1. Vital Signs

2. What do you already know about vital signs?
With a partner, write down as many facts as you know about vital signs.

3. Essential Question
What does temperature tell the nurse about a patient’s condition?

4. Vital Signs Important indicators of health states of the body.
Provide information about the basic body conditions of a patient.
Four main vital signs: temperature, pulse, respiration, blood pressure
Pain is often referred to as the 5th vital sign

5. Temperature (T)
Measurement of the balance between heat lost and heat produced by the body.
Lost : perspiration, respiration, excretion
Produced: metabolism of food, muscle and gland activity

6. Temperature (T) Homeostasis ~ balance
Ability to maintain a constant internal environment in response to environmental changes
Body temperature too high or too low, homeostasis is affected.

7. Temperature (T)
Usually measured in Fahrenheit, but many places are converting to Celsius.
˚C=(˚F - 32) X
˚F=(˚C X 1.8) + 32

8. Convert the Following Temperatures
˚C = (˚F - 32) X
100.2˚F = ?˚C
99.2˚F = ?˚C

9. Convert the Following Temperatures
˚C = (˚F - 32) X
100.2˚F
( ) X
68.2 X = 37.9˚C
99.2˚F
( ) X
67.2 X = 37.3˚C

10. Convert the Following Temperatures
˚F = (˚C X 1.8) + 32
38.8˚C = ?˚F
37.6˚C = ?˚F

11. Convert the Following Temperatures
˚F = (˚C X 1.8) + 32
38.8˚C
(38.8 X 1.8) + 32
= 101.8˚F
37.6˚C
(37.6 X 1.8) + 32
= 99.7˚F

12. Temperature (T) Normal range = 97˚ - 100˚ F
Average temperature = 98.6˚ F / 37˚ C
Reasons for variations in range
Individual differences ~ some people run cooler or hotter
Time of day ~ higher in evening
Body site ~ different areas of the body run hotter or cooler

13. Temperature (T) Febrile ~ running a fever (above 101˚F)
Afebrile ~ without fever
Oral temperature ~ taken by mouth
Rectal ~ taken by rectum
Axillary ~ taken by armpit
Aural (tympanic)~ taken by ear

14. Temperature (T)
When using a clinical (glass) thermometer each line represents 0.2 degrees.
Electronic and clinical thermometers have coverings to prevent cross-contamination.

15. Handout
Reading a glass thermometer

16. Temperature (T) Causes of increased temperature Illness Infection
Exercise
Excitement
High temperatures in the environment

17. Temperature (T) Causes that decrease temperature Starvation or fasting
Sleep
Decreased muscle activity
Mouth breathing
Exposure to cold temperatures in the environment
Certain diseases (homonal/thyroid/addisons)

18. Temperature (T) Hypothermia ~ below 95˚ F Hyperthermia ~ above 104˚ F
Caused by prolonged exposure to cold
Death when temp below 93˚ F
Hyperthermia ~ above 104˚ F
Caused by prolonged exposure to hot temperatures, brain damage, or serious infection
Temperatures above 106˚F can lead to convulsions and death

19. Review Define the following terms: Afebrile ~ Febrile ~ Hypothermia ~
Hyperthermia ~
Homeostasis ~
What are the four vital signs?
What is the normal range for temperature?

20. Pulse
The pressure of the blood pushing against the wall of an artery as the heart beats and rests.
IN OTHER WORDS…throbbing of the arteries that is caused by the contractions of the heart.

21. Pulse
More easily felt in arteries that lie close to the skin and can be pressed against a bone by the fingers.
Temporal ~ side of head
Carotid ~ neck
Brachial ~ elbow
Radial ~ wrist
Femoral ~ upper thigh (groin area)
Popliteal ~ behind knee
Dorsalis pedis ~ top of foot
Can you locate these pulses on yourself?

22. Rate of a Pulse Measured as the number of beats per minute. (BPM)
Pulse rates vary depending on age, sex, and body size.
As the cardiovascular system matures with age, the pulse rate decreases.
Women tend to have a faster pulse than men

23. Average Range of Pulse Adults: 60-80 BPM
Children over 7yrs : BPM
Children 1yr-7yrs : BPM
Infants : BPM

24. Pulse Rate Terms Bradycardia ~ pulse rate below normal range
Causes: physically fit, medications, severe lack of oxygen
Tachycardia ~ pulse rate over normal range
Causes: physical/mental stress, pain, exercise, infection, lack of oxygen, low blood pressure

25. More Pulse Terms Antecubital space ~ bend of the elbow
Where the brachial pulse is found
Palpate ~ feeling a pulse
Use you first two-three fingers
Auscultate ~ hearing a pulse
Use a stethoscope

26. With Your Table Partner
Using the radial pulse palpate your partner’s pulse and determine the rate.

27. Respiratory Rate
Respiration ~ process of taking in oxygen and expelling carbon dioxide from the lungs and respiratory tract.
Inhalation + exhalation = 1 breath
Rate = breaths per minute
Respirations must be counted in such a way that the patient is unaware of the procedure.

28. Respiratory Rate Measure the rise and fall of the chest in adults.
Measure the rise and fall of the abdomen in young children.
Normal respiration rate
Adult = RR
Child = RR
Infant = RR

29. Abnormal Respirations
Apnea ~ absence of respirations (usually temporary)
Tachypnea ~ rapid, shallow respiratory rate (above 25 RR)
Bradypnea ~ slow respiratory rate (below 10 RR)

30. With Your Table Partner
Observe the rise and fall of your partners chest. Count the respirations for one minute and determine your partners respiration rate.

31. Lesson Essential Question
What does blood pressure tell us about a person’s health?

32. Think Pair-Share
Tell your partner one thing you know about blood pressure.

33. Blood Pressure (BP)
(BP) ~ Measurement of the pressure that the blood exerts on the walls of the arteries as blood pulsates through them
Blood Pressure reading is measured in millimeters (mm) of mercury (Hg)
Sphygmomanometer ~ instrument
used to measure blood pressure.

34. Types of Blood Pressure Measurements
Systolic ~ pressure that occurs when the heart is contracting.
Diastolic ~ pressure that is present when the heart is at rest.
BP is recorded as a fraction.
Systolic reading is the top number
Diastolic reading is the bottom number

35. Blood Pressure Measurements
Normal Range:
Systolic: mm Hg
Diastolic: 60-80mm Hg
Hypertension ~ high blood pressure
Systolic: >140mm Hg
Diastolic: > 90mm Hg
Hypotension ~ low blood pressure
Systolic: < 90mm Hg
Diastolic: < 60mm Hg

36. Blood Pressure Measurements
Prehypertension ~ warning that high blood pressure will develop unless steps are taken to prevent it.
Systolic: mm Hg
Diastolic: mm Hg

37. Write the following blood pressure readings on a sheet of paper
Write the following blood pressure readings on a sheet of paper. Label each as normal, pre-hypertension, hypertension or hypotension.
134/80 mm Hg
110/91 mm Hg
146/70 mm Hg
100/70 mm Hg
180/90 mm Hg
82/66 mm Hg
188/98 mm Hg
120/78 mm Hg
88/68mm Hg
166/ 78mm Hg
Compare your answers with your partners. Discuss any discrepancies and determine a unified answer.

38. Causes of Hypertension
Stress
Anxiety
Obesity
High salt intake
Aging
Kidney disease
Vascular conditions
Hypertension is often called the “silent killer”
Why do you think??? Share with your partner.

39. Causes of Hypotension Heart failure Dehydration Depression
Severe burns
Hemorrhage
Shock

40. Sites for Taking Blood Pressure
Blood Pressure can be obtained from any artery.
A pulse site is used in the assessment
Common areas for BP
Brachial ~ taken in upper arm
Radial ~ taken on the lower arm
Popliteal ~ taken on the thigh
Doralis pedis ~ taken on the lower leg
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