1. 3.01 Understand Diagnostic and Therapeutic Services
Vital Signs
Provide information about body function
Include:
temperature
pulse
respiration
blood pressure
Changes may be the first
sign of disease
3.01 Understand Diagnostic and Therapeutic Services 1

2. Vital Signs Accuracy is imperative! REPORT ABNORMAL RESULTS
OF ANY VITAL SIGN
IMMEDIATELY
3.01 Understand Diagnostic and Therapeutic Services 2

3. PATIENT ASSESSMENT AND DIAGNOSIS
Measuring and Recording Temperature
Measurement of balance between heat produced and heat lost by the body.
Lost through: Perspiration Respiration
Excretion
Produced by:
Metabolism of food
Muscle and gland activity

4. PATIENT ASSESSMENT AND DIAGNOSIS
If metabolism and muscle/gland activity increase temperature, when would your temperature be the highest during the day????
Temperature is usually higher in the evening.
Temperature is measured in:
F = Fahrenheit
C = Celsius

5. PATIENT ASSESSMENT AND DIAGNOSIS
Factors that  body temperature
Illness
Infection
Exercise
Excitement
High temperatures in the environment

6. PATIENT ASSESSMENT AND DIAGNOSIS
Factors that  body temperature
Starvation or fasting
Sleep
Decreased muscle activity
Exposure to cold in the environment
Certain diseases

7. PATIENT ASSESSMENT AND DIAGNOSIS
Fever elevated temperature, above 101º F
“febrile” “pyrexia” words to indicate fever
“afebrile” without fever
Hyperthermia elevated temperature, above 104º F
Temperatures above 106º F can
lead to convulsions and death

8. PATIENT ASSESSMENT AND DIAGNOSIS
Hypothermia below 95º F
Caused by prolonged exposure to cold
Death when temp below 93º F

9. Vital Signs Temperature
Sites to measure temperature:
Oral – mouth
Rectal – rectum
Aural – auditory canal
Axillary – armpit
3.01 Understand Diagnostic and Therapeutic Services 9

10. PATIENT ASSESSMENT AND DIAGNOSIS
Oral In the mouth (probe is blue) Most common
Normal 98.6º F or 37º C
Eating, drinking hot or cold liquids, or smoking can alter oral temperature. Wait 15 minutes before taking the temperature.
Rectal Most accurate (probe is red)
Normal 99.6º F or 38.6C

11. PATIENT ASSESSMENT AND DIAGNOSIS
Aural In the ear
Usually in less than 2 seconds
Normal 98.6º F,
measures “core” or “blood temperature”
Axillary Armpit Normal 97.6º F
Least accurate

12. PATIENT ASSESSMENT AND DIAGNOSIS
Measuring and Recording Pulse
The pressure of blood pushing against the wall of an artery as the heart beats and rests
There are 3 that should be noted about every pulse:
Rate
Rhythm
Volume

13. PATIENT ASSESSMENT AND DIAGNOSIS
RATE number of beats
per minute, when using
radial pulse, counted for 15
seconds and x 4
Average pulse =72
Normal range=
Bradycardia below 60 beats
per minute
Tachycardia above 100 beats

14. PATIENT ASSESSMENT AND DIAGNOSIS
RHYTHM
Is the pulse
regular OR
Irregular
What is an irregular rhythm called??
arrhythmia

15. PATIENT ASSESSMENT AND DIAGNOSIS
VOLUME indicates strength/intensity
Is the pulse
“bounding” and strong
or is it weak and “thready”

16. PATIENT ASSESSMENT AND DIAGNOSIS
Pulse can be increased by:
Exercise
Stimulant drugs
Excitement
Fever
Shock
Nervous tension
Pulse can be decreased by:
Sleep
Depressant drugs
Heart disease
Coma

17. PATIENT ASSESSMENT AND DIAGNOSIS
Radial Artery
Temporal Artery
Carotid Artery
Brachial Artery
Femoral Artery
Popliteal Artery
Dorsalis Pedis Artery

18. PATIENT ASSESSMENT AND DIAGNOSIS
Apical Pulse
Taken with a stethoscope,
at the apex of the heart
Heart sounds heard resemble “lubb-dubb”
Why would you take an apical pulse instead of a radial pulse??
Irregular pulse
Infant/child due to rapid pulse rate

19. PATIENT ASSESSMENT AND DIAGNOSIS
Measuring and Recording Respiration
Respiration is the process of exchanging O2 and CO2
Pulmonary Ventilation =1 inspiration + 1 expiration
Normal rate = 14 – 18 per minute

20. PATIENT ASSESSMENT AND DIAGNOSIS
Character – depth and quality of respirations
Are they:
Deep
Shallow
Labored/Difficult
Moist (fluid heard in lungs)

21. PATIENT ASSESSMENT AND DIAGNOSIS
Dyspnea – difficult or labored breathing
Apnea – absence of respirations
Cheyne-Stokes – periods of dyspnea followed by periods of apnea; noted in the dying patient
Tachypnea > 25 breaths /minute

22. PATIENT ASSESSMENT AND DIAGNOSIS
Bradypnea < 10 breaths/minute
Wheezing high pitched sound, heard in asthmatics
Rales – bubbling sounds caused by fluids or
mucus in the air passages, heard in bronchitis

23. PATIENT ASSESSMENT AND DIAGNOSIS
Measuring and Recording Blood Pressure
BP is the pressure blood exerts on the walls of arteries
Read in millimeters (mm) of mercury (Hg)
Instrument is known as a sphygmomanometer
or BP cuff
Usually aneroid or mercury, although many hospitals are using electronic.

24. PATIENT ASSESSMENT AND DIAGNOSIS
Systolic: pressure on the walls of arteries when the heart contracts to pump blood to the body
This is the 1st sound heard when obtaining a BP
Normal range – 100 to 140 mm Hg
Diastolic: constant pressure on heart/arteries even when they are at rest or in the relaxation phase
This is the last sound heard when obtaining a BP
Normal range – 60 to 90 mm Hg
Blood pressure is recorded as a
fraction = systolic/diastolic
120/ /70

25. PATIENT ASSESSMENT AND DIAGNOSIS
Factors that  blood pressure
Excitement, anxiety, nervous tension
Stimulant drugs
Exercise and eating
Factors that  blood pressure
Rest or sleep
Depressant drugs
Shock
Excessive loss of blood

26. PATIENT ASSESSMENT AND DIAGNOSIS
Hypertension BP > 140/90
Hypotension BP < 100 systolic
Orthostatic hypotension BP when you get up suddenly,
Body isn’t able to respond to sudden change in BP
BP is highest when you are lying down and
lowest when you are standing

27. PATIENT ASSESSMENT AND DIAGNOSIS
Measuring/Recording Height and Weight
Used to determine if a patient is underweight or overweight
Height/weight chart
used as averages
+ or - 10% considered normal

28. PATIENT ASSESSMENT AND DIAGNOSIS
When are height-weight measurements routinely done in a health care setting?
Admission to the hospital
Part of a general physical
Babies and children
Necessary for calculating medicine dosages and some lab values

29. PATIENT ASSESSMENT AND DIAGNOSIS
Daily Weights
Usually ordered for patients with edema due to heart, kidney, or other diseases. (fluid weight)
Be sure to:
Use the same scale every day
Weigh the patient at the same time each day
patient is wearing the same amount of clothing each day (2 lbs.)
OBSERVE SAFETY PRECAUTIONS!

30. PATIENT ASSESSMENT AND DIAGNOSIS
Types of Scales
Clinical scales contain a balance beam
and measuring rod.
Bed scales or chair scales.
Infant scales

31. PATIENT ASSESSMENT AND DIAGNOSIS
When weighing an infant…keep one hand slightly over but not touching the infant
A tape measure is used to measure infant height.
Make a mark on the exam table paper at the top of the head.
Stretch out the infant's leg and make a mark the paper at the heel.
Use a tape measure to measure from mark to mark.