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Vital Signs

Vital Signs. Blood pressure Pulse Respirations Temperature. will cover later. Level of consciousness pupil status breath sounds. Signs & Symptoms. Signs are observed or measured Symptoms are told to you by the patient. Respirations. Count number of breaths per minute Assess Quality

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Vital Signs

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  1. Vital Signs Blood pressure Pulse Respirations Temperature

  2. will cover later... • Level of consciousness • pupil status • breath sounds

  3. Signs & Symptoms • Signs are observed or measured • Symptoms are told to you by the patient

  4. Respirations • Count number of breaths per minute • Assess Quality • Rhythm • Effort • Noise • Assess tidal volume • Increased • Normal • Decreased

  5. Normal values • Adult 12 - 20 per minute • Child 18 - 30 per minute • Infant 30 - 60 per minute

  6. Terms • Apnea = not breathing • Bradypnea = slow breathing • Tachypnea = fast breathing • Hypoventilation = poor tidal volume • Hyperventilation = deep tidal volume

  7. Pulse • Rate • Number of beats in one minute or in 30 seconds multiplied by 2 • Strength • Bounding, strong, or weak (thready) • Regularity • Regular or irregular

  8. Pulse Points • Dorsalis Pedis • Popliteal • Posterior Tibialis • (AKA Medial Tibialis) • Femoral • Apical • Carotid • Radial • Brachial • Temporal

  9. normal values • Adult 60 - 100 • Child 70 - 120 • Toddler 90 - 150 • Newborn 120 - 160

  10. Terms • Bradycardia = slow pulse • under 60 (adult) • Tachycardia = fast pulse • 100 or more (adult)

  11. Blood Pressure • The pressure of the circulating blood against the walls of the arteries. • A drop in blood pressure may indicate: • Loss of blood • Loss of vascular tone • Cardiac pumping problem • Blood pressure should be measured in all patients older than 3 years.

  12. Blood pressure • Systolic - higher number • pressure at ventricular contraction • Diastolic - lower number • pressure at ventricular relaxation • Measured in millimeters of mercury (mm Hg) • Recorded as systolic/diastolic

  13. Auscultation vs Palpation • Using a sphygmomanometer there are two methods • Auscultation • obtains both systolic & diastolic readings • Palpation = to feel • only systolic reading obtained

  14. Normal Ranges of Blood Pressure Age Range Adults (systolic) 100 to 140 mm Hg (diastolic) 60 to 90 mm Hg Children (systolic) 80 to 110 mm Hg Infants (systolic) 60 mm Hg

  15. terms • Hypotension - low blood pressure • Hypertension - high blood pressure

  16. BP indicators – If you can get this pulse, the BP is: Carotid - at least 60 systolic Femoral - at least 70 systolic Radial - at least 80 systolic

  17. Pulse Pressure • pulse pressure is the difference between systolic & diastolic readings. • 120/80 pulse pressure = 40 • 156/66 pulse pressure = 90

  18. What is Blood Pressure? BP = CO x PVR

  19. orthostatic vital signs AKA - postural vital signs assessment for hypovolemia/shock • Take blood pressure & pulse supine - sitting - standing

  20. orthostatic vital signs wait 1 minute after changing positions. increase in pulse or decrease in blood pressure of 20 points or more equals hypovolemia. Indicates 15% volume loss.

  21. Temperature • Axillary • Oral • Rectal • Other*** • Normal = 98.6

  22. core temp • rectal temp THE MOST ACCURATE METHOD

  23. The Skin • Color • Pink, pale, blue, flushed, or jaundice • Temperature • Warm, hot, or cool • Moisture • Dry, moist, or wet

  24. Capillary Refill • Evaluates the ability of the circulatory system to restore blood to the capillary system (perfusion) • Tested by depressing the patient’s fingertip and looking for return of blood

  25. Remember ... • Treat the patient not the numbers!!! • Look at the whole picture!

  26. END questions?

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