Vital Signs n 1 2 3 4 Are

Vital Signs n 1. 2. 3. 4. Are measurements of the body's most basic functions: Body temperature (Temp) Pulse/heart rate (HR) Respiration rate (RR) Blood pressure (BP) 1

Assessing Body Temperature n The normal range of the body temperature is between 35. 9 c(96. 6 f)-37. 4 c(99. 3). 3

ﺗﻐییﺮﺍﺕ ﻣﺮﺑﻮﻁ ﺑﻪ ﺳﻦ ﺩﺭ ﻋﻼیﻢ ﺣیﺎﺗی Age Temp. Pulse rate Resp. rate Blood pressure New born 36. 8 C ° Axillary 80 -180 30 -80 73/55 1 -3 years 37. 7 C° rectal 80 -140 20 -40 90/55 6 -8 years 37 C ° oral 75 -120 15 -25 95/75 10 years 37 C ° oral 75 -110 15 -20 102/80 Teens 37 C ° oral 60 -100 15 -20 102/80 Adults 37 C ° oral 60 -100 15 -20 120/80 70 years 36 C ° oral 60 -100 15 -20 120/80 normally Be up to 160/95 4

Hypothermia n HYPOTHERMIA : it is a body temperature below the normal limit – 34 c°. 13

Sites for Assessing Temperature 1. 2. 3. 4. Orally (common way). (3 – 5 min) Axillary (safe way). (10 min) Rectal (accurate reading). (2 – 3 min) Tympanic membrane. 14

Average Normal Temperature for Healthy Adults C°/ F° Oral Rectal Axillary Centigrade 37. 0 C° 37. 5 C° 36. 5 C° Fahrenheit 98. 6 F° 99. 5 F° 96. 6 F° 15

When we cannot use oral thermometer? 1. 2. 3. 4. 5. 6. The child under 6 years. Unconscious patients. Psychiatric patients. Patient who cannot breath from his nose Mouth surgery or infection. Patient on oxygen mask. 16

When we cannot use rectal thermometer? 1. 2. 3. 4. With patients who have rectal surgery. With patients who have any rectal disorders. With patient who have cardiac disorders. Decrease in platelets. 17

Thermometers n n Electronic thermometer. Glass thermometer. Paper thermometer. Tympanic membrane thermometer. 18

Pulse Rate n n n The normal heart rate in adult is ( 60 – 100 beat/min. ) TACHYCARDIA : is a rapid pulse rate , greater than 100 beat /min. BRADYCARDIA : is a pulse rate below 60 beats / min. in adults. 20

Factors Contribute to Increase Pulse Rate n n n n Pain. Fever. Stress. Exercise. Bleeding. Decrease in blood pressure. Some medications as (adrenalin, aminophylline) 21

Factors May Slow The Pulse § § § Rest. Increasing age. People with thin body size. Medication as ( digitalis ). Thyroid gland disturbances. 22

PULSE SITES TEMPORAL PULSE § CAROTID PULSE § BRACHIAL PULSE § RADIAL PULSE § FEMORAL PULSE § POPLITEAL PULSE § POSTERIOR TIBIAL PULSE § DORSALIS PULSE Auscultation APICAL PULSE with stethoscope § § 23

PULSE SITES 24

Vital Signs: n n n Pulse (cont. ) Locate pulse by pressing lightly with index and middle finger pads at the pulse site Count the number of beats felt in 1 minute If regular – may count beats for 30 seconds and multiply by 2

Vital signs: Regular Pulse Rhythm Ø Count for 30 seconds, then multiply by 2 (a rate of 35 beats in 30 seconds equals a pulse rate of 70 beats/minute) Click for Sound Pulse (cont. ) Irregular Pulse Rhythm Ø Count for one full minute Ø May use stethoscope to listen for apical pulse and count for a full minute Click for Sound

NORMAL PULSE PER MINUTE AT VARIOUS AGE Age Range Average Newborn– 1 month 120 – 160 140 1 month - 12 months 80 – 140 12 months – 2 years 80 – 130 110 2 year - 6 year 75 – 120 100 6 year - 12 year 75 – 110 95 Adolescence to adult 60 - 100 80 27

Respiration n n Respiratory rate – indication of how well the body provides oxygen to the tissues Check by watching, listening, or feeling movement

Factors Affecting Respiration n n n n Pain. Anxiety. Exercise. Medications. Trauma. Infection. Respiratory and cardiovascular disease. Alteration in fluids, electrolytes, acid- base balances. 31

Assessing Respirations n n Inspection. Listening with stethoscope. Monitoring arterial blood gas results. Using a pulse oximeter. 32

Respiration n Irregularities – indication of possible disease n Hyperventilation – excessive rate and depth n Dyspnea – difficult or painful breathing n Tachypnea – rapid breathing n Hyperpnea – abnormally rapid or deep breathing

Vital Signs: n Respiration (cont. ) Other irregularities n Rales (noisy) n n n Cheyne-Stokes respirations n n n Constriction or blockage of bronchial passages Pneumonia, bronchitis, asthma, or other pulmonary disease Periods of increasing and decreasing depth of respiration between periods of apnea Strokes, head injuries, brain tumors, congestive heart failure Apnea – absence of breathing

Vital Signs: Respiration (cont. ) Normal Respiratory Rates (26 -40) (20 -30) (18 -24) (16 -24) NOTE: Ranges reflect breaths per minute (12 -24) (12 -20)

Patterns of Respiration Desperation Normal 12 – 20 breath / minute Tachypnea 24 b / min ﺳﻄﺤی Bradypnea 10 b / min ﻣﻨﻈﻢ Hyperventilation Increased rate and depth Hypoventilation Decreased rate and depth Irregular 36

Blood Pressure n n Blood pressure: is the force required by the heart to pump blood from the ventricles of the heart into the arteries. It is measured in systolic and diastolic pressure. 37

Vital Signs: Blood Pressure (cont. ) 120/80 Systolic Pressure Diastolic Pressure Ø Contraction of left ventricle Ø Top or first number Ø Heart at rest Ø Bottom or second number

Vital Signs: Blood Pressure (cont. ) Hypertension High blood pressure readings n Major contributor to heart attacks and strokes n n n Normal for some people Severely low blood pressure readings occur with: n n Shock Heart failure Severe burns Excessive bleeding Hypotension

Blood Pressure (Cont’d) n n Systolic : is known as the force to pump blood out of the heart. Diastolic: it is known as relaxation period of the heart pump (ventricles ) Blood pressure = systolic pressure / diastolic pressure. The normal BP is 120/ 80 mm. Hg. 40

Blood Pressure (Cont’d) n n Hypertension: it means high blood pressure. Factors increasing blood pressure : n Increasing age. n Obese person. n Emotions as anger, fear. n Tension. n Exercise. n Food intake. n Illness. n Medications. 41

Blood Pressure (Cont’d) n n Hypotension: it means low blood pressure Factors that reduce blood pressure : n severe blood loss ( bleeding ) n burns. n vomiting. n Diarrhea. n medications 42

Equipment for Assessing Blood Pressure n n n Stethoscope and sphygmomanometer. Doppler ultrasound. Electronic or digital devices. 43

The End 44