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Vital Signs

3.01 Understand Diagnostic and

Therapeutic Services

Vital Signs

• Provide information about body function

• Include:

– temperature

– pulse

– respiration

– blood pressure

• Changes may be the first

sign of disease

• Accuracy is imperative! 2



Vital Signs

Temperature

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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Vital Signs

Temperature

Normal ranges

– 97º - 100º F

– 36.1º - 37.8º C

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Vital Signs

Temperature

Hypothermia

• Temperature below 95º F

• Death can occur if below 93º F

5

Vital Signs

Temperature

Hypothermia

Temperature decreases with:

– environment

– exposure to cold

– inactivity

– sleep

– starvation

Symptoms:

– shivering

– cold skin

– confusion



6



Vital Signs

Temperature

Hyperthermia

• Temperature 100-104º F

• Temperature above 104º F is life-threatening

• Prolonged hyperthermia may cause

brain injury.

7

Vital Signs

Temperature

Hyperthermia

Temperature increases with: – environment

– exercise

– illness, infection, injury

– stress

Symptoms:

– hot, dry, red skin

– nausea/vomiting

– headache

– low blood pressure



8



Vital Signs

Temperature

Clinical

Non-mercury glass

Electronic Aural

Thermometers

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Vital Signs

Temperature

Sites to measure temperature:

• Aural – auditory canal

• Axillary – armpit

• Oral – mouth

• Rectal – rectum

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Vital Signs

Temperature

To record temperature:

– Oral 98.6º (O)

– Rectal 99.6º (R)

– Axillary 97.6º (ax)

– Aural 98.6º (T)

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Vital Signs

Temperature Measurement

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

ABNORMAL RESULTS

OF ANY VITAL SIGN

IMMEDIATELY

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Vital Signs

Temperature



Demonstrate the skill

Provide for guided practice

Provide for independent practice

Verify student passing

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Vital Signs

Oral

Vital Signs

Temperature Measurement

• Aural

• 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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Temperature







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Vital Signs

Aural



Vital Signs

Pulse

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 foot

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Vital Signs

Pulse

When would you use these pulse sites?

Temporal

Carotid

Brachial

Radial

Femoral

Popliteal

Dorsalis pedis



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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

Vital Signs

Pulse

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Vital Signs

Pulse

• Pulse can be increased by:

– exercise

– stimulant drugs

– excitement

– fever

– shock

– nervousness

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Vital Signs

Pulse

• Pulse can be decreased by:

– sleep

– depressant drugs

– heart disease

– coma

21



REPORT

ABNORMAL RESULTS

OF ANY VITAL SIGN

IMMEDIATELY

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Vital Signs

Radial Pulse







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Vital Signs

Vital Signs

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 Pulse







25

Vital Signs



Vital Signs

Respiration

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 character

Rhythm – regular or irregular

Character – depth, ease of breaths

26



Vital Signs

Respiration

• Abnormal respiratory patterns

Apnea – periods of absent breathing

Cheyne-stokes – periods of apnea and

dyspnea

Dyspnea – difficult breathing

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REPORT

ABNORMAL RESULTS

OF ANY VITAL SIGN

IMMEDIATELY

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Vital Signs

Respirations







29

Vital Signs



Vital Signs

Blood pressure

Pressure of blood on the arterial walls

Recorded as a fraction: 120/80

Systolic pressure – wall of left ventricle

is contracting

Normal range: 100-140 mm Hg

Diastolic pressure– wall of left ventricle

is resting

Normal 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 Signs

Blood pressure

31



REPORT

ABNORMAL RESULTS

OF ANY VITAL SIGN

IMMEDIATELY

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Vital Signs

Blood Pressure







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Vital Signs

Combined Vital Signs

TPR BP







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Vital Signs



Diagnostic Skills:

Height 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

35



Diagnostic Skills:

Daily Weights

• Daily weights are used to monitor patients with

chronic disease processes:

– Hormone disorders

– Renal disorders

– Heart disease

– Cancer

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Diagnostic Skills:

Daily Weights

• 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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Diagnostic Skills:

Daily Weights

OBSERVE SAFETY PRECAUTONS!

Prevent injury from falls and the

protruding height lever.

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Measuring Height and Weight







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Diagnostic Skills

Diagnostic Skills:

Measure Visual 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:


• 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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Diagnostic Skills

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