VITAL SIGNS

BLOOD PRESSURE PULSE TEMPERATURE RESPIRATIONS

WHY MEASURE VITAL SIGNS?

REFLECTIVE OF THE HEALTH STATUS OF AN INDIVIDUAL

EASILY OBTAINABLE

BLOOD PRESSURE

1 in 3 Americans have high blood pressure

31.6% of persons that have high blood pressure are unaware that they have it

High blood pressure(hypertension) significantly increases the risk for heart disease and stroke

What is Blood Pressure?

Blood pressure is the force in the arteries when the heart beats(systolic), and when the heart is at rest(diastolic)

Blood pressure is measured in millimeters of mercury(mmHg)

HEART FUNCTION IN BP

NORMAL BLOOD PRESSURE

HYPERTENSION

PERSISTENTLY ELEVATED BLOOD PRESSURE – CURRENT

STANDARDS > 140/90

METHODS FOR OBTAINING A BLOOD PRESSURE

DIRECT – Direct intra-arterial measurement with a catheter

INDIRECT – Compression of the brachial artery using a sphygmomanometer(blood pressure cuff)

INDIRECT METHOD OF OBTAINING A BLOOD

PRESSURE

Introduced in 1896 by Riva Rocci The method involves occluding the

brachial artery and listening for audible sounds

These sounds are called “Korotkoff” sounds named after the Russian physician that described them

Systolic – Pressure at which the sounds first appear

Diastolic – Pressure at which the sounds are no longer audible

EQUIPMENT FOR OBTAINING A BLOOD

PRESSURE

DEVICES FOR OBTAINING A BLOOD PRESSURE

STETHOSCOPE

PLACEMENT OF EAR PIECES

METHOD FOR TAKING A BP

SEAT THE PATIENT IN A COMFORTABLE POSITION

SELECT THE APPROPRIATE SIZE CUFF

Adult – The bladder should encircle 80% of the arm

Children – The bladder should encircle 100% of the arm

Palpate and locate the brachial artery

Position the cuff so the bladder is over the artery and the cuff is 1-2cm above the

antecubital fossa

Position the cuff so you can see the manometer

Inflate the BP cuff Inflate to 70 mm

Hg and increase by 10 mm until the radial pulse disappears

Note this level and inflate the cuff 20 -30 mm Hg more to overcome an ausculatory gap

Recording the BP Place the

stethoscope over the brachial artery just above the antecubital fossa

Inflate the cuff slowly, then release the valve

Record the systolic and diastolic readings

First sounds heard will be the systolic

Continue deflating the cuff until the last sound is heard the diastolic

Measurement should be repeated after 30 seconds

The blood pressure is the average of the two readings

ERRORS IN TAKING BP

Cuff too big – BP too high Cuff over clothing – inaccurate

reading Stethoscope occluding ear –

distorted sound Stethoscope turned incorrectly –

no sound

PULSE Palpate the radial

artery Use the middle and

index fingers(NO thumb)

Count the pulses for 15, 30 seconds and X

Count the pulses for 1 minute

RESPIRATIONS Seat the patient in a quiet

comfortable environment Count the number of times the chest

rises and falls in 30 or 60 seconds Average number of respirations 12 –

20/minute Bradypnea – Slower that 12/minute Tachypnea - Persistent over

20/minute

TEMPERATURE

TEMPERATURE

ORAL

AXILLARY - LOWER

RECTAL - HIGHER

PRACTICE!!!!