Transcript Vital Signs

Vital Signs
“signs of life”
What are vital signs?
*Temperature- body temp
*Pulse Rate- wave of blood,from
contraction of heart.
*Respiratory Rate- number of breaths (respirations) per
minute.
*Blood Pressure- amount of pressure exerted on
vessel walls as blood pulsates. 2 pressures measured.
Vital Signs
Abbreviations for documenting (charting)
“T”- temperature
“P”- pulse
“R”- respirations
“BP”- blood pressure
Temperature
Reading Sites:
Oral- within mouth, under tongue
Axillary- in armpit, aka axilla
Tympanic- in ear canal
Rectal- through anus, in rectum
Temperature
Thermometer types:
Electronic- measure temperature through probe
at end of device (or) infrared capture.
Glass- contains mercury which rises to
appropriate level to indicate reading
temperature.
Temperature
Fahrenheit to Celsius conversion
C°= Degrees Celsius
Water freezes at 0°C
F°= Degrees Fahrenheit
Water freezes at 32°F
Temperature
°F to °C- Deduct 32, then
multiply by 5, then divide by 9
°C to °F- Multiply by 9, then
divide by 5, then add 32
Temp-Conversion EX.
96.8°F-32*5÷9= 36°C
36°C*9÷5+32= 96.8°F
Temperature
Normal adult temperature range considered
98.6°F
Most range from 96.8°F to 100.4°F (36.0°C to
38.0°C).
Temperature
Many factors affect body temperature:
Exposure to (heat/cold)
Time of day- normally cooler in AM
Illness, Stress, Allergic Reaction,etc.
Temperature
When temperature is above 100.4F (38.0C), the
patient is febrile- “with fever”.
When temperature is within normal range (96.8F
to 100.4) the patient is afebrile- “without fever”
Pulse Rate
Pulse- wave of blood flow created by contraction
of the heart
Pulse Rate- number of times the heart beats in
one minute (60 seconds).
BPM-beats per minute
Pulse Sites
Text
*Table 9-1 on page 326
Pulse Sites
Temporal-side of head
Carotid-neck
Apical-just below left nipple (listen)
Brachial-inside elbow
Radial-wrist
Femoral-groin
Popliteal- behind knee
Pedal-top of foot
Pulse Rhythm
Pulse Rhythm- should be regular, “evenly paced”.
Can be irregular- “dysrhythmia”
If irregular, pulse should always be counted
entire minute for average pulse rate.
Irregular heart (pulse) rate is sometimes
normal condition in infants, through young
adulthood.
Pulse- Bilateral?
Bilateral- “both sides”
pulses should be found “equal bilaterally”
If found only on one side of body at a pulse point
it is referred to as “unilateral”.
Pulse Volume
“Strength of Pulse”
Measure of the force against the arterial wall and
your fingertips as you palpate.
See Chart on next slide
Described often as:
Absent, Thready/Weak, Strong/Normal,
Bounding/Full
Pulse Volume
“Chart”
0
Absent, Unable to detect
1
Thready/Weak, difficult to palpate; easy to obliterate
2
Strong/Normal, easily found; obliterated by pressure
3
Bounding/Full, difficult to obliterate with fingertips
Pulse
Normal Pulse Ranges:
Newborn
120-160
1 month to 1 year
1-6 years
80-140
80-120
6 to adolescence
75-110
Adulthood
72-80
Late Adult
60-80
Table 9-2 p.327
Pulse Rates
“outside of normal range”
Lower than normal= Bradycardia
Higher than normal= Tachycardia
Pulse Rates
“Factors that affect pulse rate”
Age-slows with age
Sex- women tend to have faster rates
Level of fitness
Physical/mental stress-elevates
Lack of Oxygen or low BP-elevates
Medications/Alcohol
Respiratory Rate
Respiration (ventilation):the act or process of
inhaling and exhaling; breathing. Also called
ventilation.
Respiratory Rate
Like the pulse rate, the normal respiratory rate
decreases as a person becomes older.
Apnea-absent respirations
Respiratory Rates
“Ranges (per minute) by Age”
Infant
Toddler
Preschool
30-60
24-40
22-34
Shool-aged
Adolescent/Adult
18-30
12-20
Respiratory
“Observing chest movement”
Adults and Older Children- chest movement
outward/upward in.
Under 7 years old- use combined chest and
abdominal breathing.
Abdominal breathing in adults= sign of difficulty
breathing (dyspnea)
Respiratory Rate
“Assessing”
Most common- observe chest movement for one
minute
Auscultation- with stethoscope on chest wall. Best
in infants whose rate is difficult to observe and
adults who may be aware you are observing.
*warm stethoscope in hands
Respiratory Rate
Hyperventilation- increase in respiratory rate;
beyond normal range.
Causes: Physical/mental stress, fever
(pyrexia), lack of oxygen, low blood
pressure.
Respiratory Rate
Hypoventilation- decrease in respiratory rate;
below normal range.
Causes: Pain Meds, Alcohol, Hypothermia,
severe lack of oxygen, No blood pressure
Respiration Rhythm
Respirations should be regular (evenly spaced).
Respiration Quality
Volume and effort of each respiration should be
comparable throughout the observation.
Dyspnea- labored/difficult breathing;
accessory muscle use seen in neck,chest,
and abdomen
Blood Pressure
BP-measurement of the pressure exerted on the
arterial walls as blood pulsates. Two pressures
are measured.(Systolic and Diastolic)
BP is measured in mmhg= millimeters of
mercury
Blood Pressure
Systolic Blood Pressure (SBP)- pressure exerted
on arterial walls during contraction phase of the
heart .
highest pressure
120/70 - Systolic is 120 mmhg
Blood Pressure
Diastolic Blood Pressure- the resting pressure on
arteries as heart “relaxes” between contractions.
120/70 - Diastolic is 70 mmhg
Blood Pressure
“Normal Ranges”
Systolic range= 100-140 mmhg
Diastolic range=
60-90 mmhg
Blood Pressure
Hypotension- When blood pressure drops below
the normal range.
Hypertension- when blood pressure is higher than
the normal range.
Blood Pressure
“Hypotension”
When a patient is hypotensive (low BP) the body tries
different methods to raise the blood pressure. This
causes some signs of shock (lack of blood flow to
tissues):
Change in level of consciousness
Increased heart rate/respirations
Weak, thready pulses
Pale, sweaty skin
Blood Pressure
“Hypertension”
Hypertension is largely “symptomless”
With severe hypertension (180+ systolic/110+ diastolic) a
patient may exhibit some of the following:
Headache
Severe anxiety
Shortness of breath
Nosebleed
Blood Pressure
“most convenient sites”
Brachial- upper arm; most common in adults and
older children.
Radial- lower arm; infants/patients with very large
upper arms.
Popliteal- thigh; alternative to arms because of
disease/trauma/medical treatments to
arms/mastectomies
Dorsalis Pedis- lower leg; common site for infants
when using electronic cuff.
Blood Pressure
Sphygmo-man-o-meter
Sphygmo= pulse
man= pressure
meter= measure
“measuring pulse pressure”
Blood Pressure
“Types of Sphygmomanometers”
Mercury-calibrated glass cylinder containing
mercury
Aneroid- calibrated dial with needle that points to
numbers
Electronic- digital display, no stethoscope
required
Blood Pressure
“Palpated BP?”
It is possible to obtain the Systolic (top #)
pressure with only a BP cuff.
Continuously palpate the radial pulse point,
inflate the cuff until the pulse is obliterated
and then +10-20 mmhg.
Deflate the cuff slowly, the number on the
dial when you first feel the pulse again
represents the systolic pressure