Vital Signs• Define

– Various determinations that provide information about the patients basic body condition

– Often the first sign that there is a problem

VITAL SIGNSVITAL SIGNS

• Temperature

• Pulse

• Respirations

• Blood Pressure

Other Vital SignsOther Vital Signs

– Pain assessment

– Skin color

– Pupil size and reaction

– Level of consciousness

– Response to stimuli

TemperatureTemperature

• Measurement of the balance between heat loss and heat produce

• Types– Oral - mouth– Rectal - rectum– Axillary - armpit– Aural (tympanic) – ear

Heat Produced and LostHeat Produced and Lost

Heat Produced– Metabolism of food

– Muscle and gland activity

Heat Lost– Perspiration

– Respiration

– Excretion of feces and urine

Normal Body TemperatureNormal Body Temperature

• Normal range 97 – 100 degrees F

Variations in Normal Body Variations in Normal Body TemperatureTemperature

Lower in morning

Higher in evening

Eating or drinking anything hot or cold, smoking a cigarette or exercising in the last 15 minutes

Measured in degrees Celsius or degrees Fahrenheit

Oral TemperatureOral Temperature• Taken in the mouth

• Thermometer left in for 3-5 minutes

• Most common, convenient, comfortable way to take temperature

• Check for eating/drinking anything

hot/cold exercising or

smoking a cigarette

15 minutes prior

Rectal TemperatureRectal Temperature

• Taken in the rectum• Thermometer left in for 3-5 minutes• Most accurate• Insert 1-1 ½ inches, hold in place

and screen patient for privacy

Axillary/Groin TemperatureAxillary/Groin Temperature

• Taken under the armpit or in the groin fold

• Thermometer left in for 8-10 minutes

• Least Accurate

• Dry armpit/groin, place in center and hold in place

Aural/Tympanic TemperatureAural/Tympanic Temperature- taken in the ear

- measures the thermal infrared energy radiating from the blood vessels in the eardrum

- position and ear wax can affect readings

-left in until it beeps

-temperature is calculated into an equivalent by mode

Temperature By Body Site• Oral

– Normal temp 98.6– Normal Range 97.6-99.6

• Rectal– Normal temp 99.6– Normal Range 98.6-100.6

• Axillary/groin– Normal temp 97.6– Normal Range 96.6-98.6

• Tympanic– Normal temp 98.6

Factors that Increase Temperature

• Illness

• Infection

• Exercise

• Excitement

• High temps in the environment

Factors that Decrease Temperature

• Starvation/fasting

• Sleep

• Decreased muscle activity

• Mouth breathing

• Exposure to cold temperatures

• Certain diseases

Temperature ConditionsTemperature Conditions

• Hyperthermia– Increased body temp

– Body temp >104ºF

– >106 ºF will cause convulsions and death

• Fever- temp over 101 ºF R

- Due to illness or injury

Temperature ConditionsTemperature Conditions

• Hypothermia– Body temp below

96 ºF

- due to exposure to cold temperatures

- Depends on core temperature, age and length of exposure

Types of Clinical ThermometersTypes of Clinical Thermometers

• Clinical thermometers– Slender glass tube containing

mercury or colored fluid– Types

• Oral – blue tip, long slender bulb, marked oral

• Security – plain tip

• Rectal – red tip, short stubby bulb, marked rectal

Mercury ThermometersMercury Thermometers• Not used now

• Colored column of red alcohol

• Toxic to the body and environment

• Can be absorbed through the skin and inhaled as a vapor through the lungs

• Heavy metal that accumulates in the brain and causes mental retardation

Clean up Broken Mercury Thermometer

• Use appropriate PPE’s• Do not touch mercury• Seal in a glass

container• Dispose according to

regulations

Types of ThermometersTypes of Thermometers

• Electronic– Can be used for oral,

rectal, or axillary

– Blue probe for oral

– Red probe for rectal

– Disposable probe covers prevent cross-contamination

• Tympanic

- used to record temperature in the ear

- Records temperature in 1-3 seconds

Positioning the Patients Ear for Tympanic temperature

• Infants under 1 year– Pull ear pinna straight back

• Infants over 1 year and adults– Pull ear pinna straight back and

down

• Positioning the pinna correctly straightens the auditory canal so the probe will point directly at the tympanic membrane– Pull ear pinna straight back and

down

Reading ThermometersReading Thermometers

• Digital thermometers

-until you hear the beep

•Tympanic thermometers

- hold in place for 2-3 seconds, remove and read

Reading a Glass ThermometerReading a Glass Thermometer• Hold thermometer at eye

level• Find the column of

mercury/red liquid• Each long hash mark

represents one degree• Each short hash mark

represents 2/10th of a degree

• Exception: long line at 986

ºF represent normal body temperature

Charting a TemperatureCharting a Temperature• Use a superscript to record 10th’s• 102.2 should be written as 102.2

• This avoids errors• Use a TPR Chart• Mark temp under correct date and time• Indicate method of taking temperature

- R - rectal- Ax – axillary- T - tympanic

• No abbreviation indicates an oral temp

Clean A Clinical ThermometerClean A Clinical Thermometer

• Use warm water to clean and rinse

• Soak in a disinfecting solution such as alcohol for 20 minutes