1. Vital signs/ Anthropometric Measurements
Dr. Jennifer Lucy

2. Vital sign
Vital signs are physical signs that indicate an individual is alive
Includes heart beat, respiratory rate, temperature, blood pressures and recently oxygen saturation.

3. Vital sign Signs may be observed, measured, and monitored
Assess an individual's level of physical functioning.

4. Vital sign
Before measurements, patient should sit for five minutes.

5. Observation Does the patient seem anxious, in pain, upset?
Remember, anxiety can affect vital sign results

6. Temperature
Vital signs

7. Temperature Babies and young children tend to have higher temperatures
Elderly clients tend to have lower, hence a 97.9 might be a fever.

8. Temperature Body temperature of affected by Gender Recent activity
Food and fluid consumption
Menstrual cycle.

9. Normal Temperature Fahrenheit/Celcius
Normal Range: F – 99 F equivalent to 36.5 C-37.2 C

10. Oral Oral ( do not take after food or smoking for 30 mins
Place probe under tongue
Second most accurate route after rectal
Converting F to C
-30 then divide by 2
C to F
x2 + 30

11. Temperature ( Rectal )
Rectal temperatures tend to be 1° higher than when taken by mouth.
Position patient in Sims ( left side lying position
Insert probe 1 inch for patients over 6 months old
½ inch for under patients under 6 months old

12. Temperature ( Axillary)
Axillary temperatures can be taken under the arm.
Temperatures taken by this route tend to be 0.3 to 0.4° (Fahrenheit) lower than those temperatures taken by mouth.

13. Tympanic ( Aural) Measure’s body's core temperature
For patients over 3 years gently pull pinna up and out
For under three years gently pull pinna down and back .

14. Temporal
Measures infrared heatwaves across skin of forehead

15. Fever
A fever is indicated when body temperature rises above orally or 99.8° F rectally.

16. Hypothermia/ Hyperthermia
Hypothermia is defined as a drop in body temperature below 96° F.
Hyperthermia is defined as a rise in body temperature above 104 F.

17. Respiratory rates
Vital signs

18. What is the respiratory rate?
The respiration rate is the number of breaths a person takes per minute.

19. Respiratory Rate
Try to do this as surreptitiously as possible. Observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse.

20. Respiratory Rate
Breaths should be counted for at 30 second then times by 2 if regular
Count for one minute if irregular

21. Respiratory Rate
Respiration rates may increase with fever , illness or pain

22. Respiratory Rate
Normal respiration rates at rest range from 12 to 20 breaths per minute. 12 20

23. Abnormal Respiratory Rate
Bradypnea under 12 breaths per minute
Tachypnea over 20 breaths per minute
under 12 breaths
over 20 breaths

24. Pulse
Vital signs

25. Pulse rate
The normal pulse for healthy adults ranges from 60 to 100 beats per minute.

26. Pulse rate
The pulse rate may fluctuate and increase with exercise, illness, injury, and emotions. Girls ages 12 and older and women, in general, tend to have faster heart rates than do boys and men.

27. Pulse rate
Athletes, such as runners, may have heart rates in the 50's and experience no problems.

28. Radial pulse
You feel the beats by firmly pressing on the arteries, which are located close to the surface of the skin at certain points of the body.

29. How to check your carotid pulse
The carotid pulse can be found on the side of the lower neck,.

30. Pulse: Quantity Regular Pulse Irregular
Measure the rate of the pulse (recorded in beats per minute). Count for 30 seconds and multiply by 2 (or 15 seconds x 4)
Measure for a full minute
Regular Pulse
Irregular

31. Pulse: Regularity
Is the time between beats constant?. Irregular rhythms, are quite common.

32. Brady / Tachycardia
Below 60: Bradycardia
Above 100: Tachycardia

33. Average Heart rate by Age
New born bpm
Infant ( 1 to 12 months) bpm
Toddler (1-3 years) bpm
Preschool (3-5-years )80-120bpm
School age ( 6-15) bpm
Adult ( over 15 years) bpm

34. Blood pressure
Vital signs

35. Preparation for measurement
Patient should abstain from eating, drinking, smoking and taking drugs that affect the blood pressure 30 mins before measurement. 

36. Position of the Patient
Sitting position
Arm and back are supported.
Feet should be resting firmly on the floor
Feet not dangling. 

37. Equipment needed to measure blood pressure
Adult Cuff size
Indications for large cuff or thigh cuff
Upper arm circumference >34 cm
Indications for forearm cuff (with radial palpation)
Upper arm circumference >50 cm

38. Blood Pressure
If cuff is too small, the readings will be artificially elevated. The opposite occurs if the cuff is too large. Clinics should have at least 2 cuff sizes available, normal and large.

39. Cuff position Patient's arm slightly flexed at elbow
Push the sleeve up, wrap the cuff around the bare arm

40. In order to measure the Blood Pressure (Cuff Position)
Cuff applied directly over skin (Clothes artificially raises blood pressure )
Position lower cuff border about 2 inches above antecubital
Center inflatable bladder over brachial artery

41. What Abnormal Results Mean

42. Blood pressure for adult
Physician will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of hypertension and initiating treatment.

43. Blood pressure (mm Hg) Normal blood pressure Systolic 100 to 119
Diastolic 60 to 79
Pre hypertension
Systolic 120 to 139
Diastolic 80 to 89

44. Hypertension
High blood pressure greater than

45. Hypertension Stages STAGE ONE ( Primary) Systolic140-159
Diastolic 90-99
STAGE TWO
Systolic 160 or higher
Diastolic 100 or higher

46. Hypertensive Crisis
Systolic 180 or above
Diastolic 110 or above

47. Hypotensive stage
Systolic less than 90
Diastolic less than 60

48. Blood pressure may be affected by many different conditions
Cardiovascular disorders
Neurological conditions
Kidney and urological disorders

49. Blood pressure may be affected by many different conditions
Preclampsia in pregnant women
Psychological factors such as stress, anger, or fear
Eclampsia

50. PALPABLE B/P Feel for radial pulse Inflate cuff
Feel when pulse is no longer palpable
Add 30
That is your starting point when you do B/P

51. Oxygen Saturation
Vital signs

52. Oxygen Saturation
Oxygen Saturation provides important information about oxygen perfusion
Normal levels %
Make sure patient has no nail polish on
Make sure hand is flat on table
Capillary refill should be less than 3 seconds.

53. Height Procedure Place paper towel on scale Place scale at Zero Point
Remove shoes
Stand straight
Measure client
Convert 5 feet 6 inches to inches
5 ft x12=60inches +6=66 inches
66 inches x 2.54=
167.64cm

54. Weight Place paper towel on scale Place scale on zero
Guide client onto scale
Read scale
Convert weight from lbs to kg by multiplying pounds by 0.45
140lbx0.45=63kg.
For kg to pounds
Multiply kg by 2.2
83kgx2.2=183lb

55. Pediatric Anthropometric Measurement Birth to 3 years
Head Circumference
Lay baby on back in supine position
Zero mark is placed at forehead. Bring around head just above the ears
Length
Gently extend leg
Measure length from head to foot
Weight
Set scale
Remove diaper
Place in middle of scale

56. Body Mass Index Take height and weight Calculate BMI BMI Values
Normal
Underweight<18.5
Overweight>
Obese>30

57. Pain Scale
0 – Pain free.
Mild Pain – Nagging, annoying, but doesn't really interfere with daily living activities.
1 – Pain is very mild, barely noticeable. Most of the time you don't think about it.
2 – Minor pain. Annoying and may have occasional stronger twinges.
3 – Pain is noticeable and distracting, however, you can get used to it and adapt.
Moderate Pain – Interferes significantly with daily living activities.
4 – Moderate pain. If you are deeply involved in an activity, it can be ignored for a period of time, but is still distracting.
5 – Moderately strong pain. It can't be ignored for more than a few minutes, but with effort you still can manage to work or participate in some social activities.
6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating.

58. Severe Pain – Disabling; unable to perform daily living activities.
7 – Severe pain that dominates your senses and significantly limits your ability to perform normal daily activities or maintain social relationships. Interferes with sleep.
8 – Intense pain. Physical activity is severely limited. Conversing requires great effort.
9 – Excruciating pain. Unable to converse. Crying out and/or moaning uncontrollably.
10 – Unspeakable pain. Bedridden and possibly delirious. Very few people will ever experience this level of pain.

59. Pain scale pictures