Measuring Vital Signs

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Measuring Vital Signs
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Vocabulary

• Afebrile temperature is within normal range
• Febrile temperature is elevated
• Hypothermia temperature is below normal
• Axillary referring to the armpit
• Aural pertaining to the ear
• Oral referring to by mouth
• Rectal referring to the end of the large
  intestine just above the anus

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Vocabulary continued

• Calibration standard measure (each line on a
  thermometer or a ruler is a calibration)
• Celsius measure of heat abbreviated C
• Fahrenheit measure of heat abbreviated F

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Why are vital signs so important?

• Indicate normal or abnormal function
• Normal homeostasis (balance)
• Accuracy can mean the difference between life and
  death

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What are vital signs?

• TPR and BP where
• T body temperature (measure of body heat)
• P pulse rate (the rate at which the heart is
  pumping blood through the body)
• R respiratory rate (the rate at which the lungs
  are breathing air in and out)
• BP blood pressure (the highest and lowest
  amount of pressure placed on the blood vessels of
  the body)

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What is body heat (temperature)?

• Heat is produced by muscle activity, food
  oxidation, and glands.
• Heat is lost through respiration, perspiration,
  and excretion.

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Factors that increase body temperature

• Exercise
• Digestion of food
• Increase environmental temperature
• Illness
• Infection
• Excitement
• Anxiety

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Factors that decrease body temperature

• Sleep
• Fasting
• Exposure to cold
• Depression
• Decreased muscle activity
• Certain illnesses
• Mouth breathing

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Most common sites to measure temperature

• Mouth (Oral)
• Axilla (Underarm)
• Rectum
• Ear (Aural)

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Types of thermometers

• Glass
• Electronic digital
• Aural or tympanometer
• Chemically treated strips

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Normal temperature readings

• Oral 98.6 F (37 C)
• Axillary 97.6 F (36.4 C)
• Rectal 99.6 F (38 C)

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Pulse

• The number of times the heart pumps or beats in a
  minute
• Indicates that blood is circulating through the
  body
• Most common sites to measure pulse radial,
  antecubital (brachial), apical (stethoscope on
  the chest wall)

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vocabulary

• Arrhythmia irregular heart beats
• Apex the top of the heart
• Bounding extremely strong heart beat
• Bradycardia slower than normal heart beat
• Hemorrhage bleeding
• Tachycardia faster than normal heart beat

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When counting the pulse, you feel the pressure of
blood against the artery as the heart contracts.
Pulse rate varies for different ages (faster in
infants)newborn 120 160teenagers 75 -
110adults 72-80
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Characteristics of a pulse

• Rate fast, slow
• Rhythm regular, steady, irregular
• Arrhythmia even or uneven intervals between
  pulse
• Force of the beat / volume bounding, thready or
  weak normal, strong

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• Pulse rates below 60 or above 100 should always
  be reported
• Athletes may have a pulse rate under 60 due to
  excellent fitness

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Factors that influence pulse rate

• Exercise (increases pulse rate)
• Hemorrhage (weakens, increases)
• Emotional excitement (increases)
• Elevated temperature (increases)
• Medication (increases or decreases)
• Age (increases)
• Aerobic fitness (decreases)
• Depression (decreases)
• Illness (increases or decreases)
• Shock (increases)

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• The radial pulse is the most common site for
  counting the pulse rate.
• Adult pulse rate may range from 60-80.
• The pulse oximeter is an electronic device that
  determines pulse and oxygen concentration in the
  hemoglobin of the arterial blood.
• pO2 lt 90 not enough oxygen in the tissues to
  function normally

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Respiration

• The process of taking in oxygen and expelling
  carbon dioxide
• Helps regulate temperature and eliminate all
  waste products
• 1 expiration / exhalation (breathing out) 1
  inspiration / inhalation (breathing in)

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Respiration rate is assessed by observing the
clients chest movement upward and outward for a
complete minute.Auscultation (listening with a
stethoscope) is another method to assess
respiratory rate.
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Abnormal respirations (lung sounds) include

• Dyspnea difficulty breathing (diminished lung
  sound)
• Apnea stopped breathing (no lung sound)
• Cheynes-Stokes periods of labored breathing
  followed by apnea
• Rales bubbling or rattling sounds caused by
  mucus

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Factors that affect respiration

• Anxiety
• Respiratory rate
• Relaxation
• Depression
• Head injury
• Age (newborn 40/minute adult 12-20/minute)
• Exercise
• Pain
• Fever
• Heart disease congestive heart failure
• medication

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• Hyperventilation increase in the respiratory
  rate may be caused by
• -physical / mental stress such as infection,
  exercise, or anxiety
• - increase in body temperature
• -lack of oxygen or low blood pressure

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• Hypoventilation decrease in respiratory rate
  may be caused by
• -pain medications and alcohol
• - decrease body temperature
• - severe lack of oxygen and no blood pressure

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Blood Pressure

• the force of the blood pushing against the walls
  of the blood vessels.
• Systolic greatest force exerted on the arteries
  when the heart is contracting causing a beat to
  be heard. This is the higher number.
• Diastolic least force exerted on the arteries
  when the heart relaxes.

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Blood Pressure depends on

• Volume of blood in the circulatory system
• Force of the heartbeat
• Condition of the arteries

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Factors that Increase Blood Pressure

• Loss of elasticity in the arteries
• Exercise
• Eating
• Stimulants (medication, coffee)
• Anxiety

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Factors that Decrease Blood Pressure

• Hemorrhage
• Inactivity
• Fasting
• Suppressants (medications that lower B/P)
• Depression

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• Expected B/P readings
• Systolic between 100 140 mm
• Diastolic between 60 90 mm
• Written as a fraction with systolic over
  diastolic
• Systolic between 120-140 mm and diastolic between
  80-90 mm is considered Prehypertension
• Hypertension blood pressure above normal (high
  blood pressure)
• Hypotension blood pressure below normal (low
  blood pressure)

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Equipment used

• Sphygmomanometer instrument used to measure
  blood pressure (also called a blood pressure
  cuff)
• Three types
• Aneroid calibrated dial
• Electronic digital display
• (does not require a stethoscope)
• Mercury calibrated cylinder with mercury
• stethoscope

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Measuring Blood Pressure

• Roll up clients sleeve above elbow, being
  careful that its not too tight. Support
  clients arm on a firm surface.
• Wrap wide part of cuff around clients arm
  directly over brachial artery. Lower edge of
  cuff should be 1 or 2 inches above the bend of
  elbow.
• Clean earpieces of stethoscope.

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1. Locate brachial artery.
2. Tighten thumbscrew on valve.
3. Hold stethoscope in place.
4. Inflate cuff to 170 mm.
5. Open valve if systolic sound is heard
   immediately, reinflate the cuff to 30 mm above
   systolic sound.
6. Note systolic at first beat.

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1. Note diastolic.
2. Open valve and release air.
3. Record blood pressure reading correctly.
4. Clean earpieces on stethoscope.
5. Put equipment away.