3.01 Vital Signs

3.01 Understand Diagnostic and Therapeutic Services Vital Signs Provide information about body function Include: temperature pulse respiration blood pressure Changes may be the first sign of disease Accuracy is imperative! 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature 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 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature Normal ranges 97º - 100º F 36.1º - 37.8º C 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature Hypothermia Temperature below 95º F Death can occur if below 93º F 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature Hypothermia Temperature decreases with: environment exposure to cold inactivity sleep starvation Symptoms: shivering cold skin confusion 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature Hyperthermia Temperature 100-104º F Temperature above 104º F is life-threatening Prolonged hyperthermia may cause brain injury. 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature Hyperthermia Temperature increases with: environment exercise illness, infection, injury stress Symptoms: hot, dry, red skin nausea/vomiting headache low blood pressure 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature Pyrexia- Febrile- Afebrile- 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature Thermometers Clinical Non-mercury glass Electronic Aural 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature Sites to measure temperature: Aural – auditory canal Axillary – armpit Oral – mouth Rectal – rectum 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature To record temperature: Oral 98.6º (O) Rectal 99.6º (R) Axillary 97.6º (ax) Aural 98.6º (T) 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature When do you use? 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature 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 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Oral Temperature Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Temperature Measurement Aural Pros: Measures core body temperature Fast and convenient Con: Inaccurate if not placed correctly in the ear canal Ear infection Ear wax 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Aural Temperature Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs Pulse Pulse: Pressure of blood on artery walls as the heart beats and relaxes 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs Pulse Normal Range 60-100 bpm Normal rates 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 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs Pulse Bradycardia: pulse rate <60 bpm Tachycardia: pulse rate >100 bpm Volume: strength of the pulse Rhythm: regular or irregular Arrhythmia: irregular heart rhythm 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs Pulse Pulse can be increased by: exercise stimulant drugs excitement fever shock nervousness 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs Pulse Pulse can be decreased by: sleep depressant drugs heart disease coma 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs Pulse Pulse 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 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs Pulse When would you use these pulse sites? Temporal Carotid Brachial Radial Femoral Popliteal Dorsalis pedis 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Radial Pulse Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Apical Pulse Pulse count taken with the stethoscope over the heart. Use if the patient has: Irregular heartbeat Arteriosclerosis Weak or rapid radial pulse Infants and children 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Apical Pulse Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Respiration 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 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Respiration Bradypnea- slow respiratory rate, <10 per        minute Tachypnea- rapid, shallow respiration,         >25 per minute Evaluate for rhythm and character Rhythm – regular or irregular Character – depth, ease of breaths 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Respiration Abnormal respiratory patterns Apnea – periods of absent breathing Dyspnea – difficult breathing Cheyne-stokes – periods of apnea and     dyspnea Orthopnea- severe dyspnea; requires breathing sitting or standing 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Respiration Other respiratory abnormalities Wheezing – difficult breathing with a high-              pitch whistling Rales – bubbling or noisy respirations     caused by fluid or mucous in the air passages Cyanosis – bluish discoloration 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Respirations Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Blood pressure Pressure of blood on the arterial walls Recorded as a fraction: 120/80 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 3.01 Understand Diagnostic and Therapeutic Services

3.01 Understand Diagnostic and Therapeutic Services Vital Signs REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Blood pressure Hypertension- high blood pressure Hypotension- low blood pressure 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Blood 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 3.01 Understand Diagnostic and Therapeutic Services

Vital Signs Blood Pressure Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3.01 Understand Diagnostic and Therapeutic Services

Combined Vital Signs TPR BP Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3.01 Understand Diagnostic and Therapeutic Services

Diagnostic Skills: Height and Weight Measured if warranted by patient’s 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 3.01 Understand Diagnostic and Therapeutic Services

Diagnostic Skills: Daily Weights Daily weights are used to monitor patients with chronic disease processes: Hormone disorders Renal disorders Heart disease Cancer 3.01 Understand Diagnostic and Therapeutic Services

Diagnostic Skills: Daily 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. 3.01 Understand Diagnostic and Therapeutic Services

Diagnostic Skills: Daily Weights OBSERVE SAFETY PRECAUTONS! Prevent injury from falls and the protruding height lever. 3.01 Understand Diagnostic and Therapeutic Services

Measuring Height and Weight Diagnostic Skills Measuring Height and Weight Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3.01 Understand Diagnostic and Therapeutic Services

Diagnostic Skills: Measure 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 3.01 Understand Diagnostic and Therapeutic Services

Diagnostic Skills: Measure 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 3.01 Understand Diagnostic and Therapeutic Services

Measure Visual Acuity Diagnostic Skills Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 3.01 Understand Diagnostic and Therapeutic Services