1Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Vital signs include:Vital signs include:

TemperatureTemperature PulsePulse RespirationRespiration Blood pressure (often included)Blood pressure (often included)

2Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Temperature can be taken:Temperature can be taken:

OrallyOrally AxillaryAxillary RectallyRectally Aurally (tympanic membrane)Aurally (tympanic membrane)

3Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Types of thermometersTypes of thermometers include:include:

ElectronicElectronic Tympanic membraneTympanic membrane ChemicalChemical Temperature-sensitive stripsTemperature-sensitive strips

4Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Temperature results may be Temperature results may be affected by:affected by:

AgeAge Variations in time of dayVariations in time of day ExerciseExercise Emotional statesEmotional states EnvironmentEnvironment PregnancyPregnancy

5Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Variation in Body Variation in Body Temperature by AgeTemperature by Age

AgeAge SiteSite Average Temp (Average Temp (°)°)

NewbornNewborn AxillaryAxillary 97-10097-100 F F 36.1-37.836.1-37.8 C C

1 year1 year OralOral 99.7 F99.7 F 37.6 C37.6 C

5 years5 years OralOral 98.6 F98.6 F 37 C37 C

AdultAdult OralOral 98.6 F98.6 F 37 C37 C

RectalRectal 99.6 F99.6 F 37.5 C37.5 C

AxillaryAxillary 97.6 F97.6 F 36.4 C36.4 C

AuralAural 98.6 F98.6 F 37 C37 C

ElderlyElderly(over 70 years)(over 70 years)

OralOral 96.8 F96.8 F 36 C36 C

6Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Pulse can be affected by:Pulse can be affected by:

AgeAge GenderGender Physical activityPhysical activity Emotional stressEmotional stress MetabolismMetabolism FeverFever MedicationsMedications

7Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Pulse can be described in Pulse can be described in terms of:terms of:

Rhythm – e.g., irregularRhythm – e.g., irregular Volume – e.g., thready/boundingVolume – e.g., thready/bounding

8Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Variation in Pulse Range and Variation in Pulse Range and Average Pulse Rate by AgeAverage Pulse Rate by Age

Age GroupAge Group Pulse Range Pulse Range (beats/min)(beats/min)

Avg Pulse Avg Pulse (beats/min)(beats/min)

NewbornNewborn 120-160120-160 140140

ToddlerToddler 90-14090-140 115115

PreschoolerPreschooler 80-11080-110 9595

School-ageSchool-age 75-10575-105 9090

AdolescentAdolescent 60-10060-100 8080

AdultAdult 60-10060-100 8080

After age 60After age 60 67-8067-80 7474

Well-trained Well-trained athletesathletes

40-6040-60 5050

9Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

RespirationRespiration

Count includes one inhalation Count includes one inhalation and exhalation.and exhalation.

Respiration exchanges oxygen Respiration exchanges oxygen and carbon dioxide.and carbon dioxide.

10Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Respiration is affected by:Respiration is affected by:

AgeAge Physical activityPhysical activity Emotional statesEmotional states FeverFever MedicationsMedications

11Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Respiration can be Respiration can be described in terms of:described in terms of:

Volume – e.g., normal, deep, Volume – e.g., normal, deep, shallow, laboredshallow, labored

Rhythm – e.g., even, regularRhythm – e.g., even, regular

12Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Variation in Respiratory Range Variation in Respiratory Range and Rate by Age Groupand Rate by Age Group

Age GroupAge Group Respiratory Respiratory Range Range

(resp/min)(resp/min)

Average RR Average RR (resp/min)(resp/min)

NewbornNewborn 30-4030-40 3535

ToddlerToddler 23-3523-35 3030

PreschoolerPreschooler 20-3020-30 2525

School-ageSchool-age 18-2618-26 2222

AdolescentAdolescent 12-2012-20 1616

AdultAdult 12-2012-20 1616

13Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Blood pressure (BP) is Blood pressure (BP) is measured in terms of:measured in terms of:

Systole – pressure on the walls Systole – pressure on the walls of the arteries when the heart of the arteries when the heart contractscontracts

Diastole – pressure on the walls Diastole – pressure on the walls of the arteries when the heart is of the arteries when the heart is at restat rest

Pulse pressure – difference Pulse pressure – difference between systolic and diastolic between systolic and diastolic pressurepressure

14Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Blood pressure is Blood pressure is affected by:affected by:

AgeAge GenderGender Diurnal variationsDiurnal variations Emotional statesEmotional states ExerciseExercise Body positionBody position MedicationsMedications

15Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Blood Pressure Classification Blood Pressure Classification for Adults 18 and Overfor Adults 18 and Over

BP BP ClassificationClassification

Systolic BPSystolic BP Diastolic BPDiastolic BP

NormalNormal Less than Less than 120120

ANDAND Less than 90Less than 90

Pre-Pre-hypertensionhypertension

120-139120-139 OROR 80-8980-89

HypertensionHypertension

Stage 1Stage 1 140-159140-159 OROR 90-9990-99

Stage 2Stage 2 160 or higher160 or higher OROR 100 or higher100 or higher