1. Cardinal signs, reflects body’s physiological status
Vital Signs
Cardinal signs, reflects body’s physiological status
Provides information critical to evaluate homeostatic balance
Five critical assessments
Temperature
Pulse
Respiration
Blood Pressure (B/P)
(Now also checking the oxygen saturation)

2. Frequency
Vital signs are taken at regular intervals depending on unit policy and patient condition. These times may be:
Every 8hrs
Every 4 hrs
Every 2 hrs
Every hour
Every 5-30 minutes
Depending on condition of client or medication administration
Vital signs indicate a positive or negative change in clients condition
If vital signs are out of range or different from previous recordings, repeat & if using mechanical equipment find a different machine

3. Factors influencing Vital Signs:
Age Gender Medications
Race Heredity Environment
Pain Stress Metabolism
Lifestyle Exercise
Components of Vital Signs:
Temperature- regulated by hypothalamus; shows balance between heat gained and heat loss

4. Temperature Temperature- measured by thermometer
Oral, rectal, ,axillary, tympanic, heat sensitive tape
Electric probe with disposal cover
Always designate where temperature is taken as O, R, A, T, tape
Register temperature as C (Centigrade) or F
(Fahrenheit)
-Mercury thermometers no longer used

5. Temperature-measured by thermometer
Oral Electronic with disposal cover
Tympanic- electric probe used in ear
Oral, rectal, axillary
Heat sensitive tape
Temperature variations:
Newborn C axillary
Infants 3 months 99.4*F axillary
1 yr 99.7*F axillary
After 4-5 yrs old can be taken orally
or ear based device

6. Temperature variations
Newborns oC
1 year 99.7oF temp taken axillary
4-5 year old taken orally or tympanic
13 years 97.8oF
Elderly range between 96.6o to 98.3oF
Taken orally, axillary it unable to close mouth may also use tympanic or heat sensitive tape

7. Pulse
Pulse – an index of the heart’s rate and rhythm, shows heart action
Need to evaluate:
Rate- number of pulsation in one minute
Rhythm- pattern, even or regular; regular irregular; irregular irregular
Quality- fullness or strength- reflex stroke volume maybe bounding, very strong, weak/ thready, absent

8. Common Terms
Pulse rate may increase or decrease for various reasons (exercise, drugs, lack of oxygen, medical conditions=dehydration, hemorrhage, etc)
Tachycardia pulse over 100 BPM.
Bradycardia pulse below 60 BPM
Pulse located:
Carotid- avoid pressuring too hard decreases blood flow to brain
Apical
Brachial ( site for auscultation of B/P)
Ulnar-near pinky finger
Radial- easy access near thumb
Femoral
Popliteal (behind knee)
Posterior Tibial-evaluate circulation lower extremities
Dorsalis Pedis- evaluate circulation lower extremities

9. Pulses should be felt against bone and using pads of 3 middle fingers
DO NOT USE YOUR THUMB
NEED A WATCH WITH SECOND HAND
Client should be either in supine or sitting position

10. Infants and Children Newborn= 80-180/min Toddler=80-110/min
School age= 50-90/min
Adolescent= 50-90/min

11. Blood Pressure
Blood pressure (B/P)- is the force of blood against arterial wall
Pulse pressure is the difference between the systolic and diastolic pressure (normal mm HG
Equipment: Stethoscope ( bell and diaphragm); sphygmomanometer
Make sure B/P cuff size is based on circumference of the limb
When unable to take B/P on arm can take on thigh

12. Factors affecting B/P Cardiac output Peripheral vascular resistance
Elasticity & Distensibility of arteries
Blood volume
Blood Viscosity
Hormones & Enzymes
Chemoreceptors
Age, sex, weight
Body position
Activity

13. Normal adult B/P ranges below 120(systolic) and less than 80(diastolic), varies with different people
Hypertensive B/P is defined as 140 mmHG or greater systolic; and/ or 90mmHG or greater diastolic
Systolic pressure- give data about the condition of the heart and great arteries
Diastolic pressure- data about the arteriolar or peripheral vascular resistance
Allow 1 to 2 minutes between taking B/P again

14. Respirations
Respiration is the process of bringing oxygen to the body tissue ( Inspiration) and removing carbon dioxide (expiration)
Normal rate of adult breaths/min.
Newborn 30- (40-60) breaths/min.
Older children breaths/min. .

15. Common Terms Bradypnea rate less than 10 breaths/min
Tachypnoea rate over 24 breaths/min.
Bradypnea rate less than 10 breaths/min
Apnoea absence of breathing
Dyspnoea difficulty breathing
Need to assess pattern, rate and depth of clients breathing
Rhythm- pattern between inspiration and expiration
Quality effort required to breathe

16. Factors affecting respiration
Age
Drugs
Stress
Emotions
Body position

17. Respirations: Newborn- 30-60/min Toddler=24-32/min
School age /min
Adolescent /min
Adults /min