Vital Signs

Vital Signs

Vital Signs

Measurements that serve as

indicators of an individual’s

overall health.



•Include: May also include:

Temperature Height

Pulse Weight

Respiratory rate

Blood pressure

Reasons for Taking Vital Signs



 To provide a baseline

 To help provider make a diagnosis

 To monitor a patient’s condition





 Vital signs are taken in a physician’s office when

a physical exam is taking place, or a patient is

being seen for a chronic condition

 Vitals can also be taken whenever the physician

calls for them

Body Temperature

 Indicates state of health, the presence of

febrile disease, helps to track response to

treatment



The balance between the heat body cells

produce through metabolism and the heat

the body loses to the environment



 Body temperature is determined largely by a

person’s BMR and is regulated by the

hypothalamus

Types of Temperature

 Surface Temperature

 The temperature of the skin and fat

○ Rises and falls in response to the environment



 Core (Internal) Temperature

 Temperature of the vital organs, such as the

brain, heart, and liver

○ More accurate indicator of organ temperature

Reasons for Variation

 Time of Day

 Diurnal variation or circadian cycle

 Individual metabolic rate

 Age

 Environment

 Activity

 Medication

 Fluid consumption

 Stress

 Hormones

 Food, drink, smoking

Fever

 AKA Pyrexia

A body temperature higher than normal for the

individual

 Signs of Fever

•Increased body •Complaints of feeling

cold

temperature

•Loss of appetite

•Increased heart rate

•Thirst

•Increased respiratory

•General malaise

rate

•Shivering •Cyanotic nail beds

•Cold, clammy skin

Locations for Taking Body

Temperature

 Oral

 Thermometer is sublingually placed (if glass)

○ Most familiar and comfortable for patients, but less accurate in

reading actual core temperature

○ Readings can be altered by eating, drinking, smoking, mouth

breathing

 Rectum

 Thermometer is placed in the rectum

○ Embarrassing for patients and may not adjust quickly to

changes in temperature, but most accurate reading of core

temperature

○ Be careful to disinfect between patients

○ Rectal thermometers should not be used to take any other

type of body temperature

 Axilla

 Thermometer is placed under the arm

○ Easily accessed and safe, but least accurate



 Tympanic

 Thermometer is placed in the external ear canal

○ Hygienic, and can be very accurate if properly used

○ The eardrum uses the same blood supply as the

hypothalamus, so the temperature reading

matching the information received by the brain

Average Temperatures

Site Average Fever (Above)





Oral 37°C/98.6°F 37.8°C/100.4°F





Rectal 37.5°C/99.5°F 38°C/100.4°F





Axillary 36.5°C/97.7°F 37.2°C/99°F





Tympanic 37.5°C/99.5°F 37.8°C/100.4°F

Types of Thermometers

 Glass / Mercury

 Long, cylindrical glass tube ending in a bulb

filled with mercury

○ Mercury expands in a predictable way in

response to heat

 Tube is calibrated to show mercury levels at different

temperatures



 Note: many hospitals and clinics have

eliminated the use of mercury thermometers

 Electric or Digital

 Battery operated unit

○ Metal probe is colour-coded for different sites

○ Probe is covered with a disposable plastic

sheath

○ Very quick readings

Pulse

Measurement of the number of times the

heart beats per minute

 Arteries expand when the heart pumps

and relax when the heart relaxes

 You can feel an artery for the expansions

and relaxations to determine pulse

 Taking a pulse involves counting the

beats, as well as assessing rhythm and

volume

Locations for Pulse

 Apical

 Measured near the heart using a stethoscope

 Peripheral

 Measured where an artery lies close to the bone

 Sites:





•Temporal •Radial •Posterior Tibial

•Carotid •Femoral

•Dorsalis Pedis

•Brachial •Popliteal

Normal Pulse Rates



Age Range Average



Newborn 120-160 140



1-2 years 80-140 120



3-6 years 75-120 100



7-11 years 75-110 95



Over 11 years 60-100 80

Factors Affecting Pulse

 Age

 Body Size and Weight

 Gender

 Exercise and Fitness (increased heart rate in

the short term, slower heart rate in the long term)

 Fever

 Medications

 Hemorrhage (heart speeds up to circulate

oxygen faster)

 Stress

Rhythm

the pacing of heart contractions



 Normally, heartbeats are regularly spaced

 Irregular beating is arrhythmia or dysrrhythmia

 Types:

○ Regular

○ Regular/Irregular: regular pattern, occasional skipped

beats

○ Irregular/Regular: repeated irregular pattern (ex

coupling)

○ Totally irregular: no distinct pattern (atrial fibrillation)

Volume

Measure of the strength of pulse



 Descriptions

 Strong (normal): easily felt, consistent strength –

firm pressure on pulse site obscures pulse

 Strong, bounding: can be felt even with firm pressure

 Weak (thready, feeble, frail): not easily felt, moderate

pressure obscures pulse



 Factors affecting volume

 Blood loss

 Shock

 Fever

 Disease

Respirations

Measurement of the rate, depth, and

regularity of a patient’s breathing



 After taking a patient’s pulse, you can

observe and count respirations

 Look for unusual noises, straining, depth,

symmetry, rhythm

Respiratory Rates

Age Range Average





Newborn 30-50 40





1-3 years 20-30 25





4-6 years 18-26 22





7-11 years 16-22 19





Over 11 years 12-20 16

Factors Affecting Respiratory Rate



 Increase  Decrease

 Stress/Excitement  Sleep

 Exercise  Medications

 Medications  Brain diseases

 Lung Disease  Decreased levels of

 Heart disease Carbon Dioxide in the

blood

 Hemorrhage

 Relaxation

 High altitude

 Obstruction of air

passages

 Pregnancy

Blood Pressure



The force exerted by the blood on the

arterial walls as the heart contracts and

relaxes



 Measured in mmHg (millimeters of

mercury)

Measurement



120 mmHg Systolic

80 mmHg Diastolic



Systolic: force exerted on arterial walls as the

ventricles contract

Diastolic: force exerted on arterial walls when the

ventricles are relaxed

- a measurement of more than 140 systolic or 90

diastolic is considered hypertension

- a measurement of less than 100 systolic or 60

diastolic is considered hypotension

Tools

 Sphygmomanometer  Stethoscope

Factors Affecting Blood Pressure

 Size and weight

 Age

 Fitness

 Smoking

 Diet

 Stress

 Medication

 Posture

 Pain

 Time of day