3 01 Vital Signs Vital Signs Provide information

3. 01 Vital Signs

Vital Signs • Provide information about body function • Include: – temperature – pulse – respiration – blood pressure • Changes may be the first sign of disease • Accuracy is imperative! 3. 01 Understand Diagnostic and Therapeutic Services 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 3. 01 Understand Diagnostic and Therapeutic Services 3

Vital Signs Temperature Normal ranges – 97º - 100º F – 36. 1º - 37. 8º C 3. 01 Understand Diagnostic and Therapeutic Services 4

Vital Signs REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3. 01 Understand Diagnostic and Therapeutic Services 5

Vital Signs Temperature Hypothermia • Temperature below 95º F • Death can occur if below 93º F 3. 01 Understand Diagnostic and Therapeutic Services 6

Vital Signs Temperature Hypothermia Temperature decreases with: – – – environment exposure to cold inactivity sleep starvation Symptoms: – shivering – cold skin – confusion 3. 01 Understand Diagnostic and Therapeutic Services 7

Vital Signs Temperature Hyperthermia • Temperature 100 -104º F • Temperature above 104º F is life-threatening • Prolonged hyperthermia may cause brain injury. 3. 01 Understand Diagnostic and Therapeutic Services 8

Vital Signs Temperature Hyperthermia Temperature increases with: – – environment exercise illness, infection, injury stress Symptoms: – – hot, dry, red skin nausea/vomiting headache low blood pressure 3. 01 Understand Diagnostic and Therapeutic Services 9

Vital Signs Temperature • Pyrexia • Febrile • Afebrile- 3. 01 Understand Diagnostic and Therapeutic Services 10

Vital Signs Temperature Thermometers Clinical Non-mercury glass Aural Electronic 3. 01 Understand Diagnostic and Therapeutic Services 11

Vital Signs Temperature Sites to measure temperature: • Aural – auditory canal • Axillary – armpit • Oral – mouth • Rectal – rectum 3. 01 Understand Diagnostic and Therapeutic Services 12

Vital Signs Temperature To record temperature: – Oral 98. 6º (O) – Rectal 99. 6º (R) – Axillary 97. 6º (ax) – Aural 98. 6º (T) 3. 01 Understand Diagnostic and Therapeutic Services 13

Vital Signs Temperature • When do you use? 3. 01 Understand Diagnostic and Therapeutic Services 14

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 3. 01 Understand Diagnostic and Therapeutic Services 15

Vital Signs Oral Temperature Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3. 01 Understand Diagnostic and Therapeutic Services 16

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 3. 01 Understand Diagnostic and Therapeutic Services 17

Vital Signs Aural Temperature Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3. 01 Understand Diagnostic and Therapeutic Services 18

Vital Signs Pulse: Pressure of blood on artery walls as the heart beats and relaxes 3. 01 Understand Diagnostic and Therapeutic Services 19

Vital Signs Pulse Normal Range 60 -100 bpm Normal rates • 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 3. 01 Understand Diagnostic and Therapeutic Services 20

Vital Signs REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3. 01 Understand Diagnostic and Therapeutic Services 21

Vital Signs Pulse • • • Bradycardia: pulse rate <60 bpm Tachycardia: pulse rate >100 bpm Volume: strength of the pulse Rhythm: regular or irregular Arrhythmia: irregular heart rhythm 3. 01 Understand Diagnostic and Therapeutic Services 22

Vital Signs Pulse • Pulse can be increased by: – exercise – stimulant drugs – excitement – fever – shock – nervousness 3. 01 Understand Diagnostic and Therapeutic Services 23

Vital Signs Pulse • Pulse can be decreased by: – sleep – depressant drugs – heart disease – coma 3. 01 Understand Diagnostic and Therapeutic Services 24

Vital Signs Pulse • Pulse Sites: Temporal – side of the forehead Carotid – side of the neck Brachial – inner elbow Radial – above thumb at radius Femoral – upper thigh Popliteal – behind the knee Dorsalis pedis – top of the arch of the foot 3. 01 Understand Diagnostic and Therapeutic Services 25

Vital Signs Pulse When would you use these pulse sites? Temporal Carotid Brachial Radial Femoral Popliteal Dorsalis pedis 3. 01 Understand Diagnostic and Therapeutic Services 26

Vital Signs Radial Pulse Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3. 01 Understand Diagnostic and Therapeutic Services 27

Vital Signs Apical Pulse • Pulse count taken with the stethoscope over the heart. • Use if the patient has: – Irregular heartbeat – Arteriosclerosis – Weak or rapid radial pulse – Infants and children 3. 01 Understand Diagnostic and Therapeutic Services 28

Vital Signs Apical Pulse Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3. 01 Understand Diagnostic and Therapeutic Services 29

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 3. 01 Understand Diagnostic and Therapeutic Services 30

Vital Signs REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3. 01 Understand Diagnostic and Therapeutic Services 31

Vital Signs Respiration • Bradypnea- slow respiratory rate, <10 per minute • Tachypnea- rapid, shallow respiration, >25 per minute Evaluate for rhythm and character • Rhythm – regular or irregular • Character – depth, ease of breaths 3. 01 Understand Diagnostic and Therapeutic Services 32

Vital Signs Respiration • Abnormal respiratory patterns üApnea – periods of absent breathing üDyspnea – difficult breathing üCheyne-stokes – periods of apnea and dyspnea üOrthopnea- severe dyspnea; requires breathing sitting or standing 3. 01 Understand Diagnostic and Therapeutic Services 33

Vital Signs Respiration • Other respiratory abnormalities üWheezing – difficult breathing with a high pitch whistling üRales – bubbling or noisy respirations caused by fluid or mucous in the air passages üCyanosis – bluish discoloration 3. 01 Understand Diagnostic and Therapeutic Services 34

Vital Signs Respirations Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3. 01 Understand Diagnostic and Therapeutic Services 35

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 3. 01 Understand Diagnostic and Therapeutic Services 36

Vital Signs REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3. 01 Understand Diagnostic and Therapeutic Services 37

Vital Signs Blood pressure • Hypertension- high blood pressure • Hypotension- low blood pressure 3. 01 Understand Diagnostic and Therapeutic Services 38

Vital Signs Blood 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 3. 01 Understand Diagnostic and Therapeutic Services 39

Vital Signs Blood Pressure Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3. 01 Understand Diagnostic and Therapeutic Services 40

Vital Signs Combined Vital Signs TPR BP Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3. 01 Understand Diagnostic and Therapeutic Services 41

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 3. 01 Understand Diagnostic and Therapeutic Services 42

Diagnostic Skills: Daily Weights • Daily weights are used to monitor patients with chronic disease processes: – – Hormone disorders Renal disorders Heart disease Cancer 3. 01 Understand Diagnostic and Therapeutic Services 43

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. 3. 01 Understand Diagnostic and Therapeutic Services 44

Diagnostic Skills: Daily Weights OBSERVE SAFETY PRECAUTONS! Prevent injury from falls and the protruding height lever. 3. 01 Understand Diagnostic and Therapeutic Services 45

Diagnostic Skills Measuring Height and Weight Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3. 01 Understand Diagnostic and Therapeutic Services 46

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 3. 01 Understand Diagnostic and Therapeutic Services 47

Diagnostic Skills: Measure 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 3. 01 Understand Diagnostic and Therapeutic Services 48

Diagnostic Skills Measure Visual Acuity Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3. 01 Understand Diagnostic and Therapeutic Services 49