Assessment of Vital SignsAssessment of Vital Signs

Pulse RatePulse Rate Blood PressureBlood Pressure Respiratory RateRespiratory Rate Temperature * *Temperature * *

Prof. Neriza G. MamasabulodProf. Neriza G. Mamasabulod

PulsePulseThe wave felt by the expansion & The wave felt by the expansion &

distention of the arterial walls as blood is distention of the arterial walls as blood is forced into the aorta & then into the forced into the aorta & then into the smaller arteries each the heart beats.smaller arteries each the heart beats.

Normal- if compressed artery is full to Normal- if compressed artery is full to touch & pulsations are strongtouch & pulsations are strong

Internal Anatomy of the HeartInternal Anatomy of the Heart

Pressure Waves or Pulse WavesPressure Waves or Pulse WavesThe heart pushes blood from the left The heart pushes blood from the left

ventricle into the aorta w/ great force. The ventricle into the aorta w/ great force. The wall of the aorta & its branches stretches a wall of the aorta & its branches stretches a little w/ the sudden burst of blood during little w/ the sudden burst of blood during each ventricular ejection. Burst after burst each ventricular ejection. Burst after burst after burst of blood ejected from the heart after burst of blood ejected from the heart produces bulge after bulge in the arterial produces bulge after bulge in the arterial wall.wall.

The rhythm & strength of the pulse in The rhythm & strength of the pulse in distal arteries can indicate how efficiently distal arteries can indicate how efficiently blood is being pumped into the circulation.blood is being pumped into the circulation.

Location of Major Points at w/c Location of Major Points at w/c Pulse can be MonitoredPulse can be Monitored

Different Pulse SitesDifferent Pulse Sites

Cont…Cont…

Assessing an Apical PulseAssessing an Apical Pulse

Factors Affecting PulseFactors Affecting Pulse1.1. Activity or exercise- increased activity means increased need Activity or exercise- increased activity means increased need

for O2 by the muscles w/c results to an increased heart rate for O2 by the muscles w/c results to an increased heart rate in an effort to deliver O2 through the blood stream.in an effort to deliver O2 through the blood stream.

2.2. Emotions- fear, worry, perception of pain stimulates the Emotions- fear, worry, perception of pain stimulates the Sympa. NS hence contractility of the heart will also increase Sympa. NS hence contractility of the heart will also increase & pulse too will increase.& pulse too will increase.

3.3. Heat or Temperature- when body temp. is elevated, PR Heat or Temperature- when body temp. is elevated, PR tends to rise about 10 bpm for every degree of temp. tends to rise about 10 bpm for every degree of temp. elevation.elevation.

4.4. Drugs- stimulants increase PR while depressants decreases Drugs- stimulants increase PR while depressants decreases PR.PR.

5.5. Time of the Day- pulse rate is lowest in the morning on Time of the Day- pulse rate is lowest in the morning on awakening & increases later in the day.awakening & increases later in the day.

6.6. Blood volume & components- excessive blood loss cause Blood volume & components- excessive blood loss cause PR to increase in an effort to keep cells supplied w/ nutrients PR to increase in an effort to keep cells supplied w/ nutrients & O2.& O2.

Arterial Blood PressureArterial Blood Pressure Is the measure of the pressure exerted by Is the measure of the pressure exerted by

the blood as it flows through the arteries. the blood as it flows through the arteries. The force produced by the volume of The force produced by the volume of

blood pressing on the resisting walls of the blood pressing on the resisting walls of the arteries.arteries.

2 Blood Pressure Measure2 Blood Pressure Measure1. 1. Systolic-Systolic- is the pressure of the blood as a is the pressure of the blood as a

result of contraction of the ventricles; it is a result of contraction of the ventricles; it is a pressure of the height of the blood wave.pressure of the height of the blood wave.

- The working period of the heartThe working period of the heart- The heart contracts & pumps blood out The heart contracts & pumps blood out

into the circulationinto the circulation

2. 2. Diastolic-Diastolic- is the pressure when the is the pressure when the ventricles are at restventricles are at rest

- The resting period of the heartThe resting period of the heart- The time when the heart is filled with The time when the heart is filled with

blood, w/c will be pumped out during the blood, w/c will be pumped out during the next systolenext systole

*Note: *Note: The difference between the systolic & The difference between the systolic & diastolic pressure is known as the PULSE diastolic pressure is known as the PULSE PRESSURE.PRESSURE.

Factors Affecting BPFactors Affecting BP1.1. Age- BP rise w/ age; arteries lose their elasticity & become more rigid Age- BP rise w/ age; arteries lose their elasticity & become more rigid

(arteriosclerosis) resulting even greater resistance to the heart’s effort to (arteriosclerosis) resulting even greater resistance to the heart’s effort to fill the arteries w/ blood or arteries may be filled w/ fat deposits fill the arteries w/ blood or arteries may be filled w/ fat deposits (atherosclerosis) that interferes w/ the amount of blood that can be (atherosclerosis) that interferes w/ the amount of blood that can be contained w/in the arteries. Thus, BP is increased.contained w/in the arteries. Thus, BP is increased.

2.2. Time of the Day- BP tends to be lowest in the morning than later during Time of the Day- BP tends to be lowest in the morning than later during the daythe day

3.3. Sex- women have lower BP than menSex- women have lower BP than men4.4. Exercise & activity- increases during period of activities or exercise & Exercise & activity- increases during period of activities or exercise &

through regular exercise helps maintain BP w/in normal limitsthrough regular exercise helps maintain BP w/in normal limits5.5. Emotions & pain- strong emotion & pain tends to make BP riseEmotions & pain- strong emotion & pain tends to make BP rise6.6. Other Factors- a person has lower BP when lying down than when stting Other Factors- a person has lower BP when lying down than when stting

or standingor standing - BP rise when urinary bladder is full & when the - BP rise when urinary bladder is full & when the

legs are crossedlegs are crossed - BP rises when a person uses tobacco or drinks a - BP rises when a person uses tobacco or drinks a

caffeinated beverage caffeinated beverage

Arterial Blood PressureArterial Blood Pressure

Blood Pressure MeasurementBlood Pressure Measurement

Korotkoff Sounds-Korotkoff Sounds- sounds heard when sounds heard when obtaining blood pressureobtaining blood pressure

Korotkoff PhasesKorotkoff Phases

Blood Pressure in Major Blood Blood Pressure in Major Blood Vessel TypeVessel Type

Blood pressure fluctuationBlood pressure fluctuationbet. Systole & diastolebet. Systole & diastoleare damped in small are damped in small arteries & arterioles. Therearteries & arterioles. Thereare no large fluctuationsare no large fluctuationsin BP in capillaries & veins.in BP in capillaries & veins.

Thank you ! ! !Thank you ! ! !