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 5th 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 cross-contamination.

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 7yrs : 70-100 BPM

• Children 1yr-7yrs : 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: 100-120mm Hg• Diastolic: 60-80mm Hg

• Hypertension ~ high blood pressure• Systolic: >140mm Hg• Diastolic: > 90mm Hg

• Hypotension ~ low blood pressure• Systolic: < 90mm Hg• Diastolic: < 60mm Hg

Blood Pressure Measurements

• Prehypertension ~ warning that high blood pressure will develop unless steps are taken to prevent it.• Systolic: 121-139mm 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.

1. 134/80 mm Hg

2. 110/91 mm Hg

3. 146/70 mm Hg

4. 100/70 mm Hg

5. 180/90 mm Hg

6. 82/66 mm Hg

7. 188/98 mm Hg

8. 120/78 mm Hg

9. 88/68mm Hg10.166/ 78mm 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