1. Vital Signs
Signs of Life

2. Vital Signs (VS) Learning Objectives: Overview of Vital Signs
5 main VS
Definition of Pulse
How to obtain & accurately measure each pulse
Identify sites for assessing pulse
Practice accurate measuring of pulse and recording results
Medical Terminology

3. Vital Signs Assignments: Discussion Articles Reading Textbook
Note taking
Handouts
Pulse Points
Graphic Chart
Review

4. Vital Signs (VS) Discussion
How many of you have been to the doctor?
What is the first thing they do when you are taken back to the exam room?
Why is it important to obtain all patient’s VS?
How often should we take a patient’s VS?
What can VS tell us about our patients?
Is it important to know what a patient’s normal set of VS is? Why?
What do we do when VS are abnormal or out of normal range?

5. Vital Signs Vitals = Life
Defintion: Important information about the condition of a patient’s body
Detect Changes in normal body function
May signal life-threatening condition
Provide responses to treatment
Usually taken at rest with person sitting or lying down

6. Types of Vitals Five Main Vital Signs: Documented as:
Temperature (T)
Pulse(P) = heart rate
Respirations(R)
Blood Pressure(BP)
Pain Score
Documented as:
TPR, BP and Pain Score

7. Vitals are Measured Upon admission
As often as required by the person’s condition
Before and after surgery
After a fall or accident
When given a drug that can affect a person’s respiratory or circulatory system
When patient complains of pain, dizziness, shortness of breath (SOB) or chest pain

8. Vital Facts about Assessing Vitals
Any extreme variations must be reported immediately
Extreme abnormal high or low rates must be reported immediately
If unable to obtain report immediately
Certain factors will change readings of vitals especially pulse, respirations and BP.
Increased rate can be affected by
Exercise
Stimulate drugs
Excitement
Fever
Shock
Anxiety

9. Decreased rates can be affected by:
Sleep
Depressant drugs
Heart Disease
Coma
Physical Training

10. Pulse

11. Read in diversified textbook pages 431-433 15:3

12. Pulse (P)
Definition: pressure of the blood felt against the wall of an artery as the heart beats
Pulse Characteristics:
Rate = # of beats per minute
Rhythm = regularity / irregularity
Volume - = strength – described as strong, weak or bounding

13. Pulse (P)
Obtained:
by palpation (to feel) of an artery and count the number of beats (lubb dubb is one). If regular can count 15 sec. X 4 or 30 sec. X2. If irregular count full 60 seconds
or auscultation (to hear) of an artery
Normal:
-rate = varies by age, sex and body size
- rhythm = regular
- volume = strong, not bounding

14. Bradycardia – less than 60 bpm Tachycardia – greater than 100bpm
Pulse (P) Terminology
Bradycardia – less than 60 bpm
Tachycardia – greater than 100bpm
Arrythmia – irregular heart beat -

15. Pulse Points Temporal – side of the forehead
Carotid – neck (used during child/adult CPR)
Brachial – inner aspects of forearm at the antecubital (crease of the elbow). Used for BP and infant CPR
Apical – below left breast. Most accurate pulse point. Use stethoscope and count for a full minute.
Radial – at the inner aspects of the wrist, above the thumb (thumb-side). Most common site to assess pulse.
Femoral – at the groin (inner side) Used for assessment and procedures
Popliteal – behind the knee. Used for assessment
Dorsalis pedis – top of the arch of the foot (between Big Toe and 2nd toe)

16. Pulse Normal Ranges Age Infant Child 1-7 years old Child 7-12
12 years and older
Pulse Per Minute
80-110
70-90
60-90

17. Charting Vital Signs
See graphing handout

18. Temperature

19. Temperature (T)
Definition: the measurement of the balance between heat loss and heat produced by the body
Obtained:
Oral – mouth – 98.6
Rectal – rectum
tympanic/aural – 98.6
axillary – armpit or groin
Temporal – forehead scan -99.6

20. Temperature (T) Measured: Degrees Fahrenheit / Celsius
Normal Body Temp – 98.6 F / 37
Temp affected by:
Body processes
Time of day (lower in morning; higher in afternoon after muscular activity)
Where temp obtained

21. Inhale & Exhale
Respirations

22. Respirations(R) Definition: reflection of breathing rate of patient
Normal RR = or 12-20
Obtained:
look, listen, feel
Measured by :
Rate = # of breaths per minute
Rhythm = regular / irregular
Character = labored, non-labored, shallow,

23. Respiratory Terminology
Dyspnea-difficult or labored breathing
Apnea- absence of breathing
Tachypnea- fast breathing
Bradypnea- slow breathing
Orthopnea-difficulty breathing when position changes
Cheyne-Stokes-dyspnea with periods of apnea
Rales- bubbling breath sounds fluid in lungs
Wheezing- high-pitched whistling during expiration
Cyanosis-blue

24. Blood Pressure
Definition – Measurement of the pressure that the blood exerts on the walls of the arteries during the various stages of heart activities.
Systolic pressure - occurs in the walls of the arteries when the left ventricle of the heart is contracting. Top number of the blood pressure.
Diastolic pressure – is the constant pressure in the walls of the arteries when the left ventricle is relaxing. Bottom number of the blood pressure.
Normal Systolic =
Normal Diastolic = 60-90
120/90 example of writing a BP
Hypertension- High BP (systolic > 140 or diastolic >90)
Hypotension – Low BP
Sphygmomanometer- instrument used to measure blood pressure in millimeters of mercury. Each line is gauged by 2 mmHg

25. -algia
Pain

26. Pain 5th VS Is a subjective symptom Measured:
By severity on a scale of 0 – 10
According to location
By description – sharp, stabbing, dull, etc.
By occurrence: constant vs. intermittent
Obtained:
From patient via verbal or non-verbal communication

27. Review
Abbreviations: VS BP R
TPR Sx F C
bpm

28. Review
Name the 5 VS
2. What is the most common site for taking a pulse?
3. What is the heart rate less than 60 bpm called?
4. Give one reason that an apical pulse should be taken.
5.What is an irregular heart rate called?
6. Why is it important to obtain a person’s VS?
7. Give three instances when vitals should be obtained.