Vital Signs

Temperature, Pulse, Respiration and Blood Pressure TEST ON MONDAY 12/2/13

 4 Routes 1) Oral
97.6 - 99.6 F (normal) Oral mercury 3 minutes Do not take if on oxygen, younger than 4, delirious, restless, confused or disoriented

2.) Rectal
1 higher than oral 98.6 - 100.6 F (normal) Inserted 1 inch Red thermometer 3 minutes Most accurate Do not take if someone has had rectal surgery

Temperature

3.) Axillary
10 minutes 96.6 - 98.6 F (normal)

4.)Tympanic ear

Before you start ask

Have you had anything hot or cold to drink, smoked or chewed gum in the last 15 minutes?

Temperature

 Greater than 100 F

Fever, febrile, hyperthermia

Over 103
High fever

100 - 103 F
Moderate fever

Under 96
Hypothermia

Reading
Use protective covering Know how to read oral thermometer

Temperature

 Count 30 seconds
Unless are abnormal in rhythm or rate

Rate
Speed of heart beating or of breathing Number of pulse, heartbeats or respirations per minute

Quality
Volume, strength of pulse beats

Poor perfusion
Blue cast to their nail beds and feel cold to touch

Pulse and Respiration

 Do not use thumb because it has a pulse of its own Normal

60-100

Irregular
Abnormal in rhythm Doesnt always beat hard enough to produce a wave of blood

Tachycardia
Greater than 100 beats per minute

Bradycardia
Less than 60 beats per minute

Pulse

 Radial pulse
Thumb side

Carotid
Neck

Popliteal
Behind the knee

Brachial
Under side of elbow

Femoral
Groin

Apical
Chest (heart)

Temporal
Side of head

Dorsal Pedalis
Foot

Pulse

 Quality of pulse rate

Rhythm regular or irregular Strength bounding or thready

Factors affecting pulse

Body temperatures Emotions Activity level Health of heart

Pulse

 1 inhalation and 1 exhalation

Observe chest rise and fall

Normal Range
12 -24

Dyspnea
Difficult, labored or painful breathing

Tachypnea
Faster than normal, shallow breathing

Hyperpnea or Hyperventilation
Faster than normal, deep breathing

Respiration

 Bradypnea
Slower than normal breathing

Apnea
No breathing

Eupnea
Normal breathing

SOB Shortness of Breath

Respiration

 Cheyne Stokes
Respirations gradually increasing in rapidity and volume, reaching a climax, and then gradually subsiding until they cease

Respiration

 Force of blood against artery walls when the heart beats Systolic indicates when left ventricle contracts to push blood into arteries Diastolic indicates pressure on artery walls when left ventricle relaxes Measured in millimeters of Mercury (mm HG)

Blood Pressure

 Normal systolic
Less than 120 mm Hg Range: 100-140mm Hg

Normal Diastolic
Less than 80 mm Hg Range: 60-90mm Hg

Normal pulse pressure range is 30-40mm Hg

Blood Pressure

 Reading can be influenced by:

Force of heartbeat Elasticity of arteries Volume of blood in arteries

Readings are changed by positions, such as sitting and standing

Blood Pressure

 Hypertension
Reading over 140/90 Causes: Excitement, anxiety, tension, stimulants, exercise, diet, smoking Results: Stress, anxiety, obesity, kidney disease, vascular conditions Prehypertension 120-139mm Hg systolic 80-89mm Hg diastolic

Hypotension
Reading below 100/60 Causes: Rest, sleep, shock, depressants, blood loss, fasting Orthostatic hypotension results from a quick change in position.

Blood Pressure

 Sphygmomanometer
Used to measure blood pressure

Older versions contained mercury

Aneroid versions use air, but still measure in millimeters of mercury

Blood Pressure