Vital Signs

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Vital Signs
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Vital Signs

• Provide information about body function
• Data is used to treat illness and diagnose
  disease
• Include
• temperature
• pulse
• respiration
• blood pressure

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• Changes may be the first
• sign of disease or a change in patient
  health status.
• Accuracy is imperative!

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Vital SignsTemperature

• 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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Vital SignsTemperature

• Normal ranges
• 97º - 100º F
• 36.1º - 37.8º C

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Vital SignsTemperature

• Hypothermia
• Temperature below 95º F
• Death can occur if below 93º F

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Vital SignsTemperature

• Hypothermia
• Temperature decreases with
• environment
• exposure to cold
• inactivity
• sleep
• starvation
• Symptoms
• shivering
• cold skin
• confusion

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Vital SignsTemperature

• Hyperthermia
• Temperature 100-104º F
• Temperature above 104º F is
• life-threatening
• Prolonged hyperthermia may cause brain
  injury.
• Sx headache, confusion

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Vital SignsTemperature

• Hyperthermia
• Temperature increases with
• environment
• exercise
• illness, infection, injury
• stress
• Symptoms
• hot, dry, red skin
• nausea/vomiting
• headache
• low blood pressure

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Vital SignsTemperature
Thermometers
Clinical Non-mercury glass
Aural good with children
Electronic
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Vital SignsTemperature

• Sites to measure temperature
• Aural auditory canal
• Axillary armpit
• Oral mouth
• Rectal rectum

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Vital SignsTemperature

• To record temperature
• Oral 98.6º (O) under tongue by jaw line
• Rectal 99.6º (R) lay pt on side
• Axillary 97.6º (ax)
• Aural 98.6º (T)

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Vital SignsTemperature Measurement

• Oral
• Ask the patient 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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• Vital Signs

• REPORT
• ABNORMAL RESULTS
• OF ANY VITAL SIGN
• IMMEDIATELY to supervisor
• Combined VS (TPRBP) can indicate a life
  threatening condition or a change in condition

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Vital SignsTemperature Measurement

• Aural
• 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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Vital SignsPulse

• Pressure of blood on artery walls
• as the heart beats and
• Relaxes (contraction and relaxation)

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• Sites
• Temporal side of the forehead
• Carotid side of the neck
• Brachial inner elbow
• Radial above the thumb at radius
• Femoral upper thigh
• Popliteal behind the knee
• Dorsalis pedis top of the arch of the
  foot (good for checking lower limb circulation)

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Vital SignsPulse

• Normal rate
• adult (male) 60 70 beats per minute
• adult (female) 65 80 beats per minute
• children (over 7) 70 100 beats per minute
• children (1 7) 80 110 beats per minute
• infants (less than 1 year) 100 160 beats per
  minute
• Rhythm regular or irregular
• Volume strength of the pulse

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Vital SignsPulse

• Pulse can be increased by
• exercise
• stimulant drugs
• excitement
• fever
• shock
• nervousness

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Vital SignsPulse

• Pulse can be decreased by
• sleep
• depressant drugs
• heart disease
• coma

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Vital Signs

• REPORT
• ABNORMAL RESULTS
• OF ANY VITAL SIGN
• IMMEDIATELY

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Vital SignsApical Pulse

• Pulse count taken with the stethoscope.
• Use if the patient has
• Irregular heartbeat
• Arteriosclerosis
• Weak or rapid radial pulse
• Infants and children

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Vital SignsRespiration
Process of taking in oxygen and expelling carbon
dioxide 1 inspiration 1 expiration
respiration Normal rate adults 12 20
breaths per minute children 16 30
breaths per minute
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• Evaluate for rhythm and character
• Rhythm regular or irregular (i.e. fast, slow)
• Character depth, ease of breaths
• Check while appearing to count pulse

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Vital SignsRespiration

• Abnormal respiratory patterns
• Apnea periods of absent breathing
• Cheyne-stokes periods of apnea and dyspnea
• Dyspnea difficult breathing

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Vital Signs

• REPORT
• ABNORMAL RESULTS
• OF ANY VITAL SIGN
• IMMEDIATELY

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Vital SignsBlood pressure
Pressure of blood on the arterial walls Recorded
as a fraction 120/80
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• 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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Vital SignsBlood pressure

• Factors that elevate blood pressure
• anxiety
• eating
• exercise
• excitement
• stimulant drugs
• Factors that lower blood pressure
• depressant drugs
• excessive loss of blood
• rest
• shock

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Diagnostic SkillsHeight and Weight

• Measured if warranted by patients 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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Diagnostic SkillsDaily Weights

• Daily weights are used to monitor patients with
  chronic disease processes
• Hormone disorders
• Renal disorders
• Heart disease
• Cancer

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Diagnostic SkillsDaily 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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Diagnostic SkillsDaily Weights

• OBSERVE ALL SAFETY
• PRECAUTONS!
• Prevent injury from falls and the
• protruding height lever.

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Diagnostic SkillsMeasure Visual Acuity

• Used to measure the ability to see
• Snellen charts used to measure distant vision
• Ishihara method tests for color
• Tonometer measures intraocular pressure

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Diagnostic SkillsMeasure Visual Acuity

• OD right eye (oculus dexter)
• OS left eye (oculus sinister)
• OU both eyes (oculus uterque)
• Myopia nearsightedness, defect in distant
  vision
• Hyperopia farsightedness, defect in near vision