2. Vital Signs

3. Provide information about body function Data is used to treat illness and diagnose disease Include: –temperature –pulse –respiration –blood pressure 3.01 Understand Diagnostic and Therapeutic Services 2

4. Changes may be the first sign of disease or a change in patient health status. Accuracy is imperative! 3.01 Understand Diagnostic and Therapeutic Services 3

5. Vital Signs Vital Signs Temperature 3.01 Understand Diagnostic and Therapeutic Services 4 Measurement of the balance between heat lost and heat produced Heat lost through: Perspiration Respiration Excretion Heat produced by: Metabolism of food Muscle and gland activity

6. Vital Signs Vital Signs Temperature Normal ranges –97º - 100º F –36.1º - 37.8º C 3.01 Understand Diagnostic and Therapeutic Services 5

7. Vital Signs Vital Signs Temperature Hypothermia Temperature below 95º F Death can occur if below 93º F 3.01 Understand Diagnostic and Therapeutic Services 6

8. Vital Signs Vital Signs Temperature Hypothermia Temperature decreases with: –environment –exposure to cold –inactivity –sleep –starvation Symptoms: –shivering –cold skin –confusion 3.01 Understand Diagnostic and Therapeutic Services 7

9. Vital Signs Vital Signs Temperature Hyperthermia Temperature 100-104º F Temperature above 104º F is life-threatening Prolonged hyperthermia may cause brain injury. Sx – headache, confusion 3.01 Understand Diagnostic and Therapeutic Services 8

10. Vital Signs Vital Signs Temperature Hyperthermia Temperature increases with: –environment –exercise –illness, infection, injury –stress Symptoms: –hot, dry, red skin –nausea/vomiting –headache –low blood pressure 3.01 Understand Diagnostic and Therapeutic Services 9

11. Vital Signs Vital Signs Temperature 3.01 Understand Diagnostic and Therapeutic Services 10 Clinical Non-mercury glass Electronic Aural – good with children Thermometers

12. Vital Signs Vital Signs Temperature 3.01 Understand Diagnostic and Therapeutic Services 11 Sites to measure temperature: Aural – auditory canal Axillary – armpit Oral – mouth Rectal – rectum

13. Vital Signs Vital Signs Temperature 3.01 Understand Diagnostic and Therapeutic Services 12 To record temperature: –Oral 98.6º ( O ) – under tongue by jaw line –Rectal 99.6º ( R ) – lay pt on side –Axillary 97.6º ( ax ) –Aural 98.6º (T)

14. Vital Signs Vital Signs Temperature Measurement Oral Ask the patient if they have ingested hot or cold food or drink, or smoked within the last ½ hour If yes, wait at least 15 minutes before measuring the oral temperature 3.01 Understand Diagnostic and Therapeutic Services 13

15. Vital Signs 3.01 Understand Diagnostic and Therapeutic Services 14 REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY to supervisor Combined VS (TPRBP) can indicate a life threatening condition or a change in condition

16. Vital Signs Vital Signs Temperature Measurement AuralAural Pros: –Measures core body temperature –Fast and convenient Con: –Inaccurate if not placed correctly in the ear canal –Ear infection –Ear wax 3.01 Understand Diagnostic and Therapeutic Services 15

17. Vital Signs Vital Signs Pulse Pressure of blood on artery walls as the heart beats and Relaxes (contraction and relaxation) 3.01 Understand Diagnostic and Therapeutic Services 16

18. Sites: Temporal – side of the forehead Carotid – side of the neck Brachial – inner elbow Radial – above the thumb at radius Femoral – upper thigh Popliteal – behind the knee Dorsalis pedis – top of the arch of the foot (good for checking lower limb circulation) 3.01 Understand Diagnostic and Therapeutic Services 17

19. 3.01 Understand Diagnostic and Therapeutic Services 18 Normal rate adult (male) 60 – 70 beats per minute adult (female) 65 – 80 beats per minute children (over 7) 70 – 100 beats per minute children (1 – 7) 80 – 110 beats per minute infants (less than 1 year) 100 – 160 beats per minute Rhythm regular or irregular Volume strength of the pulse Vital Signs Vital Signs Pulse

20. Pulse can be increased by: –exercise –stimulant drugs –excitement –fever –shock –nervousness 3.01 Understand Diagnostic and Therapeutic Services 19

21. Vital Signs Vital Signs Pulse Pulse can be decreased by: –sleep –depressant drugs –heart disease –coma 3.01 Understand Diagnostic and Therapeutic Services 20

22. REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3.01 Understand Diagnostic and Therapeutic Services 21 Vital Signs

23. Vital Signs Apical Vital Signs Apical Pulse Pulse count taken with the stethoscope. Use if the patient has: –Irregular heartbeat –Arteriosclerosis –Weak or rapid radial pulse –Infants and children 3.01 Understand Diagnostic and Therapeutic Services 22

24. Vital Signs Vital Signs Respiration 3.01 Understand Diagnostic and Therapeutic Services 23 Process of taking in oxygen and expelling carbon dioxide 1 inspiration + 1 expiration = respiration Normal rate: adults – 12 – 20 breaths per minute children – 16 – 30 breaths per minute

25. Evaluate for rhythm and character Rhythm – regular or irregular (i.e. fast, slow) Character – depth, ease of breaths Check while appearing to count pulse 3.01 Understand Diagnostic and Therapeutic Services 24

26. Vital Signs Vital Signs Respiration Abnormal respiratory patterns Apnea – periods of absent breathing Cheyne-stokes – periods of apnea and dyspnea Dyspnea – difficult breathing 3.01 Understand Diagnostic and Therapeutic Services 25

27. REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 3.01 Understand Diagnostic and Therapeutic Services 26 Vital Signs

28. Vital Signs Vital Signs Blood pressure 3.01 Understand Diagnostic and Therapeutic Services 27 Pressure of blood on the arterial walls Recorded as a fraction: 120/80

29. Systolic pressure – wall of left ventricle is contracting Normal range: 100-140 mm Hg Diastolic pressure– wall of left ventricle is resting Normal range: 60-90 mm Hg 3.01 Understand Diagnostic and Therapeutic Services 28

30. Vital Signs Vital Signs Blood pressure Factors that elevate blood pressure: – anxiety –eating –exercise –excitement –stimulant drugs Factors that lower blood pressure: –depressant drugs –excessive loss of blood –rest –shock 3.01 Understand Diagnostic and Therapeutic Services 29

31. Diagnostic Skills: Height and Weight Measured if warranted by patient’s age and physical condition Measured routinely: –on admission to health care facility –as part of annual physical examination –each provider visit for children Important for evaluation of laboratory tests and calculation of medications 3.01 Understand Diagnostic and Therapeutic Services 30

32. Diagnostic Skills: Daily Weights Daily weights are used to monitor patients with chronic disease processes: –Hormone disorders –Renal disorders –Heart disease –Cancer 3.01 Understand Diagnostic and Therapeutic Services 31

33. Diagnostic Skills: Daily Weights Guidelines for daily weights: use the same scales at the same time wearing the same type of clothing patient voids to empty bladder Make sure to balance the scales before weighing the patient. 3.01 Understand Diagnostic and Therapeutic Services 32

34. Diagnostic Skills: Daily Weights OBSERVE ALL SAFETY PRECAUTONS! Prevent injury from falls and the protruding height lever. 3.01 Understand Diagnostic and Therapeutic Services 33

35. Diagnostic Skills: Measure Visual Acuity Used to measure the ability to see Snellen charts: used to measure distant vision Ishihara method tests for color Tonometer measures intraocular pressure 3.01 Understand Diagnostic and Therapeutic Services 34

36. Diagnostic Skills: Measure Visual Acuity OD – right eye (oculus dexter) OS – left eye (oculus sinister) OU – both eyes (oculus uterque) Myopia – nearsightedness, defect in distant vision Hyperopia – farsightedness, defect in near vision 3.01 Understand Diagnostic and Therapeutic Services 35