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3.01 Vital Signs
PP4
Vital Signs
Provide information about body function
• Include:
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temperature
pulse
respiration
blood pressure
• Changes may be the first sign of disease
• Accuracy is imperative!
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Therapeutic Services
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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
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Temperature
Normal ranges
– 97º - 100º F
– 36.1º - 37.8º C
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Hypothermia
• Temperature below 95º F
• Death can occur if below 93º F
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Hypothermia
Temperature decreases with:
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environment
exposure to cold
inactivity
sleep
starvation
Symptoms:
– shivering
– cold skin
– confusion
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Hyperthermia
• Temperature 100-104º F
• Temperature above 104º F is life-threatening
• Prolonged hyperthermia may cause
brain injury.
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Hyperthermia
Temperature increases with:
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environment
exercise
illness, infection, injury
stress
Symptoms:
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hot, dry, red skin
nausea/vomiting
headache
low blood pressure
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Thermometers
Clinical
Non-mercury glass
Aural
Electronic
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Temperature Sites
• Aural – auditory canal
• Axillary – armpit
• Oral – mouth
• Rectal – rectum
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To record temperature:
– Oral 98.6º (O)
– Rectal 99.6º (R)
– Axillary 97.6º (ax)
– Aural 98.6º (T)
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Oral Temperature Measurement
• Ask pt 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
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Aural Temperature Measurement
• Pros:
– Measures core body temperature
– Fast and convenient
• Con:
– Inaccurate if not placed correctly
in the ear canal
– Ear infection
– Ear wax
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Pulse
Pressure of blood on artery walls as the heart
beats and relaxes
Sites:
1.Temporal – side of the forehead
2.Carotid – side of the neck
3.Brachial – inner elbow
4.Radial – above the thumb at radius
5.Femoral – upper thigh
6.Popliteal – behind the knee
7.Dorsalis pedis – top of the arch of the foot
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When would you use these pulse sites?
Temporal
Carotid
Brachial
Radial
Femoral
Popliteal
Dorsalis pedis
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Pulse
Normal rate
adult (male) 60 – 70 beats per minute
adult (female) 65 – 80 beats per minute
children (over 7) 70 – 100 beats/minute
children (1 – 7) 80 – 110 beats/minute
infants (less than 1 year) 100 – 160 beats/minute
Rhythm: regular or irregular
Volume: strength of the pulse
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Pulse
can be increased by:
– exercise
– stimulant drugs
– excitement
– fever
– shock
– nervousness
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Pulse
can be decreased by:
– sleep
– depressant drugs
– heart disease
– coma
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Apical Pulse
count taken with stethoscope
Use if the patient has:
– Irregular heartbeat
– Arteriosclerosis
– Weak or rapid radial pulse
– Infants and children
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Respirations
Process of taking in oxygen and expelling
carbon dioxide
1 inspiration + 1 expiration = respiration
Normal rate:
adults – 12 – 20 breaths/minute
children – 16 – 30 breaths/minute
Evaluate for rhythm and character
Rhythm – regular or irregular
Character – depth, ease of breaths
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Abnormal respiratory patterns
Apnea – periods of absent breathing
Cheyne-stokes – periods of apnea and
dyspnea
Dyspnea – difficult breathing
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Blood pressure
Pressure of blood on the arterial walls
Recorded as a fraction: 120/80
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
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Blood pressure
Factors that elevate blood pressure:
– anxiety
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eating
exercise
excitement
stimulant drugs
Factors that lower blood pressure:
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depressant drugs
excessive loss of blood
rest
shock
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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
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Daily Weights
• used to monitor patients with chronic disease
processes:
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Hormone disorders
Renal disorders
Heart disease
Cancer
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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 weighing the
patient.
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Daily Weights
OBSERVE SAFETY PRECAUTONS!
Prevent injury from falls and the
protruding height lever.
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Diagnostic Skills:
Measure Visual Acuity
1. Used to measure the ability to see
2. Snellen charts: used to measure
distant vision
3. Ishihara method tests for color
4. Tonometer measures intraocular
pressure
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Diagnostic Skills:
Measure Visual Acuity
OD – right eye (oculus dexter)
OS – left eye (oculus sinister)
OU – both eyes (oculus uterque)
Myopia – nearsightedness
o defect in distant vision
Hyperopia – farsightedness
o defect in near vision
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