1. Vital Signs
Fundamentals Unit 5

2. Vital Signs- Temperature
Temperature terms:
Afebrile-not having elevated temperature
Cardinal symptoms- Vital Signs
Febrile- having as elevated body temperature
Hypothermia- decreased body temperature
Hyperthermia- elevated body temperature

3. Vital Signs Body temperature is a balance between
heat lost and heat produced, controlled by the hypothalamus
What influences temperature?
Age
Time of day
Exercise
Hormones
Stress
Environment
Illness

4. Vital Signs Sx of high temperature include…
Flushed
Glassy eyes
Rapid breathing and heart rate
Unusual thirst, anorexia, nausea
Changes in mental status
Sx of subnormal temperature include…
Pale
Cold
Clammy

5. Vital Signs
An abnormally high or low temperature is a medical emergency
Normal body temperature is 98.6 degrees Fahrenheit or 37 degrees Centigrade (Celsius).
A normal range is about 1 degree above or below a Fahrenheit reading or 0.5 degrees above or below a Centigrade reading

6. Vital Signs Celsius (Centigrade) vs. Fahrenheit Conversion Formulas
Celsius = F – 32 x 5/9 OR
Celsius = F – 32 / 1.8
Fahrenheit = C x 9/5 + 32
Fahrenheit = 1.8 x C + 32

7. Vital Signs The Thermometer The oldstyle mercury thermometer
Taking the temperature…some general rules
Oral
Rectal
Axillary

8. Vital Signs
There are different characteristics for each site you’d take a temperature…
Oral-keep mouth closed
Rectal-longer time for accurate measurement
Axillary- longest period of time
Tympanic- registers in less than 2 seconds
Temporal-infared, measures temperature of temporal artery

9. Vital Signs-Pulse The 3 pulse assessments Rate- 60-100
Tachycardia-greater than 100 beats per minute
Bradycardia-less than 60 beats a minute
Rhythm- regular or irregular
Dysrhythmia=irregular pulse
Quality (Volume)- amount of blood pushing against artery

10. Vital Signs What factors influence pulse rate?
Age-decreases birth to adulthood
Activity and position- exercise and laying down = lower heart rate
Gender- males are lower
Body temperature- increase=increase
Blood volume and circulating
components-decrease volume, increase rate
Stress, emotion, pain-increase rate
Drugs

11. Vital Signs What factors influence pulse?
When I feel the rhythm…(spacing of beats)
When I note the quality/volume… (strength of beats)
Normal
Thready or Weak-difficult to feel
Full or bounding- strong even with pressure
What is a doppler?

12. Vital Signs
Where can I feel pulses at?

13. Vital Signs Which sites are best used for… An emergency- Carotid
Convenience- Radial
Most accurate- Apical
Circulation assessment- Dorsalis Pedis

14. Vital Signs Assessing the Radial Pulse Assessing the Apical Pulse
The heart sounds…
Let’s look at the stethoscope…
Assessing an Apical/Radial Pulse
Pulse Deficit-difference between Apical and Radial Pulses

15. Vital Signs-Respirations
Did you know there are 2 parts to 1 respiration?
Inspiration-chest rise, lungs expand
Expiration- chest decreases, air forced out
Organs of respiration- lungs, chest muscles, diaphragm
Did you know there are 2 types of respiration?
External-use of lungs for gas exchange
Internal- exchange of gases between the blood and tissue cells

16. Vital Signs
The respiratory center is located in the brain and stimulated by CO2
Respirations increase or decrease in direct relationship with the CO2 in the blood.

17. Vital Signs
We need to consider several factors with our respiratory assessment.
Rate-influenced by many factors
Rhythm- regular or irregular
Depth- chest movement seen or felt
Quality- chest movement, skin color, noise, symmetry, restlessness, disorientation

18. Vital Signs What influences each of these factors?
Age- faster when younger in age
Disease- chronic or acute
Gender- females slightly faster
Exercise-increase activity, increase rate
Body position- affects depth
Stress- increase rate and depth
Drugs- depressants=depress, stimulants=increse
Assessing respirations…

19. Vital Signs-Blood Pressure
Let’s talk about terms and equipment.
Blood pressure- measure of blood against the walls of arteries
Hypertension- Elevated blood pressure
Hypotension- Low blood pressure
Sphygmomanometer- instrument for measuring blood pressure
Pulse pressure-Difference between Systolic and Diastolic readings
Korotkoff’s sounds- "tapping" sounds heard with a stethoscope as the cuff is gradually deflated.

20. Vital Signs Systolic Pressure- the upper number
The pressure present when the left ventricle of the heart contracts and forces blood to the arteries.
Diastolic Pressure- the lower number
The relaxation of the left ventricle allowing blood to refill

21. Vital Signs Types of sphygmomanometers
Mercury
Aneroid
Electronic
The brachial artery is most commonly used
Site contraindications are…
IV fluids are infusing
Shunt
Cast or bulky dressing
Trauma or paralysis
Side of breast or axillary surgery

22. Vital Signs Where is the brachial artery?
Assessing the blood pressure…
Systolic and diastolic
The standard of measurement is millimeters
of mercury or mmHg

23. Vital Signs
Heart Rate x Stroke Volume = Cardiac Output (reflected in systolic reading)
Peripheral vascular resistance is reflected in the diastolic reading
MAP = systolic + (2 x diastolic) 3

24. Vital Signs Some factors influence blood pressure…
Circulating blood volume-increase volume, increase pressure
Age- younger=lower
Exercise-increases blood pressure
Time of day-lower BP earlier in the day
Sex-females have lower
Stress, anxiety, fear, pain-raise BP
Medications-antihistamines, steroids, caffeine, nicotine
Race- Caucasian males have lower BP
Cardiac disease-
Obesity-Higher BP

25. Vital Signs How do I take a blood pressure?
How do I document the blood pressure, and the other vital signs?
Practice your vital signs assessment in total.

26. Vital Signs- Terms to know
Height
Height-ht
Inch-in or “
Centimeter-cm
Foot-ft
Meter-m
Weight
Weight- wt
Ounce- oz
Pound- lb
Kilogram-kg
Gram- g

27. Vital Signs Types of scales Bed scale Standing scale Wheelchair scales
Bariatric scales
Pediatric scales

28. Vital Signs Why do daily weights? Rules for daily weights
Fluid balance indicator
Calculating medications
Nutritional status
Rules for daily weights
Same scale
Same time
Same clothing
Same bed linens and pillows (if bed scale)
Done with Unit 5.

29. Vital Signs Important conversions 2.2 pounds=1 kilogram
1000 grams=1 kilogram
12 inches=1 foot
2.5 centimeter= inch