Vital Signs Vital Signs Provide information about body

Vital Signs

Vital Signs • Provide information about body function • Data is used to treat illness and diagnose disease • Include: – temperature – pulse – respiration – blood pressure 3. 01 Understand Diagnostic and Therapeutic Services 2

• Changes may be the first sign of disease or a change in patient health status. • Accuracy is imperative! 3. 01 Understand Diagnostic and Therapeutic Services 3

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 4

Vital Signs Temperature Normal ranges – 97º - 100º F – 36. 1º - 37. 8º C 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. • Sx – headache, confusion 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 Thermometers Clinical Non-mercury glass Aural – good with children Electronic 3. 01 Understand Diagnostic and Therapeutic Services 10

Vital Signs Temperature Sites to measure temperature: • Aural – auditory canal • Axillary – armpit • Oral – mouth • Rectal – rectum 3. 01 Understand Diagnostic and Therapeutic Services 11

Vital Signs Temperature To record temperature: – Oral 98. 6º (O) – under tongue by jaw line – Rectal 99. 6º (R) – lay pt on side – Axillary 97. 6º (ax) – Aural 98. 6º (T) 3. 01 Understand Diagnostic and Therapeutic Services 12

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 13

Vital Signs REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY to supervisor Combined VS (TPRBP) can indicate a life threatening condition or a change in condition 3. 01 Understand Diagnostic and Therapeutic Services 14

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 15

Vital Signs Pulse Pressure of blood on artery walls as the heart beats and Relaxes (contraction and relaxation) 3. 01 Understand Diagnostic and Therapeutic Services 16

• 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 (good for checking lower limb circulation) 3. 01 Understand Diagnostic and Therapeutic Services 17

Vital Signs Pulse Normal rate 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 Rhythm regular or irregular Volume strength of the pulse 3. 01 Understand Diagnostic and Therapeutic Services 18

Vital Signs Pulse • Pulse can be increased by: – exercise – stimulant drugs – excitement – fever – shock – nervousness 3. 01 Understand Diagnostic and Therapeutic Services 19

Vital Signs Pulse • Pulse can be decreased by: – sleep – depressant drugs – heart disease – coma 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 Apical Pulse • Pulse count taken with the stethoscope. • Use if the patient has: – Irregular heartbeat – Arteriosclerosis – Weak or rapid radial pulse – Infants and children 3. 01 Understand Diagnostic and Therapeutic Services 22

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 23

• Evaluate for rhythm and character • Rhythm – regular or irregular (i. e. fast, slow) • Character – depth, ease of breaths • Check while appearing to count pulse 3. 01 Understand Diagnostic and Therapeutic Services 24

Vital Signs Respiration • Abnormal respiratory patterns üApnea – periods of absent breathing üCheyne-stokes – periods of apnea and dyspnea üDyspnea – difficult breathing 3. 01 Understand Diagnostic and Therapeutic Services 25

Vital Signs REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3. 01 Understand Diagnostic and Therapeutic Services 26

Vital Signs Blood pressure Pressure of blood on the arterial walls Recorded as a fraction: 120/80 3. 01 Understand Diagnostic and Therapeutic Services 27

• 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 28

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 29

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 30

Diagnostic Skills: Daily Weights • Daily weights are used to monitor patients w chronic disease processes: – – Hormone disorders Renal disorders Heart disease Cancer 3. 01 Understand Diagnostic and Therapeutic Services 31

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 we the patient. 3. 01 Understand Diagnostic and Therapeutic Services 32

Diagnostic Skills: Daily Weights OBSERVE ALL SAFETY PRECAUTONS! Prevent injury from falls and the protruding height lever. 3. 01 Understand Diagnostic and Therapeutic Services 33

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 34

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 35