1. Medical Foundations by Dr. Z
VITAL SIGNS
Medical Foundations
by Dr. Z

2. Vital Signs (Signs of Life)
Temperature (usually in degrees Fahrenheit)
Pulse (heart beats per minutes)
Respirations (inhalations and exhalations per minute)
Blood Pressure (1 reading, two numbers)
Other important items:
Pupil size and symmetry
Oxygen concentration (percentage)

3. TEMPERATURE afebrile hypothermia pyrexia pyrogenic
a = without, febrile = fever
hypothermia
Below 950 F
pyrexia
Above normal temperature
pyrogenic
Anything that causes fever

4. Types of Thermometers Aural (ear) Temporal Artery (forehead)
Chemically Treated Paper or Plastic
Electronic/Digital Thermometer

5. Sites to Take Body Temperature
Oral: mouth
Simple and most common, convenient, and comfortable site. Ranges from to 99.60
Rectal: above the anus
Used on young patients or those who mouth breathe. Most accurate. Ranges from to
Aural: ear canal
Accurate, easy to use. Normal is 98.60
Axillary: armpit
Least accurate. Normal range is to 98.60
Use this site if the first three are not available.

6. PULSE
Definition = pressure of the blood on the walls of arteries as the heart contracts and relaxes
Throbbing pattern; indicates how well the blood is circulating around the body
Measured in beats per minute (bpm)
Count for 15 seconds and multiply by 4 = 60 seconds
Count for 30 seconds and multiply by 2 = 60 seconds

7. Pulse Sites temple neck apex of the heart inside elbow groin wrist
back of knee
top of foot

8. PULSE CHARACTERISTICS
Rate: number of beats per minute
Normal beats per minute
Over 100 = tachycardia
Under 60 = bradycardia
Rhythm: regularity of beats
steady or uneven?
irregular pulse = arrhythmia
Volume: strength of pulse
bounding = forceful
thready = weak

9. RESPIRATIONS Taking oxygen (O2) into the body
Inhale, inspiration, breathing in
Expelling carbon dioxide (CO2) out of the body
Exhale, expiration, breathing out
1 breath in + 1 breath out = 1 respiration
Watch the chest rise and fall.
*Do not let the patient know that you are measuring his/her respiratory rate or they may not breathe normally. Do while taking blood pressure.

10. RESPIRATORY CHARACTERISTICS
Rate = number per minute
Normal is per minute
Rhythm = regularity of breathing
Quality = amount of air exchanged and effort it takes to breathe

11. RESPIRATORY CHARACTERISTICS
Dyspnea
shortness of breath, difficulty breathing
Tachypnea
abnormally fast breathing
Apnea
no breathing present
Cheyne-Stokes
labored breathing followed by apnea
Rales; Wheezing
bubbling or rattling sounds; wheezing noise

12. OXYGEN CONCENTRATION
Pulse oximeter = measures oxygen in arteries by passing infrared light through vascular bed
Fingertip, ear lobe, bridge of nose, or toe
Indicator of respiratory and cardiac condition
Normal is 95 – 100% oxygen
Below 90% calls for oxygen treatment

13. Pupil size can change from 2 millimeters to 8 millimeters
Pupil size can change from 2 millimeters to 8 millimeters. This means that by changing the size of the pupil, the eye can change the amount of light that enters it by 30 times.
PEARRL:
Pupils
Equally
Round and
Reactive to
Light
If a patient’s pupils are not PEARRL, that patient is in severe distress, usually from an acute spinal cord or head injury/stroke in brain. Rush to E.R.
PUPILS

14. PUPIL SIZE Glaucoma: mid-dilated pupil may be a sign
Aneurysm: dilated pupil
Brain tumor: problems within the pupil
Recreational drug use: dilated or constricted
Medications: dilated pupils
Head trauma: unequal pupils
Cluster headaches: constricted pupil
Stroke: changes in the size
Syphilis: small, unequal, misshapen pupils that constrict with near focusing but do not react normally to light

15. BLOOD PRESSURE

17. Tips for Taking Blood Pressure

18. How to take a blood pressure reading:
1) Make sure the proper size cuff is circled around the upper arm and fixed in place.
2) Inflate the cuff
3) Listen to the brachial artery at the edge of the lower part of the cuff.
4) When beats first become audible: systolic pressure
5) When beats are last audible: diastolic pressure
Written as: (for example): 120/80 (systolic pressure over diastolic pressure)