Vital Signs

What do you already know about vital signs? With a partner, write down as many facts as you know about vital signs.

Essential Question What does temperature tell the nurse about a patient’s condition?

Vital Signs Important indicators of health states of the body. Provide information about the basic body conditions of a patient. Four main vital signs: temperature, pulse, respiration, blood pressure Pain is often referred to as the 5th vital sign

Temperature (T) Measurement of the balance between heat lost and heat produced by the body. Lost : perspiration, respiration, excretion Produced: metabolism of food, muscle and gland activity

Temperature (T) Homeostasis ~ balance Ability to maintain a constant internal environment in response to environmental changes Body temperature too high or too low, homeostasis is affected.

Temperature (T) Usually measured in Fahrenheit, but many places are converting to Celsius. ˚C=(˚F - 32) X 0.5556 ˚F=(˚C X 1.8) + 32

Convert the Following Temperatures ˚C = (˚F - 32) X 0.5556 100.2˚F = ?˚C 99.2˚F = ?˚C

Convert the Following Temperatures ˚C = (˚F - 32) X 0.5556 100.2˚F (100.2 - 32) X 0.5556 68.2 X 0.5556 = 37.9˚C 99.2˚F (99.2 - 32) X 0.5556 67.2 X 0.5556 = 37.3˚C

Convert the Following Temperatures ˚F = (˚C X 1.8) + 32 38.8˚C = ?˚F 37.6˚C = ?˚F

Convert the Following Temperatures ˚F = (˚C X 1.8) + 32 38.8˚C (38.8 X 1.8) + 32 69.84 + 32 = 101.8˚F 37.6˚C (37.6 X 1.8) + 32 67.68 + 32 = 99.7˚F

Temperature (T) Normal range = 97˚ - 100˚ F Average temperature = 98.6˚ F / 37˚ C Reasons for variations in range Individual differences ~ some people run cooler or hotter Time of day ~ higher in evening Body site ~ different areas of the body run hotter or cooler

Temperature (T) Febrile ~ running a fever (above 101˚F) Afebrile ~ without fever Oral temperature ~ taken by mouth Rectal ~ taken by rectum Axillary ~ taken by armpit Aural (tympanic)~ taken by ear

Temperature (T) When using a clinical (glass) thermometer each line represents 0.2 degrees. Electronic and clinical thermometers have coverings to prevent cross-contamination.

Handout Reading a glass thermometer

Temperature (T) Causes of increased temperature Illness Infection Exercise Excitement High temperatures in the environment

Temperature (T) Causes that decrease temperature Starvation or fasting Sleep Decreased muscle activity Mouth breathing Exposure to cold temperatures in the environment Certain diseases (homonal/thyroid/addisons)

Temperature (T) Hypothermia ~ below 95˚ F Hyperthermia ~ above 104˚ F Caused by prolonged exposure to cold Death when temp below 93˚ F Hyperthermia ~ above 104˚ F Caused by prolonged exposure to hot temperatures, brain damage, or serious infection Temperatures above 106˚F can lead to convulsions and death

Review Define the following terms: Afebrile ~ Febrile ~ Hypothermia ~ Hyperthermia ~ Homeostasis ~ What are the four vital signs? What is the normal range for temperature?

Pulse The pressure of the blood pushing against the wall of an artery as the heart beats and rests. IN OTHER WORDS…throbbing of the arteries that is caused by the contractions of the heart.

Pulse More easily felt in arteries that lie close to the skin and can be pressed against a bone by the fingers. Temporal ~ side of head Carotid ~ neck Brachial ~ elbow Radial ~ wrist Femoral ~ upper thigh (groin area) Popliteal ~ behind knee Dorsalis pedis ~ top of foot Can you locate these pulses on yourself?

Rate of a Pulse Measured as the number of beats per minute. (BPM) Pulse rates vary depending on age, sex, and body size. As the cardiovascular system matures with age, the pulse rate decreases. Women tend to have a faster pulse than men

Average Range of Pulse Adults: 60-80 BPM Children over 7yrs : 70-100 BPM Children 1yr-7yrs : 80- 110 BPM Infants : 100-160 BPM

Pulse Rate Terms Bradycardia ~ pulse rate below normal range Causes: physically fit, medications, severe lack of oxygen Tachycardia ~ pulse rate over normal range Causes: physical/mental stress, pain, exercise, infection, lack of oxygen, low blood pressure

More Pulse Terms Antecubital space ~ bend of the elbow Where the brachial pulse is found Palpate ~ feeling a pulse Use you first two-three fingers Auscultate ~ hearing a pulse Use a stethoscope

With Your Table Partner Using the radial pulse palpate your partner’s pulse and determine the rate.

Respiratory Rate Respiration ~ process of taking in oxygen and expelling carbon dioxide from the lungs and respiratory tract. Inhalation + exhalation = 1 breath Rate = breaths per minute Respirations must be counted in such a way that the patient is unaware of the procedure.

Respiratory Rate Measure the rise and fall of the chest in adults. Measure the rise and fall of the abdomen in young children. Normal respiration rate Adult = 12-20 RR Child = 16-30 RR Infant = 30-50 RR

Abnormal Respirations Apnea ~ absence of respirations (usually temporary) Tachypnea ~ rapid, shallow respiratory rate (above 25 RR) Bradypnea ~ slow respiratory rate (below 10 RR)

With Your Table Partner Observe the rise and fall of your partners chest. Count the respirations for one minute and determine your partners respiration rate.

Lesson Essential Question What does blood pressure tell us about a person’s health?

Think Pair-Share Tell your partner one thing you know about blood pressure.

Blood Pressure (BP) (BP) ~ Measurement of the pressure that the blood exerts on the walls of the arteries as blood pulsates through them Blood Pressure reading is measured in millimeters (mm) of mercury (Hg) Sphygmomanometer ~ instrument used to measure blood pressure.

Types of Blood Pressure Measurements Systolic ~ pressure that occurs when the heart is contracting. Diastolic ~ pressure that is present when the heart is at rest. BP is recorded as a fraction. Systolic reading is the top number Diastolic reading is the bottom number

Blood Pressure Measurements Normal Range: Systolic: 100-120mm Hg Diastolic: 60-80mm Hg Hypertension ~ high blood pressure Systolic: >140mm Hg Diastolic: > 90mm Hg Hypotension ~ low blood pressure Systolic: < 90mm Hg Diastolic: < 60mm Hg

Blood Pressure Measurements Prehypertension ~ warning that high blood pressure will develop unless steps are taken to prevent it. Systolic: 121-139mm Hg Diastolic: 81-89 mm Hg

Write the following blood pressure readings on a sheet of paper Write the following blood pressure readings on a sheet of paper. Label each as normal, pre-hypertension, hypertension or hypotension. 134/80 mm Hg 110/91 mm Hg 146/70 mm Hg 100/70 mm Hg 180/90 mm Hg 82/66 mm Hg 188/98 mm Hg 120/78 mm Hg 88/68mm Hg 166/ 78mm Hg Compare your answers with your partners. Discuss any discrepancies and determine a unified answer.

Causes of Hypertension Stress Anxiety Obesity High salt intake Aging Kidney disease Vascular conditions Hypertension is often called the “silent killer” Why do you think??? Share with your partner.

Causes of Hypotension Heart failure Dehydration Depression Severe burns Hemorrhage Shock

Sites for Taking Blood Pressure Blood Pressure can be obtained from any artery. A pulse site is used in the assessment Common areas for BP Brachial ~ taken in upper arm Radial ~ taken on the lower arm Popliteal ~ taken on the thigh Doralis pedis ~ taken on the lower leg video