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Vital Signs . Vital Signs:. Various determinations that provide info about basic body functions Four main V.S. Temperature Pulse Respiration Blood Pressure . Vital Signs cont… . Accuracy is essential Abnormal v.s . may indicate disease Never guess or report an inaccurate reading
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Vital Signs: • Various determinations that provide info about basic body functions • Four main V.S. • Temperature • Pulse • Respiration • Blood Pressure
Vital Signs cont… • Accuracy is essential • Abnormal v.s. may indicate disease • Never guess or report an inaccurate reading • A health assistant may not reveal this information to the pt • The physician will tell the pt
Temperature • Measurement of the balance btwn heat lost & heat produced in the body • Heat lost by • Perspiration • Respiration • Excretion • Heat produced by • Metabolism • Muscle activity • Gland activity
Temperature cont… • Homeostasis: state of constant fluid balance (good thing) • If temp is too high or too low, fluid balance is affected • Body temp regulates chem reaction in body
Variations in Body Temp Normal 97.0 —100.0 F (36.1— 37.8 C) Fever >101.0 F (38.3 C) Hyperthermia >104.0 F (40.0 C) Hypothermia <95.0 F (35 C)
Variations in Body Temp cont… • Normal variations in temp caused by • Individual differences • High/low metabolism • Time of day • Usually lower in AM • Higher in PM after eating & activity • Part of body where temp is taken • Oral • Rectal • Axillary
Variations in Body Temp cont… • Oral temp • Thermometer in place 3-5 min • Most convenient & comfortable • Rectal temp • Thermometer in place 3-5 min • Most accurate • Axillary/Groin temp • Thermometer in place 10 min • Both are less accurate because they are external
Types of Thermometers • Glass • Contains mercury • Must be shaken down below 98.0 F • Soak in alcohol for 30 min • Electronic • Used in most facilities • Has a plastic cover to prevent x-contamination • Paper • Contains special chemical to change colors
Conversions • Fahrenheit to Celsius • Subtract 32 from F • Multiply result by 5/9 or 0.5556 • Example: • C = (212 – 32) x 0.5556 180 x 0.5556 C = 100
Conversions • Celsius to Fahrenheit • Multiply C by 9/5 or 1.8 • Add 32 to total • Example: • F = (37 x 1.8) + 32 66.6 + 32 F = 98.6
Factors that cause increase in body temperatures… Illness and/or infection Exercise and/or excitement High temperatures in the environment
Factors that cause decrease in body temperatures… Starvation or fasting Decrease muscle activity Cold temperatures in the environment
Avoid factor that could alter or change temperatures Eating/drinking (hot or cold) Smoking Make sure pt. has not had anything to eat, drink or smoke for at least 15 min.
Pulse • The pressure of the blood pushing against the walls of an artery as the heart beats & rests • Felt as throbbing of an artery caused by contraction of the heart
Major Pulse Sites • Temporal: side of head • Carotid: side of neck • Brachial: inside crease of elbow • (antecubital space) • Radial: inside of wrist, above thumb • Femoral: inside of upper thigh • Popliteal: behind knee • DorsalisPedis: top of foot arch
Pulse Rate • Noted as # beat per min • Cary with age, sex & body size • All adults — 60-90 B/M • Adult men — 60-70 B/M • Adult women — 65-80 B/M • Children >7 — 72-90 B/M • Children 1-7 — 80-120 B/M • Infants — 90-140 B/M
Pulse Rate cont… • Bradycardia: pulse rate <60 • Tachycardia: pulse rate >100 • Except children • Pulse rhythm: refers to spacing or regularity of beats • Regular or irregular • Pulse volume: refers to strength or intensity of pulse • Strong, weak, thready, bounding etc… RECORD ALL INFORMATION: RHYTHM, RATE, VOLUME
Rate Volume Rhythm
Factors that will change rate: • Increased by: • Exercise • Stimulants • Excitement • Fever • Shock • Nervous tension • Decreased by: • Sleep • Depressant drugs • Heart disease • Coma
Apical Pulse • Count taken at apex of the heart with a stethoscope • Special pulse taken for pt’s with • Irregular heart beats • Arteriosclerosis • Weak or rapid pulse • Infants or children Sound resembles a “Lubb-Dubb” Each “Lubb-Dubb” is counted as one
Pulse Deficit When apical pulse is higher than other pulse sites Heart beat is weak or rapid & doesn’t produce a pulse each time Apical pulse – radial pulse= pulse deficit
Respirations • Measures breathing, one inspiration & one exhalation • Normal respiratory rates • Adults: 12-20 breaths per min • Adults >25 are accelerated • Children: 16-25 breaths per min • Infants: 30-50 breaths per min
Respirations • Character of respirations refers to the depth & quality • Described as: • Deep • Shallow • Labored • Moist • Difficult • Stertorous (like snoring) • Rhythm of respirations refers to regularity or spacing • Regular or irregular
Abnormal Respirations Dyspnea: difficult or labored Apnea: absence of respirations Cheyne Stokes: period of dyspnea followed by periods of apnea (dying pt’s) Rales: bubbling or noisy sounds caused by fluid or mucus
Abnormal Respirations etc… • Respirations are under partially voluntary control • Pt’s may tend to breath faster if they know you are counting • Keep your hand on the pulse site and count respirations when pt is unaware • Record all info: rate, character, rhythm Ex: 11 June 2010 4:30 pm R18 Deep & Reg. L. Wall R.D.H.
Blood Pressure • Measurement of the pressure that the blood exerts on the walls of the arteries during the various stages of heart activity • Measured in millimeters of mercury (mmHg) • Measurements read at two points • Systolic and diastolic
Blood Pressure cont… • Systolic pressure • Pressure that occurs in walls of arteries when heart is contracting • Normal = 120 mmHg • Range = 100 - 140 mmHg • Diastolic pressure • Constant pressure what occurs in walls of arteries when heart is at rest or btwn contractions • Normal = 80 mmHg • Range= 60 – 90 mmHg
Blood Pressure cont… • Factors that influence BP • Force of heartbeat • Resistance of the arteries • Elasticity of the arteries • Volume of blood • Factors that increase BP • Excitement, anxiety • Stimulants • Exercise • Eating • Standing up • Factors that decrease BP • Sleep/Rest • Depressant drugs • Excessive loss of blood • Lying down
Blood Pressure cont… • BP is recorded as a fraction • Systolic/Diastolic (EX: 120/80) • Equipment needed to take BP • Sphygmomanometers • Mercury or aneroid • Stethoscope