Recording-2025-03-10T23:38:41.062Z

Vital Signs Overview

• Definition: Vital signs are measurements that indicate the general health of a person and help in assessing possible diseases and monitoring recovery progress.

• Vital signs typically include temperature, blood pressure, pulse, and respiration. Some facilities may include pain as the fifth vital sign.

Temperature Measurement

• Definition: Measurement of the warmth or coolness of a person; expressed in Fahrenheit or Celsius.

• Normal Body Temperature: Average is 98.6°F, with a range of 97.8°F to 99.1°F.

• Terminology:

  • Febrile: Above normal temperature (fever).

  • Afebrile: Normal temperature, indicating no fever.

  • Hyperpyrexia: Extremely high fever, above 106.7°F.

  • Pyrexia: Temperature above normal (fever).

• Types of Thermometers:

  • Electronic Thermometers: Fast and accurate; common in clinics.

  • Tympanic Thermometers: Measures temperature in the ear; uses disposable covers.

    • Technique: Pull adult's ear up and back, child's ear down and back.

  • Temporal Thermometers: Glides across the forehead; non-invasive and growing in popularity.

  • Oral Thermometers: Placed under the tongue; patient should not bite down. Wait 15 minutes after smoking, eating, or drinking for accurate readings.

  • Rectal Thermometers: Most accurate method, mainly used for infants and small children.

    • Technique: Inserted about 1 inch for adults, 0.5 inches for children, with PPE (gloves) required.

  • Axillary Thermometers: Placed in the armpit, requires the arm to be pressed against the body for accurate reading.

• Factors Affecting Temperature: Stress, exercise, environmental conditions (cold or heat).

Pulse Measurement

• Definition: Number of heartbeats per minute; measured at rest.

• Normal Pulse Rate: 60 to 100 beats per minute for healthy adults; women may have slightly higher rates.

• Techniques & Locations:

  • Manual counting methods are often used, along with a pulse oximeter.

  • Common Sites for Pulse Measurement:

    • Radial pulse (inner wrist, thumb side)

    • Brachial pulse (in the elbow pit for children)

    • Apical pulse (5th intercostal space on left side of sternum).

    • Other sites: Temporal, carotid, femoral, popliteal, dorsalis pedis, and posterior tibial.

• Terminology:

  • Tachycardia: Heart rate over 100 bpm; can indicate health issues like infection, dehydration, anxiety, or heart conditions.

  • Bradycardia: Heart rate under 60 bpm; could be normal in trained athletes but caution is advised as it may indicate a heart condition.

  • Pulse Oximetry: Measures blood oxygen saturation. Normal is above 95%. Below 90% necessitates reporting.

Respirations

• Definition: Number of breaths taken per minute (one inhalation and one exhalation equals one respiration).

• Normal Respiratory Rate: 12 to 20 breaths per minute for healthy adults.

• Key Terms:

  • Hyperventilation: Rapid, deep breathing.

  • Dyspnea: Difficulty breathing.

  • Bradypnea: Respiratory rate under 12.

  • Tachypnea: Respiratory rate over 20.

  • Hyperpnea: Rapid, deep breathing often seen post-exercise.

  • Abnormal Breath Sounds:

    • Rales: Crackling sounds indicating fluid in lungs; commonly seen with pneumonia.

    • Rhonchi: Deep, snoring sounds during exhalation, associated with asthma or airway obstruction.

    • Apnea: Absence of respiration.

Blood Pressure

• Measurement: Indicates the force of blood against arterial walls; typically measured at the brachial pulse.

• Blood Pressure Readings: Generally expressed as systolic over diastolic (e.g., 120/80).

• Terminology:

  • Systolic Pressure: Pressure during heartbeats.

  • Diastolic Pressure: Pressure when heart is resting between beats.

• Normal Range: Less than 120/80.

• Hypertension: Readings of 140/90 or above suggests high blood pressure; prolonged hypertension can lead to serious conditions.

• Hypotension: Blood pressure below 90/60; not typically chronic.

• Measurement Techniques:

  • Palpatory Method: Measures systolic pressure only via feeling the pulse.

  • Auscultatory Method: More accurate; requires using a stethoscope to hear Korotkoff sounds.

• Postural Blood Pressure Changes:

  • Orthostatic Hypotension: Drop in blood pressure and increase in heart rate upon standing.

  • Postural Hypertension: Increase in blood pressure when changing positions.

Body Measurements

• Weight Measurement: Recorded to the nearest quarter pound; tracked during each visit.

• Height Measurement: Recorded during initial visit and annually; measured to the nearest quarter inch.

• Body Mass Index (BMI): Calculated using weight (in pounds) and height (in inches) using the formula:

  • BMI Formula: (Weight / (Height * Height)) * 703.

  • BMI Categories:

    • Underweight: < 18.5

    • Healthy weight: 18.5 to 24.9

    • Overweight: 25 to 29.9

    • Obese: > 30.

• Other body measurements for conditions may include tracking swelling of limbs or measuring wounds.

General Physical Exam Protocol

• Purpose: Conducted by licensed providers to determine overall health and establish baseline vitals; performed annually or as necessary for different purposes like school or work.

• Role of Medical Assistants:

  • Support patient comfort and assist with exams, documentation, and communication.

  • Safety measures include hand washing, proper use of PPE, and proper waste disposal.

• Patient Preparation:

  • Ensure patient privacy and comfort; provide gowns if needed and offer restrooms before exams.

• Common Positions for Examination:

  • Sitting, supine, dorsal recumbent, lithotomy, Fowler's, and Sims positions.

• Examination Methods:

  • Inspection, palpation, percussion, auscultation, mensuration, and manipulation.

Conclusion

• Review normal ranges for temperature, pulse, respiration rate, blood pressure, and BMI calculations as they will be integral in practical training.