolic Blood Pressure (SBP)- pressure exerted on arterial walls during contraction phase of the heart .
highest pressure
120/70 - Systolic is 120 mmhg
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Blood Pressure Blood Pressure
Diastolic Blood Pressure- the resting pressure on arteries as heart “relaxes” between contractions.
120/70 - Diastolic is 70 mmhg
Diastolic Blood Pressure- the resting pressure on arteries as heart “relaxes” between contractions.
120/70 - Diastolic is 70 mmhg
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Blood Pressure“Normal Ranges”
Blood Pressure“Normal Ranges”
Systolic range= 100-140 mmhg
Diastolic range= 60-90 mmhg
Systolic range= 100-140 mmhg
Diastolic range= 60-90 mmhg
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Blood PressureBlood Pressure
Hypotension- When blood pressure drops below the normal range.
Hypertension- when blood pressure is higher than the normal range.
Hypotension- When blood pressure drops below the normal range.
Hypertension- when blood pressure is higher than the normal range.
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Blood Pressure “Hypotension”
Blood Pressure “Hypotension”
When a patient is hypotensive (low BP) the body tries different methods to raise the blood pressure. This causes some signs of shock (lack of blood flow to tissues):
Change in level of consciousness
Increased heart rate/respirations
Weak, thready pulses
Pale, sweaty skin
When a patient is hypotensive (low BP) the body tries different methods to raise the blood pressure. This causes some signs of shock (lack of blood flow to tissues):
Change in level of consciousness
Increased heart rate/respirations
Weak, thready pulses
Pale, sweaty skin
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Blood Pressure“Hypertension”
Blood Pressure“Hypertension”
Hypertension is largely “symptomless”
With severe hypertension (180+ systolic/110+ diastolic) a patient may exhibit some of the following:
Headache
Severe anxiety
Shortness of breath
Nosebleed
Hypertension is largely “symptomless”
With severe hypertension (180+ systolic/110+ diastolic) a patient may exhibit some of the following:
Headache
Severe anxiety
Shortness of breath
Nosebleed
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Blood Pressure“most convenient sites”
Blood Pressure“most convenient sites”
Brachial- upper arm; most common in adults and older children.
Radial- lower arm; infants/patients with very large upper arms.
Popliteal- thigh; alternative to arms because of disease/trauma/medical treatments to arms/mastectomies
Dorsalis Pedis- lower leg; common site for infants when using electronic cuff.
Brachial- upper arm; most common in adults and older children.
Radial- lower arm; infants/patients with very large upper arms.
Popliteal- thigh; alternative to arms because of disease/trauma/medical treatments to arms/mastectomies
Dorsalis Pedis- lower leg; common site for infants when using electronic cuff.
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Blood PressureBlood Pressure
Sphygmo-man-o-meter
Sphygmo= pulse
man= pressure
meter= measure
“measuring pulse pressure”
Sphygmo-man-o-meter
Sphygmo= pulse
man= pressure
meter= measure
“measuring pulse pressure”
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Blood Pressure“Types of Sphygmomanometers”Blood Pressure
“Types of Sphygmomanometers”
Mercury-calibrated glass cylinder containing mercury
Aneroid- calibrated dial with needle that points to numbers
Electronic- digital display, no stethoscope required
Mercury-calibrated glass cylinder containing mercury
Aneroid- calibrated dial with needle that points to numbers
Electronic- digital display, no stethoscope required
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Blood Pressure“Palpated BP?”
Blood Pressure“Palpated BP?”
It is possible to obtain the Systolic (top #) pressure with only a BP cuff.
Continuously palpate the radial pulse point, inflate the cuff until the pulse is obliterated and then +10-20 mmhg.
Deflate the cuff slowly, the number on the dial when you first feel the pulse again represents the systolic pressure
It is possible to obtain the Systolic (top #) pressure with only a BP cuff.
Continuously palpate the radial pulse point, inflate the cuff until the pulse is obliterated and then +10-20 mmhg.
Deflate the cuff slowly, the number on the dial when you first feel the pulse again represents the systolic pressure