Vital Signs Provide information about body function Data is used to treat illness and diagnose disease Include: –temperature –pulse –respiration –blood

Vital SignsVital Signs

Vital SignsVital Signs• Provide information about body

function • Data is used to treat illness and

diagnose disease• Include:

– temperature– pulse– respiration– blood pressure

3.01 Understand Diagnostic and Therapeutic Services

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• Changes may be the first sign of disease or a change in

patient health status.

• Accuracy is imperative!


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Vital SignsVital SignsTemperature


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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


Normal rangesNormal ranges

– 97º - 100º F – 36.1º - 37.8º C


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Hypothermia

•Temperature below 95º F

•Death can occur if below 93º F


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HypothermiaTemperature decreases with:

– environment– exposure to cold– inactivity– sleep– starvation

Symptoms:– shivering– cold skin– confusion


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Hyperthermia

•Temperature 100-104º F

•Temperature above 104º F is

•life-threatening

•Prolonged hyperthermia may cause brain

injury.

•Sx – headache, confusion


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Hyperthermia

Temperature increases with: – environment– exercise– illness, infection, injury– stress

Symptoms:– hot, dry, red skin– nausea/vomiting– headache– low blood pressure


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Clinical

Non-mercury glass

ElectronicAural – good with children

Thermometers



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Sites to measure temperature:

•Aural – auditory canal

•Axillary – armpit

•Oral – mouth

•Rectal – rectum



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To record temperature:

– Oral 98.6º (O) – under tongue by

jaw line

– Rectal 99.6º (R) – lay pt on side

– Axillary 97.6º (ax)

– Aural 98.6º (T)

Vital SignsVital SignsTemperature Measurement

Oral 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 REPORT

ABNORMAL RESULTS ABNORMAL RESULTS

OF ANY VITAL SIGN OF ANY VITAL SIGN

IMMEDIATELY IMMEDIATELY to supervisorto supervisorCombined VS (TPRBP) can indicate a life Combined VS (TPRBP) can indicate a life

threatening condition or a change in threatening condition or a change in conditioncondition

Vital SignsVital SignsTemperature Measurement

• AuralAural

• 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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Vital SignsVital SignsPulse

Pressure of blood on artery walls

as the heart beats and

Relaxes (contraction and relaxation)


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• 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 (good for checking lower limb circulation)


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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



• Pulse can be increased by:– exercise– stimulant drugs– excitement– fever– shock– nervousness


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• Pulse can be decreased by:

– sleep

– depressant drugs

– heart disease

– coma


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REPORT REPORT



IMMEDIATELYIMMEDIATELY


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Vital SignsVital SignsApical 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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Vital SignsVital SignsRespiration


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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 (i.e. fast, slow)

• Character – depth, ease of breaths• Check while appearing to count

pulse


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Vital SignsVital SignsRespiration

• Abnormal respiratory patternsApnea – periods of absent breathing

Cheyne-stokes – periods of apnea and dyspnea

Dyspnea – difficult breathing


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REPORT REPORT



IMMEDIATELYIMMEDIATELY


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Vital SignsVital SignsBlood pressure


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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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Vital SignsVital SignsBlood pressure

Factors that elevate blood pressure:– anxiety

– eating– exercise– excitement– stimulant drugs

Factors that lower blood pressure:– depressant drugs– excessive loss of blood– rest– shock


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Diagnostic Skills:Diagnostic Skills:Height and WeightHeight 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


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Diagnostic Skills:Diagnostic Skills:Daily WeightsDaily Weights

• Daily weights are used to monitor patients with chronic disease processes:– Hormone disorders– Renal disorders– Heart disease– Cancer


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• 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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OBSERVE ALL SAFETY OBSERVE ALL SAFETY

PRECAUTONS!PRECAUTONS!

Prevent injury from falls and the

protruding height lever.


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Diagnostic Skills:Diagnostic Skills:Measure Measure Visual AcuityVisual 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:Diagnostic Skills:Measure Visual AcuityMeasure Visual Acuity

• 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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Documents

Vital Signs Provide information about body function Data is used to treat illness and diagnose disease Include: –temperature –pulse –respiration –blood