Vital Signs Define Various determinations that provide information about the patients basic body condition Often the first sign that there is a problem

VITAL SIGNS Temperature Pulse Respirations Blood Pressure

Other Vital Signs Pain assessment Skin color Pupil size and reaction Level of consciousness Response to stimuli

Temperature Measurement of the balance between heat loss and heat produce Types Oral - mouth Rectal - rectum Axillary - armpit Aural (tympanic) – ear

Heat Produced and Lost Heat Produced Heat Lost Metabolism of food Muscle and gland activity Heat Lost Perspiration Respiration Excretion of feces and urine

Normal Body Temperature Normal range 97 – 100 degrees F

Variations in Normal Body Temperature Lower in morning Higher in evening Eating or drinking anything hot or cold, smoking a cigarette or exercising in the last 15 minutes Measured in degrees Celsius or degrees Fahrenheit

Oral Temperature Taken in the mouth Thermometer left in for 3-5 minutes Most common, convenient, comfortable way to take temperature Check for eating/drinking anything hot/cold exercising or smoking a cigarette 15 minutes prior

Rectal Temperature Taken in the rectum Thermometer left in for 3-5 minutes Most accurate Insert 1-1 ½ inches, hold in place and screen patient for privacy

Axillary/Groin Temperature Taken under the armpit or in the groin fold Thermometer left in for 8-10 minutes Least Accurate Dry armpit/groin, place in center and hold in place

Aural/Tympanic Temperature - taken in the ear - measures the thermal infrared energy radiating from the blood vessels in the eardrum - position and ear wax can affect readings -left in until it beeps -temperature is calculated into an equivalent by mode

Temperature By Body Site Oral Normal temp 98.6 Normal Range 97.6-99.6 Rectal Normal temp 99.6 Normal Range 98.6-100.6 Axillary/groin Normal temp 97.6 Normal Range 96.6-98.6 Tympanic Normal temp 98.6

Factors that Increase Temperature Illness Infection Exercise Excitement High temps in the environment

Factors that Decrease Temperature Starvation/fasting Sleep Decreased muscle activity Mouth breathing Exposure to cold temperatures Certain diseases

Temperature Conditions Hyperthermia Increased body temp Body temp >104ºF >106 ºF will cause convulsions and death Fever temp over 101 ºF R Due to illness or injury

Temperature Conditions Hypothermia Body temp below 96 ºF due to exposure to cold temperatures Depends on core temperature, age and length of exposure

Types of Clinical Thermometers Slender glass tube containing mercury or colored fluid Types Oral – blue tip, long slender bulb, marked oral Security – plain tip Rectal – red tip, short stubby bulb, marked rectal

Mercury Thermometers Not used now Colored column of red alcohol Toxic to the body and environment Can be absorbed through the skin and inhaled as a vapor through the lungs Heavy metal that accumulates in the brain and causes mental retardation

Clean up Broken Mercury Thermometer Use appropriate PPE’s Do not touch mercury Seal in a glass container Dispose according to regulations

Types of Thermometers Electronic Can be used for oral, rectal, or axillary Blue probe for oral Red probe for rectal Disposable probe covers prevent cross-contamination

- used to record temperature in the ear Tympanic - used to record temperature in the ear - Records temperature in 1-3 seconds

Positioning the Patients Ear for Tympanic temperature Infants under 1 year Pull ear pinna straight back Infants over 1 year and adults Pull ear pinna straight back and down Positioning the pinna correctly straightens the auditory canal so the probe will point directly at the tympanic membrane

Reading Thermometers Digital thermometers -until you hear the beep •Tympanic thermometers - hold in place for 2-3 seconds, remove and read

Reading a Glass Thermometer Hold thermometer at eye level Find the column of mercury/red liquid Each long hash mark represents one degree Each short hash mark represents 2/10th of a degree Exception: long line at 986 ºF represent normal body temperature

Charting a Temperature Use a superscript to record 10th’s 102.2 should be written as 102.2 This avoids errors Use a TPR Chart Mark temp under correct date and time Indicate method of taking temperature - R - rectal - Ax – axillary - T - tympanic No abbreviation indicates an oral temp

Clean A Clinical Thermometer Use warm water to clean and rinse Soak in a disinfecting solution such as alcohol for 20 minutes