Vitals

What are vital signs?

Temp, pulse, reparations range, blood pressure, and sometimes oxygenation or pain is the 5th

When Should I Measure a Patient’s Vital Signs?

when the patient’s condition changes

Normal adult oral temperature

98-98.6 degrees F

Normal adult rectal temperature

99-99.6 degrees F

Normal adult range for a pulse

60-100 beats per minute

Average beats per minute in adult pulse

80 bpm

Normal adult respiration range

12-20 breaths/min

normal adult blood pressure range

less than 120 (systolic) / less than 80 (diastolic)

response to variations in temp

Higher temp- sweating

lower temp- shivering

What Factors Influence Body Temperature?

Developmental Level (infants/older adults), environment, sex, exercise, emotions and stress, circadian rhythm (internal clock)

What temp Sites Should I Use?

When measuring temperature, record the value obtained and the site used. Do not convert temperatures mathematically between sites.

What Factors Influence the Pulse Rate?

variations in heart rate, any condition interfering with heart function, changes in elasticity of arterial walls, changes in volume of blood pumped through heart

What sites should I take pulse?

Temporal, carotid, brachial, ulnar, radial, femoral, popliteal, posterior tibial, dorsalis pedis, apical pulse (pulse point on chest)

When Should I Take an Apical Pulse?

You’ll hear beats that can detect conditions

Apical pulse location

5th intercostal space, midclavicular line

What Data Should I Collect when taking a pulse?

Pulse Rate, Pulse Rhythm, Pulse Quality

What Factors Influence Respiration?

• Older adults

• Exercise

• Pain

• Stress

• Smoking

• Fever

• Hemoglobin

• Disease

• Medications

• Position

What Data do I Obtain for respiration?

Respiratory Rate, Respiratory Depth, Respiratory Rhythm

Eupnea

normal respirations with equal rate and depth, 12-20 breaths/min

Bradypnea

slow respirations, less than 10 breaths/ min, usually drug overdose or carbon monoxide poisoning

Tachypnea

fast respirations, more than 24 breaths/ min, usually shallow, seen with pneumonia and chronic obstructive pulmonary disease

Apnea

absence of breathing

respiratory effort

degree of work required to breathe, normal breathing is effortless

dyspnea

increased effort with breathing

orthopnea

difficulty or inability to breathe when in horizontal position

Breath Sounds (wheezes) (asthma)

Wheeze = squeeze, the lower airway is being squeezed

Breath sounds (Rhonchi (Bronchitis))

“Junky”, Mucus, May improve with cough

Breathe sounds (Crackles, aka “Rales” (Heart failure)

Fluid, Wet velcro/rice crispies

Breathe sounds (Stridor (Croup))

Upper airway obstruction

Systolic pressure

peak pressure exerted against arterial walls as the ventricles contract and eject blood

diastolic pressure

minimum pressure exerted against arterial walls between cardiac contractions when the heart is at rest

What Factors Influence BP?

developmental stage, sex, family history, lifestyle, exercise, body position stress, pain, race, obesity, diurnal variations, medications, diseases

Assist with Incentive Spirometry

designed to encourage patients to take deep breaths, by reaching a goal-directed volume of air