Vital Signs

1. Vital Signs Mrs. Rhonda Williams Instructor HST I and II

2. Vital Signs • – Temperature • – Pulse • – Respiration • – Blood Pressure • -With pediatric patients, remember the weight may become a factor (T/P/R B/P)

3. Remember….. Vital signs not documented, are Vital signs not taken!

4. Inquiring Minds Need to Know…. • Vital signs are important elements in monitoring the status of the patient • They should be obtained when the patient is first seen! • They provide a baseline of information by which members of the health care team can track any changes in the patient's condition • Remember, they are trends so you must have more than one set

5. Temperature • Severe fluctuations may be life threatening • Controlled by the hypothalamus • Recorded in typically in Fahrenheit • Range in adults- 97-100 degrees Fahrenheit Methods- Oral, Aural, Rectal, Axillary Hypothermia= below 95 degrees( F) Hyperthermia= above 104 degrees(F)

6. Causes of increasedTemperature • exercise • thyroid problems • systemic infections • localized infection with pus • fractured bones • soft tissue injury from trauma • myocardial infarction • Thrombophlebitis • leukemia • surgery

7. Signs of fever • Skin may/may not be warm and flushed • Tachycardia • Chills • Night sweats

8. Pulse The pulse is an indicator of a patient's cardiovascular status.Subtle changes in pulse are the first sign of changes in the patient's condition. • Note the quality and rhythm of the pulse; is it fast, slow, irregular, weak, strong or bounding The rhythm should be regular; however, in children and young adults, the pulse may speed up with inspiration and slow down with expiration

9. Continued…. • The normal pulse rate for an adult ranges from 60 to 90 beats per minute and is usually taken via the Radial Pulse. • In the pediatric population, the pulse rate varies with age and is usually taken Apically.

10. Effecting Factors • Physical condition • Age • Medication • Fever • Fear • Positioning

11. Who should be monitored/reported? A pulse below 60 or above 100 beats/minute in an adult or Pulse rates that falls below 70 or above 110 beats /minute in a child from 1-7 yrs. of age or below 100 or above 160 beats/minute in an infant or Any substantial increase or decrease in the pulse rate May be the first indication that something is changing in the patient's condition and should be reported and monitored closer:

12. Respirations • Evaluate rate, depth( character), pattern (rhythm) • Count while feeling the patient’s pulse • Norms – infants: 30-60 – children: 20-30 – adults: 12-20

13. Respiratory Patterns(See Unit 14:4)

14. Breath Sounds Listen to breath Sounds document the following: Clear to auscultation, wheezing, absence of breath sounds, “wet” lung

16. Blood Pressure • Blood pressure is the force at which the blood surges through the arteries generated by the pumping action of the heart. • The blood pressure is measured as a fraction of systole / diastole. • Blood pressure is measured in millimeters of mercury (mm Hg).

17. B/P continued • An average adult blood pressure ranges from 100 to 140 systolic and 60 to 90 diastolic. • Sometimes the patient may have additional symptoms, such as headache with hypertension and dizziness with hypotension but Hypertension is known as “The Silent KILLER”- so beware!!

18. B/P • Systole reflects the amount of force needed for the heart to contract and push blood into the arteries. • Diastole is the resting phase of the heart as it fills with blood from the veins.

19. Systole and Diastole • Systole reflects the amount of force needed for the heart to contract and push blood into the arteries. • Diastole is the resting phase of the heart as it fills with blood from the veins. Abnormalities • Hypertension (high blood pressure values, such as 160/90 mm Hg or higher) orHypotension (low- blood pressure measurement of 90/40 mm Hg or lower) must be reported to the RN.

20. Incorrect B/P Readings • Pain • Stress • Medication • Exercise • Wrong size blood pressure cuff. – Too small a cuff gives a false high reading, – Too big a cuff gives a false low reading. Placing the cuff somewhere other than the arm (e.g., thigh) must be documented.

21. Oximetry • A sensor is attached to part of the body • Nail polish may interfere with the reading. • A normal pulse oximetry reading in an adult ranges from 95 to 100% saturation. • Adults with chronic obstructive pulmonary disease (COPD), such as emphysema or asthma, typically have a lower saturation level. • An oxygen saturation level of less than 70% is considered life-threatening.

22. Possible False Readings • Carbon monoxide poisoning • Low perfusion • Edema • Movement • Anemia

23. Inquiring Minds Want To Know… Got questions?

24. Vital Sign Quiz • A pulse site at the neck is the: a) carotid b) temporal c) femoral d) popliteal • A pulse is described as regular or irregular by the following term: a) rate b) character b) volume d) rhythm

25. Continued 3) An adult with a pulse rate of 110 bpm is experiencing: a) bradycardia b) tachycardia 4) T.P.R. stands for:_____, ______, __________ 5) The pulse site most commonly used in adults is the ________ pulse: a) carotid b) radial c) apical d) brachial

26. Mrs. Jones respiratory rate is 32. This is within the normal limits.a) true b) false • Hypertension is low blood pressure: a) true b) false • If hypertension is not treated, it can lead to a myocardial infarction. a) true b) false 9) Which of the following may lead to an elevated temperature: a) systemic infection b) starvation c) elevated B/P d) bradycardia • Difficult or labored respirations are known as: a) apnea b) dyspnea c) rales d) bradycardia