1. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Chapter 16 Vital Signs

2. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:1 Measuring and Recording Vital Signs Vital signs provide information about a patient’s basic body conditions Temperature – Measure of balance between heat lost and produced by body – Usually measured on Fahrenheit scale

3. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:1 Measuring and Recording Vital Signs (continued) Pulse – Pressure of blood felt against wall of an artery – Rate: number of beats per minute – Rhythm: regularity – Volume: strength, force, or quality

4. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:1 Measuring and Recording Vital Signs (continued) Respirations – Patient’s breathing rate Blood pressure – Force exerted by blood against arterial walls Apical pulse – Taken with stethoscope at apex of heart

5. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:2 Measuring and Recording Temperature Temperature measures balance between heat lost and heat produced in the body – Heat lost through perspiration, respiration, excretion – Heat produced by food metabolism, muscle and gland activity Homeostasis – Constant state of fluid balance in the body

6. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Variations in Body Temperature Normal range: 97°to 100° Fahrenheit Causes of variations – Individual differences – Time of day – Body sites (refer to Table 16-1 in Text)

7. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Variations in Body Temperature (continued) Oral temperature Rectal temperature Axillary temperature Aural temperature Temporal temperature

8. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Variations in Body Temperature (continued) Hypothermia – Body temperature below 95°F Pyrexia (fever) – Body temperature above 101°F Hyperthermia – Rectal body temperature exceeding 104°F

9. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Types of Thermometers Clinical thermometers – Slender glass tube containing mercury – Used by few health care agencies – Danger of mercury contamination Electronic thermometers – Used in most health care facilities

10. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Types of Thermometers (continued) Tympanic thermometers Temporal scanning thermometers – Accurate and noninvasive for internal body temperature Plastic or disposable thermometers

11. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Reading and Recording Temperature Record temperature to the nearest two-tenths of a degree Refer to Figure 16-9 in Text Record to avoid error in reading

12. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Cleaning Thermometers Clean thermometers thoroughly after each use Use cool water on glass thermometers to prevent breakage Disposable plastic sheath may be used Follow agency policies

13. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:3 Measuring and Recording Pulse Pulse – Pressure of blood pushing against the wall of an artery as the heart beats and rests Major arterial or pulse sites – Refer to Figure 16-18 in Text

14. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:3 Measuring and Recording Pulse (continued) Pulse rate – Number of beats per minute – Bradycardia: pulse rate under 60 beats/minute – Tachycardia: pulse rate over 100 beats/minute Pulse rhythm – Regularity of pulse – Arrhythmia

15. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:3 Measuring and Recording Pulse (continued) Pulse volume – Strength, force, quality, or intensity of pulse – Strong, weak, thready, bounding Factors that change pulse rate Measuring and recording radial pulse – Refer to Procedure 16:3 in Text

16. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:4 Measuring and Recording Respirations Respiration – Process of taking in oxygen and expelling carbon dioxide from lungs and respiratory tract One respiration – One inspiration (breathing in) and one expiration (breathing out)

17. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:4 Measuring and Recording Respirations (continued) Rate of respirations – Number of breaths per minute Character of respirations – Depth and quality of respirations Rhythm of respirations – Regularity of respirations/space between breaths

18. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:4 Measuring and Recording Respirations (continued) Abnormal respirations – Dyspnea – Apnea – Tachypnea – Bradypnea – Orthopnea – Cheyne-Stokes – Rales – Wheezing – Cyanosis

19. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:5 Graphing TPR Graphic sheets are used for recording temperature, pulse, and respirations (TPR) Presents a visual diagram of variations in patient’s vital signs May use color coding Refer to Procedure 16:5 in Text

20. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:5 Graphing TPR (continued) Factors affecting vital signs are often noted Computerized graphs may be printed or kept in the electronic health record (EHR) Graphic charts are legal medical records – Neat, legible, accurate – Correct all errors

21. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:6 Measuring and Recording Apical Pulse Pulse count taken with stethoscope at apex of the heart Usually ordered by physician Reasons for taking an apical pulse Protect patient ’ s privacy and avoid exposure

22. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:6 Measuring and Recording Apical Pulse (continued) Two heart sounds Pulse deficit – Difference between apical and radial pulse Refer to Procedure 16:6 in Text

23. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:7 Measuring and Recording Blood Pressure Measurement of pressure blood exerts on walls of arteries during various stages of heart activity Read in millimeters (mm) of mercury (Hg) on a sphygmomanometer Measurements read at two points

24. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:7 Measuring and Recording Blood Pressure (continued) Systolic pressure – Pressure in walls of arteries when left ventricle contracts Diastolic pressure – Constant pressure in walls of arteries when left ventricle is at rest

25. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:7 Measuring and Recording Blood Pressure (continued) Pulse pressure – Difference between systolic and diastolic pressure Hypertension (high blood pressure) – Greater than 140 mm Hg systolic, 90 mm Hg diastolic

26. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:7 Measuring and Recording Blood Pressure (continued) Hypotension (low blood pressure) – Less than 90 mm Hg systolic, 60 mm Hg diastolic Refer to Table 16-2 in Text for adult blood pressure classifications

27. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:7 Measuring and Recording Blood Pressure (continued) Individual factors can influence blood pressure readings, increase or decrease blood pressure Types of sphygmomanometers – Mercury – Aneroid – Electronic

28. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16:7 Measuring and Recording Blood Pressure (continued) AHA factors to observe for accurate readings – 5 minutes of quiet rest – Take two separate readings and average Correct cuff size is essential for accuracy Refer to Procedure 16:7 in Text