1. Vital Signs
Define
Various determinations that provide information about the patients basic body condition
Often the first sign that there is a problem

2. VITAL SIGNS
Temperature
Pulse
Respirations
Blood Pressure

3. Other Vital Signs Pain assessment Skin color Pupil size and reaction
Level of consciousness
Response to stimuli

4. Temperature
Measurement of the balance between heat loss and heat produce
Types
Oral - mouth
Rectal - rectum
Axillary - armpit
Aural (tympanic) – ear

5. Heat Produced and Lost Heat Produced Heat Lost Metabolism of food
Muscle and gland activity
Heat Lost
Perspiration
Respiration
Excretion of feces and urine

6. Normal Body Temperature
Normal range 97 – 100 degrees F

7. Variations in Normal Body Temperature
Lower in morning
Higher in evening
Eating or drinking anything hot or cold, smoking a cigarette or exercising in the last 15 minutes
Measured in degrees Celsius or degrees Fahrenheit

9. Oral Temperature Taken in the mouth
Thermometer left in for 3-5 minutes
Most common, convenient, comfortable way to take temperature
Check for eating/drinking anything
hot/cold exercising or
smoking a cigarette
15 minutes prior

10. Rectal Temperature Taken in the rectum
Thermometer left in for 3-5 minutes
Most accurate
Insert 1-1 ½ inches, hold in place and screen patient for privacy

11. Axillary/Groin Temperature
Taken under the armpit or in the groin fold
Thermometer left in for 8-10 minutes
Least Accurate
Dry armpit/groin, place in center and hold in place

12. Aural/Tympanic Temperature
- taken in the ear
- measures the thermal infrared energy radiating from the blood vessels in the eardrum
- position and ear wax can affect readings
-left in until it beeps
-temperature is calculated into an equivalent by mode

13. Temperature By Body Site
Oral
Normal temp
Normal Range
Rectal
Normal temp
Normal Range
Axillary/groin
Normal temp
Normal Range
Tympanic
Normal temp 98.6

14. Factors that Increase Temperature
Illness
Infection
Exercise
Excitement
High temps in the environment

15. Factors that Decrease Temperature
Starvation/fasting
Sleep
Decreased muscle activity
Mouth breathing
Exposure to cold temperatures
Certain diseases

16. Temperature Conditions
Hyperthermia
Increased body temp
Body temp >104ºF
>106 ºF will cause convulsions and death
Fever
temp over 101 ºF R
Due to illness or injury

17. Temperature Conditions
Hypothermia
Body temp below
96 ºF
due to exposure to cold temperatures
Depends on core temperature, age and length of exposure

18. Types of Clinical Thermometers
Slender glass tube containing
mercury or colored fluid
Types
Oral – blue tip, long slender bulb, marked oral
Security – plain tip
Rectal – red tip, short stubby bulb, marked rectal

20. Mercury Thermometers Not used now Colored column of red alcohol
Toxic to the body and environment
Can be absorbed through the skin and inhaled as a vapor through the lungs
Heavy metal that accumulates in the brain and causes mental retardation

21. Clean up Broken Mercury Thermometer
Use appropriate PPE’s
Do not touch mercury
Seal in a glass container
Dispose according to
regulations

22. Types of Thermometers Electronic
Can be used for oral, rectal, or axillary
Blue probe for oral
Red probe for rectal
Disposable probe covers prevent cross-contamination

23. - used to record temperature in the ear
Tympanic
- used to record temperature in the ear
- Records temperature in 1-3 seconds

24. Positioning the Patients Ear for Tympanic temperature
Infants under 1 year
Pull ear pinna straight back
Infants over 1 year and adults
Pull ear pinna straight back and down
Positioning the pinna correctly straightens the auditory canal so the probe will point directly at the tympanic membrane

25. Reading Thermometers Digital thermometers -until you hear the beep
•Tympanic thermometers
- hold in place for 2-3 seconds, remove and read

26. Reading a Glass Thermometer
Hold thermometer at eye level
Find the column of mercury/red liquid
Each long hash mark represents one degree
Each short hash mark represents 2/10th of a degree
Exception: long line at 986 ºF represent normal body temperature

28. Charting a Temperature
Use a superscript to record 10th’s
102.2 should be written as 102.2
This avoids errors
Use a TPR Chart
Mark temp under correct date and time
Indicate method of taking temperature
- R - rectal
- Ax – axillary
- T - tympanic
No abbreviation indicates an oral temp

30. Clean A Clinical Thermometer
Use warm water to clean and rinse
Soak in a disinfecting solution such as alcohol for 20 minutes