NCM 103: Vital Signs

Vital Signs

Important signs of our bodies wherein we can tell that there is something wrong, if it is not c/in normal range

Blood Pressure

The force exerted by circulating blood against the walls of blood vessels. Measured in millimeters of mercury (mmHg) with two values: systolic (when the heart beats) and diastolic (when the heart rests).

Arterial Blood Pressure

A measure of the pressure exerted by the blood as it flows through the arteries

Systolic Pressure

The pressure of the blood vessels as a result of the contraction of the ventricle

Diastolic Pressure

When the ventricles are at rest; present at all times c/in the arteries

Pulse Pressure

Difference bet. systolic and diastolic pressure

Mean Arterial Pressure

Equivalent to 2/3 DP + 1/3 SP

70 - 110 mmHg

Normal range of mean arterial pressure

Less blood is pumped (lower cardiac output); decreased BP

Weak pumping action indicates

More blood is pumped (higher cardiac output); increased BP

Strong pumping action indicates

Peripheral Vascular Resistance

The resistance in the blood vessels that the heart must overcome to push blood through the circulatory system.

• Capacity of arterioles and capillaries

• Compliance of the arteries

• Viscosity of the blood

Factors of Peripheral Vascular Resistance

Blood Volume

The total amount of blood circulating in the body at a given time. It is crucial for maintaining blood pressure and delivering oxygen and nutrients to tissues.

Decreased BP

Decreased blood volume is to…

Increased BP

Increased blood volume is to…

Increased BP

Highly viscous blood causes

• age

• exercise

• stress

• race

• sex

• medications

• obesity

• diurnal variations

• hypertension

• hypotension

Factors affecting BP

1. Normal

2. Elevated

3. Hypertension stage 1

4. Hypertension stage 2

Classifications of BP

SP = <120; DP = <80

Normal BP

SP = 120-129; DP = <80

Elevated BP

SP = 130-139; DP = 80-89

Hypertension stage 1

SP = >140; DP = >90

Hypertension stage 2

• Inflation bulb

• Air release valve

• Pressure cuff

• Index Marking

• Aneroid Manometer

• Artery position indicator label

• Tube connectors

Parts of a sphygmomanometer

• Binaural

• tubing

• Eartips

• Binaural spring

• Diaphragm

• Bell

• Drum

Parts of a stethoscope

BP reading will be artificially elevated

Blood Pressure Cuff is too small means

BP reading will be too low

Blood pressure cuff is too large

• Upper arm (brachial artery)

• Forearm (radial artery)

• Thigh (popliteal artery)

• Lower leg (posterior tibial artery)

Blood Pressure assessment sites

Auscultatory Gap

Temporary disappearance of sounds normally heard over the brachial artery when cuff pressure is high followed by reappearance of the sounds at a lower level

• Instruct patient to avoid coffee, smoking, or any other unprescribed drug with sympathetic activity on the day of measurement

• ensure equipment is intact and functioning

Remember the following for accuracy in readings

• Sitting position

• Arm and back are supported

• Feet should be resting firmly on the floor

• Feet not dangling

Position of patient when taking BP

Body Temperature

Reflects the balance between the heat produced and the heat lost from the body

Core Temperature

Temperature of the deep tissues; remains constant

Surface Temperature

Temperature of the skin, subcutaneous tissue, and fat; rises and falls in response to the environment

• basal metabolic rate

• muscle activity

• thyroxine output

• epinephrine, norepinephrine, and sympathetic ns simulation

• fever

Factor's affecting body heat production

• Radiation

• Conduction

• Convection

• Evaporation

Heat is lost through…

Conduction

Transfer of heat with contact to two other objects with lower temperature

Radiation

Transfer of heat without contact between two objects

Convection

Transfer of heat by air currents

Evaporation

Continuous vaporization of moisture from the respiratory tract and from the mucosa of teh mouth and from the skin

• sensors in the periphery and core

• integrators in the hypothalamus

• effector system that adjusts the production and loss of heat

Factors regulating Body temperature

• age

• diurnal variation

• exercise

• hormones

• stress

• environment

Factors affecting body temperature

Pyrexia

Body temperature above normal

Hyperpyrexia

When temperature is over 41 deg C

Pulse

Palpable bounding of blood flow in the peripheral artery

Peripheral Pulse

Pulses away from the heart

Apical Pulse

Central pulse; heartbeat

Cardiac Output

Volume of blood pumped into the arteries by the heart and equal the result of the stroke volume times the heart rate per minutes

• age

• sex

• exercise

• fever

• medications

• stress

• position

• pathology

Factors affecting pulse rate

130 (80-190)

Newborn pulse average

120 (80-140)

1 y/o pulse average

100 (75-120)

5-8 y/o pulse average

70 (50-90)

10 y/o pulse average

75 (50-90)

Teen pulse average

80 (60-100)

Adult pulse average

70 (60-100)

Older adult pulse average

• temporal

• carotid

• apical

• brachial

• radial

• femoral

• posterior tibial

• dorsalis pedis

Pulse sites

Tachycardia

Excessively fast heart rate

Bradycardia

Less than 60bpm in adults

Costal Breathing

Aka thoracic beathing; involves external intercostals and other accessory muscles; observed by chest movement

Diaphragmatic Breathing

Aka abdominal breathing; involves the contraction of the diaphragm; observed by movement of abdomen

Eupnea

Normal breathing

Dyspnea

Shortness of breath; difficulty breathing

Bradypnea

Abnormally slow respirations

Tachypnea

Abnormally fast respirations

Apnea

Absence of breathing

• exercise

• stress

• environment

• medications

• pathology

Factors affecting respiration

Hyperventilation

Very deep rapid respirations

Hypoventilation

Very shallow rapid respirations

Respiratory rhythm

Refers to the regularity of expirations and inspirations

FALSE

True or False, inform your pt, that you will be taking their RR

Biot’s Respiration

Respirations that are abnormally shallow for 2 or 3 breaths; followed by an irregular period of apnea

Cheyne-stokes breathing

Rate and depth are irregular; characterized by periods of apnea and hyperventilation

• Stridor

• Stertor

• Wheeze

• Bubbling

Breath sounds

• Intercostal retraction

• Substernal retraction

• Suprasternal retraction

Chest Movements

Pulse Oximeter

Noninvasive device that estimates a client’s bood oxygen saturation by means of a sensor attached to the client’s finger, toe, nose, earlobe, or forehead

Hypoxemia

Low O2 Sat.

95% - 100%

Normal range of O2 Sat

90%

Level at which O2 Sat should be evaluated

70%

Level at which O2 Sat is lfe threatening

• 2 light emitting diodes (LEDS)

• Photodetector placed directly opposite to the LEDs

Parts of an oximeter

• hemoglobin

• circulation

• activity

• carbon monoxide poisoning

• disease

• virulence

• communicable disease

• pathogenicity

• opportunistic pathogen

Factors affecting o2 saturation