Vital Signs *Foundation Standard 10: Technical Skills Apply technical skills required for all career specialties and demonstrate skills and knowledge as appropriate 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (temperature, pulse, respirations, blood pressure, pain).

Vital Signs Respiration Blood pressure Temperature Pulse 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (temperature, pulse, respirations, blood pressure, pain).

Thermometers Types Oral- mouth Tympanic-ear Axillary- armpit Rectal- rectum Temporal- forehead 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (temperature).

Normal Temperature Range Temperatures Route Normal Temperature Range Sites Oral  97°F (36.1°C) to 99°F (37.2°C) Mouth Tympanic 99.1oF(37.3 ºC) to 99.6 ºF(37.6oC) Ear Rectal Rectum Axillary 97.6 ºF(36.4oC) to 98.1oF(36.7 ºC) Armpit Temporal 97.6oF (36.4oC) to 98.1oF (36.7oC) Forehead 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (temperature).

Procedure Record to the nearest 0.1o Oral- wait 15 minutes after eating or drinking Tympanic- primarily for children Rectal- wear gloves, lubricate the thermometer, insert ½” for infants and 1” for adults Axillary probe must touch skin Tympanic- must cross temporal artery 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (temperature).

Pulse Number of times heart beats per minute Normal resting pulse range- Newborns (0-3 months) 100-150 Infants (3-6 months) 90-120 Infants (6-12 months 100-160 Children ages 1-10 70-130 Children over age 10 and adults 60-100 Well-conditioned athletes 40-60 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (pulse).

Procedure Locate pulse (radial-adult, brachial- infant), press lightly with index and third fingers Irregular pulse- note Tachycardia- > 100 bpm Bradycardia- < 60 bpm Weak Irregular 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (pulse).

Respiration Respiration- 1 inhalation and 1 exhalation Normal resting respiration rate Approximate Age Range Respiratory Rate Newborn 30-50 0-5 months 25-40 6-12 months 20-30 1-3 years 3-5 years 6-10 years 15-30 11-14 years 12-20 15-20 years 12-30 Adults 16-20 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (respirations).

Procedure Count number of breaths per minute Look, listen with a stethoscope, feel Note Effort (shallow or deep) Hyperventilation- excessive rate Dyspnea- painful breathing Tachypnea- rapid breathing 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (respirations).

Blood Pressure Systolic pressure- ventricles are contracting, first heart sound when taking blood pressure, top number Diastolic pressure- ventricles are relaxing, last heart sound when taking blood pressure, bottom number Blood pressure = Systolic Pressure Diastolic Pressure 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (blood pressure).

Blood Pressure Ranges Age Systolic Diastolic 1-12 months 75-100 50-70 1-4 years 80-110 50-80 3-5 years 6- 13 years 85-120 55-80 13-18 years 95-140 60-90 Adult <120 <80 Normal 120-139 80-89 Prehypertension 140-159 90-99 Stage 1 hypertension >160 >100 Stage 2 hypertension 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (blood pressure).

Procedure Equipment- Sphygmomanometer (inflatable cuff, pressure bulb, and manometer) and stethoscope Measuring blood pressure Place cuff on the upper arm above the brachial pulse site Inflate cuff 200 mmHg Release the air in cuff and listen for the first heartbeat (systolic pressure) and the last heartbeat (diastolic pressure) Record results with systolic as the top number and diastolic as the bottom number 10.11 Apply procedures for measuring and recording vital signs including the normal ranges (blood pressure).