1. Unit H: Diagnostic Skills
Measure and Record Vital Signs
Medical Assisting and Laboratory Skills

2. Temperature
What is temperature?

3. Temperature What is temperature?
The measurement of balance between heat lost and produced by the body.

4. How does heat get lost from our bodies?

5. How does heat get lost from our bodies?
Perspiration
Respiration
Excretion (urine and feces)

6. How is heat produced in our bodies?

7. How is heat produced in our bodies?
Metabolism of food
Muscle and gland activity

8. What is homeostasis?

9. What is homeostasis? Equal balance in the body fluids
Ideal state in the human body
If body temperature is too high or too low, homestasis is affected!

10. Measurement of Temperature
F = Fahrenheit
C = Celsius or Centigrade
Normal range of temperature:
Oral = F or 36.5 – 37.5 C
Rectal = 98.6 – F or 37 – 38.1 C
Axillary = 96.6 – 98.6 F or 36 – 37 C
Tympanic or Aural = placed in ear or
auditory canal
Temperature is usually higher in the evening why?

11. What factors affect body temperature?

12. What factors affect body temperature?
What increases body temperature?

13. What factors affect body temperature?
What increases body temperature?
Illness, infection, exercise,
excitement, and high temperatures
in the environment

14. What factors affect body temperature?
What decreases body temperature?

15. What factors affect body temperature?
What decreases body temperature?
Starvation or fasting, sleep, decreased
muscle activity, exposure to cold in
the environment, and certain diseases

16. Temperature Terms Hypothermia = prolonged exposure to cold
Temp. below 95 F; death below 93 F
Hyperthermia = prolonged exposure to hot
temperatures, brain damage, or serious
infection Temp. above 104 F; death or
convulsions above 106 F
Fever or pyrexia = elevated body
temperature usually above 101 F

17. Afebrile = temperature within a normal
range
Febrile = referring to elevated temperature
Pyrogenic = producing fever
Calibration = standard measure (line on a
thermometer or ruler)

18. Clinical Thermometer Types and where temperature taken
Oral – in the mouth with either glass or electronic thermometer
Most common method
Glass ones contain alcohol based
red dye; No longer use mercury
Long and slender bulb or blue
tip
If person eating, drinking, or smoking wait 15 minutes after they stop to take temperature.

19. Rectal – temperature taken in the rectal
area
Most accurate way to measure
Has a red tip and bulb is short,
stubby, and rounded
Used when patients are less than 6 yrs. old, mouth breathers, on O2, weakness,
difficulty breathing, and confused, unconscious or senile.

20. Aural or tympanic – taken in the ear
Accurate and easy to use
Can be used in place of oral temp.
Axillary – taken in the armpit
Least accurate and only used if
oral, rectal or aural temperatures
cannot be used.

21. Temperature Conversion between Celsius and Fahrenheit
To convert Celsius to Fahrenheit:
F = (C x 1.8) + 32
Example: degree C to Fahrenheit
F = (35 x 1.8) + 32
F = (63) + 32
F = 95 degrees

22. Temperature Conversion between Fahrenheit and Celsius
To convert Fahrenheit to Celsius:
C = (F – 32) or (F - 32) divided by 1.8
1.8
Example: Convert 104 F to degrees Celsius
C = (104 – 32) divided by 1.8
C = (72) divided by 1.8
C = 40 degrees

23. Try your skill !!!! Convert the following temperatures: A. 37.2 C to F
B F to C
C. 96 F to C
D. 41 C to F
Why is it important to double check your results when you do conversions?

24. Pulse Measurements What causes a pulse?
The pressure of the blood pushing against the wall of an artery as the heart contracts and relaxes.
Important because indicates how well the blood is circulating through the body.

25. Pulse Terminology Rate = number of pulse beats per minute
Rhythm = regularity of beats
Volume = strength or pressure felt with
each beat.
Arrhythmia = an irregular pulse rate
Bounding = leaping, strong, or forceful
pulse

26. Thready = weak, barely felt pulse; thin, like
like a thread.
Tachycardia = pulse rate over 100 beats
per minute (for adults)
Bradycardia = pulse rate below 60 beats
per minute.

27. Apex = pointed end of something; for
example the pointed end of the
heart is called the apex.
Stethoscope = instrument used to amplify
sound. Used to listen to the Apical
pulse; pulse counted at the apex
of the heart.

28. Pulse Points Temporal – side of forehead Carotid – neck
Brachial – crease of elbow
Radial – thumb side of wrist
Femoral – inner aspect of upper thigh
Popliteal – behind knee
Dorsalis pedis – top of foot arch

29. Normal pulse values Before birth – 140 – 150 bpm
At birth – 160 bpm
Children 1-7yr – 80 – 130 bpm
Children over 7 – 70 – 115 bpm
Adult men bpm
Adult women – 80 bpm
bpm = beats per minute

30. Factors that affect Pulse
Factors that increase pulse rate:
exercise, stimulant drugs, fever,
shock, excitement, nervous tension
Factors that decrease pulse rate:
sleep, depressent drugs, heart disease
coma, physical training

31. Counting the pulse
The radial pulse is the most commonly used pulse site.
Count the beats for 30 seconds and multiply by 2.
If can not count radial pulse and must use the apical pulse, count for one (1) full minute to get beats per minute.
ALERT! Report any abnormal pulse rate

32. Measuring Respirations
What constitutes respiration?
It is the process of taking in oxygen (O2) into the body and expelling carbon dioxide (CO2) from the body.
One inspiration (breathing in) and one expiration (breathing out) = one respiration

33. Normal Values of Respirations
Newborn rates are 40 respirations per
minute
Normal adult rates are 12 – 20 respirations
per minute

34. Respiratory Terms Rate – number of respirations per minute
Rhythm – regularity or irregularity of
breathing
Quality – amount of air exchanged and the
effort it takes to breath
Dyspnea – shortness of breath
Tachypnea – abnormally fast respirations

35. Apnea – absence of respirations, has
breathing stopped?
Cheyne-Stokes – periods of labored
respirations followed by apnea;
usually noted in the dying pt.
Rales – bubbling or rattling sounds cause
by mucus in the air passages
ALERT! Always report abnormal respirations

36. How to count respirations
When counting a patients respirations:
Do not want them to be aware that you are counting as he/she may not breath normally.
Leave you hand on the pulse while counting respirations and count for 30 seconds and multiply by 2

37. Measuring Blood Pressure
What is blood pressure?
It is the force of the blood pushing against
the walls of the blood vessels.
It is measured with an instrument known
as a sphygmomanometer (blood
pressure cuff) and read in millimeters (mm)
of mercury (Hg)

38. Blood Pressure Terms Systolic pressure – is the greatest force
exerted on the walls of the arteries
when the heart is contracting.
Normal range is 90 – 140 mm Hg
Diastolic pressure – is the least force
when the heart is at rest.
Normal range is 60 – 90 mm Hg

39. Blood Pressure Terms cont.
Pulse pressure - difference between the
systolic and diastolic pressure.
Normal pulse pressure is mm Hg
Hypertension – high blood pressure
Hypotension – low blood pressure

40. Types of equipment for BP
Two main blood pressure apparatus:
Aneroid – have a round gauge with long and
short lines; long are 10 mm intervals and
the short are 2 mm intervals and used
with a stethoscope to hear beats.
Electronic/digital – push a button and are
battery powered or plugged in and
gives a reading on a screen.

41. Factors that affect BP Factors that increase BP:
stress, anxiety, obesity, high salt
intake, aging, kidney disease, thyroid
deficiency, eating, arteriosclerosis
Factors that decrease BP:
heart failure, hemorrhage, inactivity,
fasting, suppressants, depression, shock,
severe burns

42. Recording Vital Signs Now lets record what we have learned about.
Always record the temperature, pulse and respirations in the same order:
T P R
Example: T F P R 16
If temperature is rectal put an ® next to the number; if axillary put an (AX) next to the number; if aural put a (T) next to the number.

43. Recording BP Blood pressure is always recorded as a fraction:
Example /76 mm Hg =
120 systolic
76 diastolic
ALERT !!!! Always report any abnormal findings in vital signs to your supervisor.