1. Vital Signs

2. 14:1 Measuring and Recording Vital Signs (VS)
Vital Signs are defined as various determinations that provide basic information about the basic conditions of the patient
The 4 main vital signs (VS)
Temperature (T)
Pulse (P)
Respiration (R)
Blood pressure (BP)

3. Other Assessments on Patients
Pain—patients asked to rate on scale of 1 to 10 (1 is minimal and 10 is severe)
Color of skin
Size of pupils and reaction to light
Level of consciousness
Response to stimuli

4. VS Readings Accuracy is essential Report abnormality or change
If unable to get reading, ask another person to check
As a health care worker, it is your responsibility to measure and record the VS of your patients

5. 14:2 Measuring and Recording Temperature
Measures balance between heat lost and heat produced in the body
Heat produced by metabolism of food and by muscle and gland activity
Homeostasis: constant state of balance in the body
Conversion between Fahrenheit and Celsius temperature

6. Variations in Body Temperature
Normal range degrees Fahrenheit
Causes of variations –individual differences, time of day, body sites
Temperature measurements—oral, rectal (often used on infants/children), axillary (arm pit) or groin, aural (ear), and temporal (forehead-is measuring the temp in the temporal artery)

7. Causes of Increased Body Temperature
Illness
Infection
Exercise
Excitement
High temperatures in the environment

8. Causes of Decreased Body Temperature
Starvation or fasting
Sleep
Decreased muscle activity
Mouth breathing
Exposure to cold temperatures in the environment
Certain diseases

9. Thermometers Clinical thermometers – are used to record temperatures
Glass – consists of a slender glass tube containing mercury or alcohol with red dye, which expands when exposed to heat
Electronic – registers the temp on a viewer in a few seconds
Tympanic – records aural temp in the ear
Temporal – measures the temp in the temporal artery of the forehead
Plastic or paper - contain special chemical dots/strips that change color when exposed to specific temps
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10. Thermometers (continued)
Reading thermometers and recording results:
* Electronic & tympanic thermometers are easily read because of digital displays
* Mercury thermometers should be held at eye level & rotated slowly to find the mercury
Examples of how to record a temperature:
98.6 is an oral reading
99.6 (R) is a rectal reading
97.9 (Ax) is an axillary reading
98.6 (A) is an aural reading

11. Cleaning Thermometers
Must be cleaned after each use
The procedure will vary with different agencies and thermometers
Glass thermometers are cleaned with water and soaked in a disinfectant solution (70% alcohol) for a minimum of 30 minutes before using again
Electronic/digital thermometers use a probe or sheath that is discarded after each use

12. 14:3 Measuring and Recording Pulse
Pressure of the blood pushing against the wall of an artery as the heart beats and rests
Major arterial or pulse sites
Pulse rate
Pulse rhythm
Pulse volume
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13. Measuring and Recording Pulse (continued)
Factors that change pulse rate
Basic principles for taking radial pulse
Recording information

14. 14:4 Measuring and Recording Respirations
Measures the breathing of a patient
Process of taking in oxygen and expelling carbon dioxide from the lungs and respiratory tract
One respiration: one inspiration (breathing in) and one expiration (breathing out)
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15. Measuring and Recording Respirations (continued)
Normal respiratory rate
Character of respirations
Rhythm of respirations
Abnormal respirations
Voluntary control of respirations
Record information

16. 14:5 Graphing TPR
Graphic sheets are special records used for recording TPR (temp., pulse, resp.)
Presents a visual diagram
Used most often in hospitals and long term care facilities
Factors affecting VS are often noted on the graph - - examples include surgery, medications that lower temperature such as aspirin and antibiotics
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17. Graphing TPR (continued)
Graphic charts are legal records – so it must be neat, legible, and accurate
To correct an error mark a single line through the error and initial beside it

18. 14:6 Measuring and Recording Apical Pulse
Pulse count taken at the apex of the heart with a stethoscope
Reasons for taking an apical pulse – pts with irregular heart beats, hardening of the arteries, weak or rapid radial pulses
Protect the patient’s privacy and avoid exposure
2 heart sounds “lubb-dupp” = 1 heart beat
Abnormal sounds or beats should be reported immediately
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19. Measuring and Recording Apical Pulse (continued)
Pulse deficit – a condition that occurs with some heart conditions – when the apical pulse rate is higher than the pulse rate on other sites on the body
Use the stethoscope : diaphragm side
Placement of stethoscope : 2-3in. to the left of the breast bone
Measuring apical pulse : count for 1 full min.
Record all information

20. 14:7 Measuring and Recording Blood Pressure
Measurement of the pressure the blood exerts on the walls of the arteries during the various stages of heart activity
Measured in millimeters of mercury on a sphygmomanometer
Measurements read at two points
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21. Measuring and Recording Blood Pressure (continued)
Systolic pressure
Diastolic pressure
Pulse pressure
Hypertension—high blood pressure
Hypotension—low blood pressure
Factors influencing blood pressure readings (high or low)
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22. Measuring and Recording Blood Pressure (continued)
Individual factors can all influence blood pressure readings
Types of sphygmomanometers
Mercury
Aneroid
Electronic
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23. Measuring and Recording Blood Pressure (continued)
Factors to follow for accurate readings
Record all required information
Do not discuss the reading with the patient; it’s the doctor’s responsibility

24. Summary Vital signs are major indicators of body function
Accuracy of measurement and recording of vital signs
The health care worker needs to be alert and report any abnormalities