Vital Signs. Provide information about body function Include: Changes may be the first sign of disease Accuracy is imperative!

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Provide information about body function Include: temperature pulse respiration blood pressure Changes may be the first sign of disease Accuracy is imperative! 2

Temperature Measurement of the balance between heat lost and heat produced Heat lost through: Perspiration Respiration Excretion Heat produced by: Metabolism of food Muscle and gland activity 3

Normal ranges Temperature 97º - 100º F 36.1º - 37.8º C 4

Temperature Hypothermia Temperature below 95º F Death can occur if below 93º F 5

Hypothermia Temperature Temperature decreases with: environment exposure to cold inactivity sleep starvation Symptoms: shivering cold skin confusion 6

Hyperthermia Temperature Temperature 100-104º F Temperature above 104º F is life-threatening Prolonged hyperthermia may cause brain injury. 7

Hyperthermia Temperature Temperature increases with: environment exercise illness, infection, injury stress Symptoms: hot, dry, red skin nausea/vomiting headache low blood pressure 8

Thermometers Temperature Clinical Non-mercury glass Aural Electronic 9

Temperature Sites to measure temperature: Aural auditory canal Axillary armpit Oral mouth Rectal rectum 10

Temperature To record temperature: Oral 98.6º (O) Rectal 99.6º (R) Axillary 97.6º (ax) Aural 98.6º (T) 11

Oral Temperature Measurement Ask the patient if they have ingested hot or cold food or drink, or smoked within the last ½ hour If yes, wait at least 15 minutes before measuring the oral temperature 12

REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 13

Oral Temperature Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 14

Temperature Measurement Aural Pros: Measures core body temperature Fast and convenient Con: Inaccurate if not placed correctly in the ear canal Ear infection Ear wax 15

Aural Temperature Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 16

Pulse Pressure of blood on artery walls as the heart beats and relaxes Sites: Temporal side of the forehead Carotid side of the neck Brachial inner elbow Radial above the thumb at radius Femoral upper thigh Popliteal behind the knee Dorsalis pedis top of the arch of the foot 17

Pulse When would you use these pulse sites? Temporal Carotid Brachial Radial Femoral Popliteal Dorsalis pedis 18

Pulse Normal rate adult (male) 60 70 beats per minute adult (female) 65 80 beats per minute children (over 7) 70 100 beats per minute children (1 7) 80 110 beats per minute infants (less than 1 year) 100 160 beats per minute Rhythm regular or irregular Volume strength of the pulse 19

Pulse Pulse can be increased by: exercise stimulant drugs excitement fever shock nervousness 20

Pulse Pulse can be decreased by: sleep depressant drugs heart disease coma 21

REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 22

Radial Pulse Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 23

Apical Pulse Pulse count taken with the stethoscope. Use if the patient has: Irregular heartbeat Arteriosclerosis Weak or rapid radial pulse Infants and children 24

Apical Pulse Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 25

Respiration Process of taking in oxygen and expelling carbon dioxide 1 inspiration + 1 expiration = respiration Normal rate: adults 12 20 breaths per minute children 16 30 breaths per minute Evaluate for rhythm and character Rhythm regular or irregular Character depth, ease of breaths 26

Respiration Abnormal respiratory patterns Apnea periods of absent breathing Cheyne-stokes periods of apnea and dyspnea Dyspnea difficult breathing 27

REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 28

Respirations Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 29

Blood pressure Pressure of blood on the arterial walls Recorded as a fraction: 120/80 Systolic pressure wall of left ventricle is contracting Normal range: 100-140 mm Hg Diastolic pressure wall of left ventricle is resting Normal range: 60-90 mm Hg 30

Blood pressure Factors that elevate blood pressure: anxiety eating exercise excitement stimulant drugs Factors that lower blood pressure: depressant drugs excessive loss of blood rest shock 31

REPORT ABNORMAL RESULTS OF ANY VITAL SIGN IMMEDIATELY 32

Blood Pressure Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 33

Combined TPR BP Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 34

Diagnostic Skills: Height and Weight Measured if warranted by patient s age and physical condition Measured routinely: on admission to health care facility as part of annual physical examination each provider visit for children Important for evaluation of laboratory tests and calculation of medications 35

Diagnostic Skills: Daily Weights Daily weights are used to monitor patients with chronic disease processes: Hormone disorders Renal disorders Heart disease Cancer 36

Diagnostic Skills: Daily Weights Guidelines for daily weights: use the same scales at the same time wearing the same type of clothing patient voids to empty bladder Make sure to balance the scales before weighing the patient. 37

Diagnostic Skills: Daily Weights OBSERVE SAFETY PRECAUTONS! Prevent injury from falls and the protruding height lever. 38

Diagnostic Skills Measuring Height and Weight Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 39

Diagnostic Skills: Measure Visual Acuity Used to measure the ability to see Snellen charts: used to measure distant vision Ishihara method tests for color Tonometer measures intraocular pressure 40

Diagnostic Skills: Measure Visual Acuity OD right eye (oculus dexter) OS left eye (oculus sinister) OU both eyes (oculus uterque) Myopia nearsightedness, defect in distant vision Hyperopia farsightedness, defect in near vision 41

Diagnostic Skills Measure Visual Acuity Demonstrate the skill Provide for guided practice Provide for independent practice Verify student passing 42