UNITVII VITAL SIGNS PRESENTED BY Mrs PRASHMA LEARNING

UNIT-VII VITAL SIGNS PRESENTED BY: Mrs. PRASHMA

LEARNING OBJECTIVES • Define vital signs • Explain guidelines to take vital signs • Define body temperature, core temperature • Explain physiology of body temperature • Explain mechanisms of heat production and loss • List out factors affecting body temperature

INTRODUCTION Vital signs include the measurement of temperature, respiratory rate, pulse, blood pressure. These numbers provide critical information (hence the name "vital") about a patient's state of health.

Definition Vital signs are a quick and efficient way of monitoring a patient’s condition or identifying problems and evaluating the patient’s response to intervention.

What are vital signs? • Body temperature “T” • Pulse or heart rate “HR” • Respiratory or breathing rate “RR” • Blood pressure “BP” Otherwise known as: TPR + BP = body temp, pulse, R. R+ BP

When to take vital signs • When the patient is admitted to a health care facility • In a hospital or care facility on a routine schedule according to the physician’s order. • Before and after a surgical procedure • Before and after an invasive diagnostic procedure • Before, during, and after the administration of medications that affect cardiovascular, respiratory and temperature control function • When the patient’s general physical condition changes(as with loss of consciousness or increased intensity of pain)

Before and after nursing interventions influencing a vital sign (e. g. , before a patient previously on bed rest ambulates or before a patient performs range-ofmotion exercises)

Body temperature Physiology • Temperature is the “hotness” or “coldness” of a substance. • The body temperature is the difference between the amount of heat produced by body processes and the amount of heat lost to the external environment. • Heat produced- heat lost= body temperature

Core Temperature • Is the body’s most inner temperature of the deep tissues. • Shell temperature or the surface temperature is temperature of the outer skin • The core temperature should be warmer than the shell or outer temperature

Core and surface temperature measurement sites Core Surface Rectum Tympanic membrane Esophagus Pulmonary artery Urinary bladder Skin Axillae Oral

Temperature Regulation center: Hypothalamus – is a structure within the brain that helps control various metabolic activities • The hypothalamus acts as a center for temperature regulation • The anterior hypothalamus controls heat loss • The posterior hypothalamus controls heat production

Heat production Heat loss • Basal metabolism • Muscular activity (shivering) • Thyroxine and epinephrine (stimulating effects on metabolic rate) • Temperature effect on cells • Radiation • Conduction/ convection • Evaporation Figure 24. 25

Heat production • Basal metabolism accounts for the heat produced by the body at absolute rest • Voluntary movements such as muscular activity during exercise require additional energy. The metabolic rate can increase up to 2000 times normal during exercise. Heat production can increase up to 50 times

• Shivering-is an involuntary body response to temperature differences in the body • Nonshivering thermogenesis- occurs primarily in neonates. Because neonates cannot shiver, a limited amount of vascular brown tissue, present at birth, is metabolized for heat production

Mechanisms of heat loss from the body • Radiation(60%) –is the transfer of heat from the surface of one object to the surface of another without another direct contact between the two. q. The nurse increases heat loss through radiation by removing clothing or blankets • Conduction(3%) – is the transfer of heat from one object to another with direct contact. When the warm skin touches a cooler object, heat is lost

q. Heat conducts through contact with solids, liquids and gases. q. The nurse increases conductive heat loss when applying an ice pack or bathing a patient with cold water. q. Applying several layers of clothing reduces conductive loss

• Convection(15%)- is the transfer of heat away by air movement q. An electric fan promotes heat loss through convection • Evaporation- is the transfer of heat energy when a liquid is changed to a gas

Age : • The infant is greatly influenced by the temperature of the environment and must be protected from extreme changes. • Older people are also particularly sensitive to extremes in the environmental temperature due to decreased thermoregulatory controls.

Exercise. • Hard work or strenuous exercise can increase body temperature to as high 38. 3 to 40 C when measured rectally. Stress. • Physical and emotional stress increase body temperature through hormonal and neural stimulation. These physiological changes increase metabolism, which increases heat production

Hormones. The women usually experience more hormone fluctuations than men. In women, progesterone secretion at the time of ovulation raises body temperature by about 0. 3 to 0. 6 C above basal temperature. Environment. Extremes in environmental temperatures can affect a person's temperature regulatory systems.

Circadian rhythm: body temperature changes 0. 5 to 1 C during a 24 -hr period. • The temperature is usually lowest between 1: 00 and 4: 00 am • During the day, body temperature rises steadily, until about 6: 00 pm and then declines to early morning levels

Today we discussed about meaning of vital signs and guidelines for taking vitals. In addition we discussed about types of temperature, physiology, regulation and factors affecting body temperature.

Vital signs are a group of the 4 most important signs that indicate the status of the body’s vital (life-sustaining) functions. These measurements are taken to help assess the general physical health of a person, give clues to possible diseases, and show progress toward recovery. The normal ranges for a person’s vital signs vary with age, weight, gender, and overall health.

MCQ’S 1. Transfer of heat from one object to another with direct contact is Radiation Conduction Convection Evaporation 2. Temperature regulation center in brain • Hypothalamus • Medulla oblongata • Brain stem • cerebrum