Vital Signs of Life Vital Signs VS Learning

Vital Signs of Life

Vital Signs (VS) ü Learning Objectives: Overview of Vital Signs ü 5 main VS ü Definition of Pulse ü How to obtain & accurately measure each pulse ü Identify sites for assessing pulse ü Practice accurate measuring of pulse and recording results ü Medical Terminology

Vital Signs Assignments: ü Discussion ü Articles ü Reading Textbook ü Note taking ü Handouts ü Pulse Points ü Graphic Chart ü Review

Vital Signs (VS) Discussion § How many of you have been to the doctor? § What is the first thing they do when you are taken back to the exam room? § Why is it important to obtain all patient’s VS? § How often should we take a patient’s VS? § What can VS tell us about our patients? § Is it important to know what a patient’s normal set of VS is? Why? § What do we do when VS are abnormal or out of normal range?

Vital Signs • Vitals = Life • Defintion: Important information about the condition of a patient’s body • Detect Changes in normal body function • May signal life-threatening condition • Provide responses to treatment • Usually taken at rest with person sitting or lying down

Types of Vitals • Five Main Vital Signs: – – – Temperature (T) Pulse(P) = heart rate Respirations(R) Blood Pressure(BP) Pain Score • Documented as: • TPR, BP and Pain Score

Vitals are Measured • Upon admission • When given a drug that can affect a person’s • As often as required by respiratory or the person’s condition circulatory system • Before and after surgery • When patient complains • After a fall or accident of pain, dizziness, shortness of breath (SOB) or chest pain

Vital Facts about Assessing Vitals • Any extreme variations must be reported immediately • Extreme abnormal high or low rates must be reported immediately • If unable to obtain report immediately • Certain factors will change readings of vitals especially pulse, respirations and BP. • Increased rate can be affected by – Exercise – Stimulate drugs – Excitement – Fever – Shock – Anxiety

• Decreased rates can be affected by: – Sleep – Depressant drugs – Heart Disease – Coma – Physical Training

PULSE

READ IN DIVERSIFIED TEXTBOOK PAGES 431 -433 15: 3

Pulse (P) • Definition: pressure of the blood felt against the wall of an artery as the heart beats • Pulse Characteristics: – Rate = # of beats per minute – Rhythm = regularity / irregularity – Volume - = strength – described as strong, weak or bounding

Pulse (P) • Obtained: – by palpation (to feel) of an artery and count the number of beats (lubb dubb is one). If regular can count 15 sec. X 4 or 30 sec. X 2. If irregular count full 60 seconds – or auscultation (to hear) of an artery Normal: -rate = varies by age, sex and body size - rhythm = regular - volume = strong, not bounding

Pulse (P) Terminology ØBradycardia – less than 60 bpm ØTachycardia – greater than 100 bpm ØArrythmia – irregular heart beat -

Pulse Points • Temporal – side of the forehead • Carotid – neck (used during child/adult CPR) • Brachial – inner aspects of forearm at the antecubital (crease of the elbow). Used for BP and infant CPR • Apical – below left breast. Most accurate pulse point. Use stethoscope and count for a full minute. • Radial – at the inner aspects of the wrist, above thumb (thumb-side). Most common site to assess pulse. • Femoral – at the groin (inner side) Used for assessment and procedures • Popliteal – behind the knee. Used for assessment • Dorsalis pedis – top of the arch of the foot (between Big Toe and 2 nd toe)

Pulse Normal Ranges Age • • Infant Child 1 -7 years old Child 7 -12 12 years and older • • Pulse Per Minute 100 -160 80 -110 70 -90 60 -90

Charting Vital Signs • See graphing handout

Temperature

Temperature (T) • Definition: the measurement of the balance between heat loss and heat produced by the body • Obtained: – Oral – mouth – 98. 6 – Rectal – rectum - 99. 6 – tympanic/aural – 98. 6 – axillary – armpit or groin - 97. 6 – Temporal – forehead scan -99. 6

Temperature (T) • Measured: Degrees Fahrenheit / Celsius • Normal Body Temp – 98. 6 F / 37 • Temp affected by: – Body processes – Time of day (lower in morning; higher in afternoon after muscular activity) – Where temp obtained

Inhale & Exhale RESPIRATIONS

Respirations(R) • Definition: reflection of breathing rate of patient • Normal RR = 12 -18 or 12 -20 • Obtained: – look, listen, feel • Measured by : – Rate = # of breaths per minute – Rhythm = regular / irregular – Character = labored, non-labored, shallow,

Respiratory Terminology q Dyspnea-difficult or labored breathing q Apnea- absence of breathing q Tachypnea- fast breathing q Bradypnea- slow breathing q Orthopnea-difficulty breathing when position changes q Cheyne-Stokes-dyspnea with periods of apnea q Rales- bubbling breath sounds fluid in lungs q Wheezing- high-pitched whistling during expiration q. Cyanosis-blue

Blood Pressure • Definition – Measurement of the pressure that the blood exerts on the walls of the arteries during the various stages of heart activities. Systolic pressure - occurs in the walls of the arteries when the left ventricle of the heart is contracting. Top number of the blood pressure. Diastolic pressure – is the constant pressure in the walls of the arteries when the left ventricle is relaxing. Bottom number of the blood pressure. Normal Systolic = 90 -120 Normal Diastolic = 60 -90 120/90 example of writing a BP Hypertension- High BP (systolic > 140 or diastolic >90) Hypotension – Low BP Sphygmomanometer- instrument used to measure blood pressure in millimeters of mercury. Each line is gauged by 2 mm. Hg

-algia PAIN

Pain • 5 th VS • Is a subjective symptom • Measured: – By severity on a scale of 0 – 10 – According to location – By description – sharp, stabbing, dull, etc. – By occurrence: constant vs. intermittent • Obtained: – From patient via verbal or non-verbal communication

Review • Abbreviations: – VS – BP –R – TPR – Sx –F –C – bpm

Review 1. Name the 5 VS 2. What is the most common site for taking a pulse? 3. What is the heart rate less than 60 bpm called? 4. Give one reason that an apical pulse should be taken. 5. What is an irregular heart rate called? 6. Why is it important to obtain a person’s VS? 7. Give three instances when vitals should be obtained.