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Vital Signs. What are they and why are they so important?. Vital Signs. Important indicators that provide information about the basic body conditions of the patient Four main vital signs: temperature, pulse, respirations, and blood pressure. Temperature.

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vital signs

Vital Signs

What are they and why are they so important?

vital signs1
Vital Signs
  • Important indicators that provide information about the basic body conditions of the patient
  • Four main vital signs: temperature, pulse, respirations, and blood pressure
temperature
Temperature
  • Definition – a measurement of the balance between heat lost and heat produced by the body
temperature1
Temperature
  • Heat is produced by the metabolism of food and muscle, and gland activity
  • Heat is lost through perspiration, respiration, and excretion
  • Homeostasis (constant state of fluid balance) is the ideal state in the human body
  • Normal temperature range is 97 to 100 degrees Fahrenheit or 36.1 to 37.8 degrees Celsius
temperature2
Temperature
  • Aseptic technique for handling
  • Oral measurement – mouth; 3-5 min
  • Rectal measurement – rectum; 3-5 min
  • Axillary measurement – armpit; 10 min
  • Aural measurement – ear; less than 2 sec
temperature3
Temperature
  • Hypothermia – very low body temperature, below 95 degrees Fahrenheit measured rectally
  • Factors that lead to decreased body temperature: starvation or fasting, decreased muscle activity, mouth breathing, exposure to cold environmental temperatures and certain diseases
  • Hyperthermia – body temperatures exceeds 104 degrees Fahrenheit measured rectally
  • Factors that lead to increased body temperature: illness, infection, exercise, excitement, and high environmental temperatures
temperature4
Temperature
  • Usually measured on Fahrenheit scale, but may see Celsius scale
  • Convert Fahrenheit to Celsius temperature, subtract 32 from the Fahrenheit temperature and then multiply the result by 5/9 or 0.5556.
  • Convert Celsius to Fahrenheit temperature, multiply the Celsius temperature by 9/5 or 1.8 and then add 32 to the total.
temperature5
Temperature
  • Equipment used for measurement
    • Clinical thermometer – slender glass tube containing mercury, which expands when exposed to heat
    • Electronic thermometer – usually battery operated unit registering temperature in about 60 sec on digital display screen
    • Tympanic thermometer – specialized electronic thermometer measuring temperature in the auditory canal in 1 to 2 sec on display screen
temperature6
Temperature
  • Conditions requiring modifications
    • Oral - eating, drinking, or smoking
    • Rectal – diarrhea
    • Axillary or groin – moisture or rubbing
    • Aural – incorrect positioning of pinna

Recording or documenting - T

  • Cleaning equipment
pulse
Pulse
  • Definition- the pressure of the blood felt against the wall of an artery as the heart contracts and relaxes, or beats
    • Felt in arteries that lie fairly close to the skin and can be pressed against a bone by the fingers
pulse1
Pulse
  • Pulse sites
    • Temporal – at side of forehead
    • Carotid – at neck
    • Brachial – at inner aspect of forearm at antecubital space
    • Radial – at inner aspect of wrist above thumb; most common site
    • Femoral – at inner aspect of upper thigh
    • Popliteal – behind knee
    • Dorsalispedis – at top foot arch
pulse2
Pulse
  • Measured in number of beats per minute
    • Rate – number of beats per minute
    • Rhythm – regularity; regular or irregular
    • Volume – strength; strong, weak, thready, or bounding
pulse3
Pulse
  • Pulse rates vary depending on age, sex, and body size
    • Adults – 60 – 90 bpm
      • Men – 60 – 70 bpm
      • Women – 65 – 80 bpm
    • Children over 7 years – 70 – 90 bpm
    • Children 1 to 7 years – 80 – 100 bpm
    • Infants – 100 – 160 bpm
pulse4
Pulse
  • Bradycardia – pulse under 60 bpm
  • Tachycardia – pulse over 100 bpm
  • Arrhythmia – irregular or abnormal rhythm
pulse5
Pulse
    • Factors that may change pulse rate
    • Increased – exercise, stimulant drugs, excitement, fever, shock, and nervous tension
    • Decreased – sleep, depressant drugs, heart disease, coma, and physical training
  • Document findings - P
respirations
Respirations
  • Definition- the process of taking in oxygen and expelling carbon dioxide from the lungs and respiratory tract
    • One respiration consists of one inspiration and one expiration
respirations1
Respirations
  • The breathing rate of the patient
    • Rate – number of respirations per minute =
      • Adults – 12 –20 rpm
      • Children – 16 – 25 rpm
      • Infants – 30 –50 rpm
    • Rhythm – regularity = regular or irregular
    • Character – type; depth and quality = deep, shallow, labored, difficult, stertorous, and moist
respirations2
Respirations
  • Abnormal respirations
    • Dyspnea- difficult or labored breathing
    • Apnea – absence of breathing
    • Tachypnea – respiratory rate above 25 rpm
    • Bradypnea – respiratory rate below 10 rpm
    • Orthopnea – difficult breathing in any position other than sitting erect or standing
respirations3
Respirations

Abnormal respirations continued

  • Cheyne-Stokes respirations – periods of dyspnea followed by periods of apnea = frequently seen in dying patients
  • Rales – bubbling or noisy sounds caused by fluids or mucus in the air passages
respirations4
Respirations
  • Must be counted in such a way that patient is unaware of the procedure as respirations are partially under voluntary control
  • Leave hand on pulse site while counting respirations
  • Document findings - R
blood pressure
Blood Pressure
  • Definition– force exerted by the heart against the arterial walls when the heart contracts or relaxes
    • Read in millimeters (mm) of mercury (Hg)
blood pressure1
Blood Pressure
  • Two types of measurements
    • Systolic – pressure in the walls of the arteries when the heart is contracting and pushing blood into the arteries
      • Reading shows greatest pressure
      • Normal reading is 120 mm Hg
      • Normal range is 100 to 140 mm Hg
    • Diastolic – constant pressure in the walls of the arteries when the heart is at rest or between contractions
      • Reading shows least pressure
      • Normal reading is 80 mm Hg
      • Normal range is 60 to 90 mm Hg
blood pressure2
Blood Pressure
  • Pulse pressure – difference between systolic and diastolic pressure
    • Important indicator of health and tone of arterial walls
    • Normal range in adults 30 to 50 mm Hg
blood pressure3
Blood Pressure
  • Hypertension – high blood pressure
    • Systolic greater than 140 mm Hg
    • Diastolic greater than 90 mm Hg
    • Causes – stress, anxiety, obesity, high-salt intake, aging, kidney disease, thyroid deficiency and vascular conditions
blood pressure4
Blood Pressure
  • Hypotension – low blood pressure
    • Systolic less than 100 mm Hg
    • Diastolic less than 60 mm Hg
    • Causes – heart failure, dehydration, depression, severe burns, hemorrhage, and shock
blood pressure5
Blood Pressure
  • Factors influencing blood pressure readings
    • Force of heartbeat
    • Resistance of the arterial system
    • Elasticity of the arteries
    • Volume of the blood in the arteries
blood pressure6
Blood Pressure
  • Factors increasing blood pressure
    • Excitement, anxiety, nervous tension
    • Stimulant drugs
    • Exercise and eating
  • Factors decreasing blood pressure
    • Rest or sleep
    • Depressant drugs
    • Shock
    • Excessive loss of blood
  • Factors causing miscellaneous readings
    • Lying down
    • Sitting position
    • Standing position
blood pressure7
Blood Pressure
  • Recorded as a fraction
    • Systolic is numerator = top number
    • Diastolic is denominator = bottom number
  • Sphygmomanometer instrument used to measure blood pressure = B/P cuff
    • Mercury – long column; 2mm marks
    • Aneroid – face scale; 2mm marks
    • Parts: cuff, bladder, control valve, bulb, tubing, measurement scale
    • Stethoscope: earpieces, diaphragm, bell and tubing
  • Document findings – B/P
apical pulse
Apical Pulse
  • Definition– pulse count taken at the apex of the heart with a stethoscope
    • Stethoscope amplifies the actual heart beat
    • Usually ordered on patients with irregular heartbeats, hardening of the arteries, or weak or rapid radial pulses, and infants
    • Two separate heart sounds are heard while listening to the heartbeat = “lubb-dupp” caused by closing of heart valves as blood flows through chambers of the heart
    • Each lubb-dupp counts as ONE heartbeat
apical pulse1
Apical Pulse
  • Pulse deficit – heart condition in which heart is weak and does not pump enough to blood to produce a pulse or heart beats too fast and there is not enough time for the heart to fill with blood
    • The heart does not produce a pulse during each beat
    • Apical pulse rate is higher than the pulse rate at the other pulse sites on the body
    • Most accurate determination of pulse deficit calculated by two persons at the same time
  • Document findings - AP
documentation
Documentation
  • Graphing vitals
    • Graphic sheets used for recording vitals
    • Visual diagram of variations in patient’s vital signs
    • Must be neat, legible, and accurate
    • Correct errors carefully
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