Vital Signs

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Vital Signs
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What do you already know about vital signs?

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

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Essential Question

• What does temperature tell the nurse about a
  patients condition?

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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

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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

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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.

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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

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Convert the Following Temperatures

• C (F - 32) X 0.5556
• 100.2F ?C
• 99.2F ?C

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Convert the Following Temperatures

• C (F - 32) X 0.5556
• 100.2F
• (100.2 - 32) X 0.5556
• 68.2 X 0.5556 37.9C
• 99.2F
• (99.2 - 32) X 0.5556
• 67.2 X 0.5556 37.3C

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Convert the Following Temperatures

• F (C X 1.8) 32
• 38.8C ?F
• 37.6C ?F

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Convert the Following Temperatures

• F (C X 1.8) 32
• 38.8C
• (38.8 X 1.8) 32
• 69.84 32 101.8F
• 37.6C
• (37.6 X 1.8) 32
• 67.68 32 99.7F

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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

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Temperature (T)

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

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Temperature (T)

• When using a clinical (glass) thermometer each
  line represents 0.2 degrees.
• Electronic and clinical thermometers have
  coverings to prevent cross-contamination.

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Handout

• Reading a glass thermometer

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Temperature (T)

• Causes of increased temperature
• Illness
• Infection
• Exercise
• Excitement
• High temperatures in the environment

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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)

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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 106F can lead to convulsions
  and death

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Review

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

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Pulse

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

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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?

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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

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Average Range of Pulse

• Adults 60-80 BPM
• Children over 7yrs 70-100 BPM
• Children 1yr-7yrs 80- 110 BPM
• Infants 100-160 BPM

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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

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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

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With Your Table Partner

• Using the radial pulse palpate your partners
  pulse and determine the rate.

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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.

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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

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Abnormal Respirations

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

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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.

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Lesson Essential Question

• What does blood pressure tell us about a persons
  health?

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Think Pair-Share

• Tell your partner one thing you know about blood
  pressure.

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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.

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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

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Blood Pressure Measurements

• Normal Range
• Systolic 100-120mm Hg
• Diastolic 60-80mm Hg
• Hypertension high blood pressure
• Systolic gt140mm Hg
• Diastolic gt 90mm Hg
• Hypotension low blood pressure
• Systolic lt 90mm Hg
• Diastolic lt 60mm Hg

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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

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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

• 88/68mm Hg
• 166/ 78mm Hg
• Compare your answers with your partners. Discuss
  any discrepancies and determine a unified answer.

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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.

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Causes of Hypotension

• Heart failure
• Dehydration
• Depression
• Severe burns
• Hemorrhage
• Shock

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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