Vital Signs

14:1 Measuring and Recording Vital Signs (VS) Vital Signs are defined as various determinations that provide basic information about the basic conditions of the patient The 4 main vital signs (VS) Temperature (T) Pulse (P) Respiration (R) Blood pressure (BP)

Other Assessments on Patients Pain—patients asked to rate on scale of 1 to 10 (1 is minimal and 10 is severe) Color of skin Size of pupils and reaction to light Level of consciousness Response to stimuli

VS Readings Accuracy is essential Report abnormality or change If unable to get reading, ask another person to check As a health care worker, it is your responsibility to measure and record the VS of your patients

14:2 Measuring and Recording Temperature Measures balance between heat lost and heat produced in the body Heat produced by metabolism of food and by muscle and gland activity Homeostasis: constant state of balance in the body Conversion between Fahrenheit and Celsius temperature

Variations in Body Temperature Normal range 97- 100 degrees Fahrenheit Causes of variations –individual differences, time of day, body sites Temperature measurements—oral, rectal (often used on infants/children), axillary (arm pit) or groin, aural (ear), and temporal (forehead-is measuring the temp in the temporal artery)

Causes of Increased Body Temperature Illness Infection Exercise Excitement High temperatures in the environment

Causes of Decreased Body Temperature Starvation or fasting Sleep Decreased muscle activity Mouth breathing Exposure to cold temperatures in the environment Certain diseases

Thermometers Clinical thermometers – are used to record temperatures Glass – consists of a slender glass tube containing mercury or alcohol with red dye, which expands when exposed to heat Electronic – registers the temp on a viewer in a few seconds Tympanic – records aural temp in the ear Temporal – measures the temp in the temporal artery of the forehead Plastic or paper - contain special chemical dots/strips that change color when exposed to specific temps (continues)

Thermometers (continued) Reading thermometers and recording results: * Electronic & tympanic thermometers are easily read because of digital displays * Mercury thermometers should be held at eye level & rotated slowly to find the mercury Examples of how to record a temperature: 98.6 is an oral reading 99.6 (R) is a rectal reading 97.9 (Ax) is an axillary reading 98.6 (A) is an aural reading

Cleaning Thermometers Must be cleaned after each use The procedure will vary with different agencies and thermometers Glass thermometers are cleaned with water and soaked in a disinfectant solution (70% alcohol) for a minimum of 30 minutes before using again Electronic/digital thermometers use a probe or sheath that is discarded after each use

14:3 Measuring and Recording Pulse Pressure of the blood pushing against the wall of an artery as the heart beats and rests Major arterial or pulse sites Pulse rate Pulse rhythm Pulse volume (continues)

Measuring and Recording Pulse (continued) Factors that change pulse rate Basic principles for taking radial pulse Recording information

14:4 Measuring and Recording Respirations Measures the breathing of a patient Process of taking in oxygen and expelling carbon dioxide from the lungs and respiratory tract One respiration: one inspiration (breathing in) and one expiration (breathing out) (continues)

Measuring and Recording Respirations (continued) Normal respiratory rate Character of respirations Rhythm of respirations Abnormal respirations Voluntary control of respirations Record information

14:5 Graphing TPR Graphic sheets are special records used for recording TPR (temp., pulse, resp.) Presents a visual diagram Used most often in hospitals and long term care facilities Factors affecting VS are often noted on the graph - - examples include surgery, medications that lower temperature such as aspirin and antibiotics (continues)

Graphing TPR (continued) Graphic charts are legal records – so it must be neat, legible, and accurate To correct an error mark a single line through the error and initial beside it

14:6 Measuring and Recording Apical Pulse Pulse count taken at the apex of the heart with a stethoscope Reasons for taking an apical pulse – pts with irregular heart beats, hardening of the arteries, weak or rapid radial pulses Protect the patient’s privacy and avoid exposure 2 heart sounds “lubb-dupp” = 1 heart beat Abnormal sounds or beats should be reported immediately (continues)

Measuring and Recording Apical Pulse (continued) Pulse deficit – a condition that occurs with some heart conditions – when the apical pulse rate is higher than the pulse rate on other sites on the body Use the stethoscope : diaphragm side Placement of stethoscope : 2-3in. to the left of the breast bone Measuring apical pulse : count for 1 full min. Record all information

14:7 Measuring and Recording Blood Pressure Measurement of the pressure the blood exerts on the walls of the arteries during the various stages of heart activity Measured in millimeters of mercury on a sphygmomanometer Measurements read at two points (continues)

Measuring and Recording Blood Pressure (continued) Systolic pressure Diastolic pressure Pulse pressure Hypertension—high blood pressure Hypotension—low blood pressure Factors influencing blood pressure readings (high or low) (continues)

Measuring and Recording Blood Pressure (continued) Individual factors can all influence blood pressure readings Types of sphygmomanometers Mercury Aneroid Electronic (continues)

Measuring and Recording Blood Pressure (continued) Factors to follow for accurate readings Record all required information Do not discuss the reading with the patient; it’s the doctor’s responsibility

Summary Vital signs are major indicators of body function Accuracy of measurement and recording of vital signs The health care worker needs to be alert and report any abnormalities