Vital Signs Overview vital signs Respiration Pulse and

Vital Signs

Overview • • • vital signs Respiration Pulse and blood pressure Pulse Sites Skin signs Pupils

Introduction • Vital signs provide information about physical condition and health • Monitoring vital signs allows identification of acute changes • Acute—sudden • Chronic—long-term

Vital Signs • measurement of patient’s condition • One direct method for being able to tell what is going on inside of someone's cardiovascular and respiratory system

Figure 12. 8 A. Constricted pupils B. Dilated pupils C. Unequal pupils (anisocoria)

Pupils – Light: pupil constricts – Light removal: pupil dilates – PERRL: pupils equal, round, and reactive to light – Brain and eye injuries alter normal reaction

Skin Signs • Skin color – Sign of respiratory and circulatory system functioning • Skin temperature and moisture – Feel forehead or abdomen • Capillary refill – Time for blood to return after skin is compressed (usually done on the fingernail)

Figure 12. 4 Note the pallor, a sign of shock

Pulse • Measures rate, strength, regularity of blood volume pumped by the heart

Pulse (cont’d. ) • Pulse rate – Health Care workers must know normal heart rate ranges • Pulse quality – Strong pulse: full and strong – Bounding pulse: abnormally strong – Weak pulse: difficult to find and feel – Thready pulse: weak and rapid (usually seen dehydrated or shock)

Normal Pulse • *Adult 60 -100 • Child 80 -120 • Newborn 120 -160

Pulse Terms • Tachycardia- is a faster than normal heart rate at rest. Above 100 • Bradycardia- is a slower than normal heart rate. Below 60

Pulse Sites

Respiration **** • Respiratory quality – Observe: • • Depth Regularity Unusual noise Effort

Respiration • Respiratory rate – health care workers must know normal values! – Count number of breaths (inspiration and exhalation) – 30 seconds X 2=

Normal Respirations • 12 -20 per min

Respiration • Classic signs of labored breathing: -Gurgling – Wheezing – Grunting

Respiration – Patients who have difficulty breathing may appear uncomfortable – Patients may show signs of increased effort or difficulty (Labored)

Pulse Oximetry • Quantifies effectiveness of breathing • Infrared light estimates percent of blood oxygenated in capillaries – 90% to 100%: normal – Below 90%: inadequate – AKA- O 2 sat (oxygen saturation in the blood)

Blood Pressure • Measure of pressure of blood against artery walls for each contraction • Sphygmomanometer: measures blood pressure • Systolic pressure: contraction • Diastolic pressure: relaxation

Adult Normal Blood Pressure Ranges • Systolic: 90 -120 (top #) First sound heard ___________ • Diastolic: 60 -80 (Bottom #) Last sound heard

Where does it go?

Cyanosis • Blueish grey coloring of the skin • Caused by lack of oxygen or perfusion

Arms—does it matter? • Which one to use?

Conclusion • Health care workers must gather baseline information on every patient! • Familiarity with normal values is important! – Helps identify abnormal vital signs • Ongoing assessment helps Health care workers adjust treatments and improve response and condition