Vital Signs What do you already know about

Vital Signs

What do you already know about vital signs? • With a partner, write down as many facts as you know about vital signs.

Essential Question • What does temperature tell the nurse about a patient’s condition?

Vital Signs • Important indicators of health states of the body. • Provide information about the basic body conditions of a patient. • Four main vital signs: temperature, pulse, respiration, blood pressure • Pain is often referred to as the 5 th vital sign

Temperature (T) • Measurement of the balance between heat lost and heat produced by the body. • Lost : perspiration, respiration, excretion • Produced: metabolism of food, muscle and gland activity

Temperature (T) • Homeostasis ~ balance • Ability to maintain a constant internal environment in response to environmental changes • Body temperature too high or too low, homeostasis is affected.

Temperature (T) • Usually measured in Fahrenheit, but many places are converting to Celsius. • ˚C=(˚F - 32) X 0. 5556 • ˚F=(˚C X 1. 8) + 32

Convert the Following Temperatures • ˚C = (˚F - 32) X 0. 5556 • 100. 2˚F = ? ˚C • 99. 2˚F = ? ˚C

Convert the Following Temperatures • ˚C = (˚F - 32) X 0. 5556 • 100. 2˚F • (100. 2 - 32) X 0. 5556 • 68. 2 X 0. 5556 = 37. 9˚C • 99. 2˚F • (99. 2 - 32) X 0. 5556 • 67. 2 X 0. 5556 = 37. 3˚C

Convert the Following Temperatures • ˚F = (˚C X 1. 8) + 32 • 38. 8˚C = ? ˚F • 37. 6˚C = ? ˚F

Convert the Following Temperatures • ˚F = (˚C X 1. 8) + 32 • 38. 8˚C • (38. 8 X 1. 8) + 32 • 69. 84 + 32 = 101. 8˚F • 37. 6˚C • (37. 6 X 1. 8) + 32 • 67. 68 + 32 = 99. 7˚F

Temperature (T) • Normal range = 97˚ - 100˚ F • Average temperature = 98. 6˚ F / 37˚ C • Reasons for variations in range • Individual differences ~ some people run cooler or hotter • Time of day ~ higher in evening • Body site ~ different areas of the body run hotter or cooler

Temperature (T) • • • Febrile ~ running a fever (above 101˚F) Afebrile ~ without fever Oral temperature ~ taken by mouth Rectal ~ taken by rectum Axillary ~ taken by armpit Aural (tympanic)~ taken by ear

Temperature (T) • When using a clinical (glass) thermometer each line represents 0. 2 degrees. • Electronic and clinical thermometers have coverings to prevent crosscontamination.

Handout • Reading a glass thermometer

Temperature (T) • Causes of increased temperature • • • Illness Infection Exercise Excitement High temperatures in the environment

Temperature (T) • Causes that decrease temperature • • • Starvation or fasting Sleep Decreased muscle activity Mouth breathing Exposure to cold temperatures in the environment • Certain diseases (homonal/thyroid/addisons)

Temperature (T) • Hypothermia ~ below 95˚ F • Caused by prolonged exposure to cold • Death when temp below 93˚ F • Hyperthermia ~ above 104˚ F • Caused by prolonged exposure to hot temperatures, brain damage, or serious infection • Temperatures above 106˚F can lead to convulsions and death

• • Review Define the following terms: Afebrile ~ Febrile ~ Hypothermia ~ Hyperthermia ~ Homeostasis ~ What are the four vital signs? What is the normal range for temperature?

Pulse • The pressure of the blood pushing against the wall of an artery as the heart beats and rests. • IN OTHER WORDS…throbbing of the arteries that is caused by the contractions of the heart.

Pulse • More easily felt in arteries that lie close to the skin and can be pressed against a bone by the fingers. • • Temporal ~ side of head Carotid ~ neck Brachial ~ elbow Radial ~ wrist Femoral ~ upper thigh (groin area) Popliteal ~ behind knee Dorsalis pedis ~ top of foot • Can you locate these pulses on yourself?

Rate of a Pulse • Measured as the number of beats per minute. (BPM) • Pulse rates vary depending on age, sex, and body size. • As the cardiovascular system matures with age, the pulse rate decreases. • Women tend to have a faster pulse than men

Average Range of Pulse • • Adults: 60 -80 BPM Children over 7 yrs : 70 -100 BPM Children 1 yr-7 yrs : 80 - 110 BPM Infants : 100 -160 BPM

Pulse Rate Terms • Bradycardia ~ pulse rate below normal range • Causes: physically fit, medications, severe lack of oxygen • Tachycardia ~ pulse rate over normal range • Causes: physical/mental stress, pain, exercise, infection, lack of oxygen, low blood pressure

More Pulse Terms • Antecubital space ~ bend of the elbow • Where the brachial pulse is found • Palpate ~ feeling a pulse • Use you first two-three fingers • Auscultate ~ hearing a pulse • Use a stethoscope

With Your Table Partner • Using the radial pulse palpate your partner’s pulse and determine the rate.

Respiratory Rate • Respiration ~ process of taking in oxygen and expelling carbon dioxide from the lungs and respiratory tract. • Inhalation + exhalation = 1 breath • Rate = breaths per minute • Respirations must be counted in such a way that the patient is unaware of the procedure.

Respiratory Rate • Measure the rise and fall of the chest in adults. • Measure the rise and fall of the abdomen in young children. • Normal respiration rate • Adult = 12 -20 RR • Child = 16 -30 RR • Infant = 30 -50 RR

Abnormal Respirations • Apnea ~ absence of respirations (usually temporary) • Tachypnea ~ rapid, shallow respiratory rate (above 25 RR) • Bradypnea ~ slow respiratory rate (below 10 RR)

With Your Table Partner • Observe the rise and fall of your partners chest. Count the respirations for one minute and determine your partners respiration rate.

Lesson Essential Question • What does blood pressure tell us about a person’s health?

Think Pair-Share • Tell your partner one thing you know about blood pressure.

Blood Pressure (BP) • (BP) ~ Measurement of the pressure that the blood exerts on the walls of the arteries as blood pulsates through them • Blood Pressure reading is measured in millimeters (mm) of mercury (Hg) • Sphygmomanometer ~ instrument used to measure blood pressure.

Types of Blood Pressure Measurements • Systolic ~ pressure that occurs when the heart is contracting. • Diastolic ~ pressure that is present when the heart is at rest. • BP is recorded as a fraction. • Systolic reading is the top number • Diastolic reading is the bottom number

Blood Pressure Measurements • Normal Range: • Systolic: 100 -120 mm Hg • Diastolic: 60 -80 mm Hg • Hypertension ~ high blood pressure • Systolic: >140 mm Hg • Diastolic: > 90 mm Hg • Hypotension ~ low blood pressure • Systolic: < 90 mm Hg • Diastolic: < 60 mm Hg

Blood Pressure Measurements • Prehypertension ~ warning that high blood pressure will develop unless steps are taken to prevent it. • Systolic: 121 -139 mm Hg • Diastolic: 81 -89 mm Hg

Write the following blood pressure readings on a sheet of paper. Label each as normal, pre-hypertension, hypertension or hypotension. 9. 88/68 mm Hg 1. 134/80 mm Hg 10. 166/ 78 mm Hg 2. 110/91 mm Hg 3. 4. 5. 6. 7. 8. 146/70 mm Hg 100/70 mm Hg 180/90 mm Hg 82/66 mm Hg 188/98 mm Hg 120/78 mm Hg Compare your answers with your partners. Discuss any discrepancies and determine a unified answer.

Causes of Hypertension • • Stress Anxiety Obesity High salt intake Aging Kidney disease Vascular conditions • Hypertension is often called the “silent killer” • Why do you think? ? ? Share with your partner.

Causes of Hypotension • • • Heart failure Dehydration Depression Severe burns Hemorrhage Shock

Sites for Taking Blood Pressure • Blood Pressure can be obtained from any artery. • A pulse site is used in the assessment • Common areas for BP • • • Brachial ~ taken in upper arm Radial ~ taken on the lower arm Popliteal ~ taken on the thigh Doralis pedis ~ taken on the lower leg video