Measuring & Recording Vital Signs

1. Measuring & Recording Vital Signs Clinical Rotations

2. The Four Vital Signs Blood Pressure Temperature ----------------------------Pulse----------------------- Respirations

3. Objectives: • Students will: • List the 4 major vital signs • Describe the principles for measuring and recording oral, rectal, axillary, tympanic and temporal temperatures • Convert Fahrenheit to Celsius • Define- temperature, pulse, respirations, blood pressure and apical pulse

4. WHAT IS BLOOD PRESSURE? • When your heart beats, it pumps blood around your body to give it the energy and oxygen it needs • As the blood moves, it pushes against the sides of the blood vessels( arteries) – • The strength of the force exerted on your vessels is called your blood pressure

5. How is blood pressure it measured? • Measured in millimeters of mercury • A blood pressure machine is called a sphygmomanometer • BP is read at two points: • Systolic • Diastolic

6. Systolic Blood Pressure Blood pressure • Pressure that occurs in the walls of the arteries when the LEFT VENTRICLE OF THE HEART is contracting • Normal systolic reading is BELOW • 120 mm or mercury • Normal range is 100- 120 mm of mercury • Systolic is the FIRST sound heard

8. Diastolic Blood Pressure • The constant pressure in the walls of the arteries when the LEFT VENTRICLE is at rest (between contractions) • Normal diastolic reading is below 80mm of mercury • Normal range is 60-80 mm of mercury • It is noted as the reading on the BP gauge when the sound STOPS or becomes very FAINT

9. Recording Blood Pressure • Recorded in the form of a fraction • Systolic is the top number • Diastolic is the bottom number Example: 120/70

10. Pulse Pressure • The difference between the SYSTOLIC and the DIASTOLIC pressure • Important indicator of the health & tone of the arterial walls • Normal pulse pressure is: 30-50 mm of mercury • Example: what is the pulse pressure of 110/80

11. Answer: • The pulse pressure of 110/80 is: • 30 mm of mercury

12. Abnormal Blood Pressure • Pre Hypertension • Warning that high blood pressure is likely to develop • This condition can harden arteries, dislodge plaque, and block vessels that nourish the heart • Indicated by pressure readings of: • Systolic –120-139 mm of mercury • Diastolic – 80-89 mm or mercury

13. Hypertension • Indicated when pressures are greater than 140mm of mercury COMMOMCAUSES: • Stress • Anxiety • High salt intake • Advanced age • Thyroid disease • Vascular disease such as arteriosclerosis

14. Hypotension • Indicated when BP is less than • 90 mm of mercury COMMOM CAUSES • Occurs with heart failure • Dehydration • Depression • Severe burns • Hemorrhage • Shock

15. Orthostatic or Postural Hypotension • Occurs when there is a sudden drop in BOTH the systolic & diastolic pressures • Occurs when an individual moves from a lying to a sitting or to a standing position • Blood vessels fail to compensate for the change in position • Individual experiences- may last a few seconds • Lightheadedness • Dizziness • Blurred vision

16. Factor affecting BLOOD PRESSURE • Heartbeat • Condition of the arterial system • Elasticity of the arteries • Volume of circulating blood • Position

17. Factors which may Increase BP • Anxiety • Nervousness • Obesity • Stimulant drugs • Exercise • Smoking • Pain

18. Factors which can DecreaseBP • Sleep • Depressant drugs • Shock • Dehydration • Hemorrhage • Fasting

19. Sphygmomanometers • Aneroid • Does not have a mercury column • It has a round gauge • Each line equals 2 mm of mercury • Position at eye level • Needle must start at 0 ZERO

20. Electronic Sphygmomanometers • Used in most health care facilities • Record blood pressure automatically after cuff is placed on patient • Will show reading in a digital display

21. Factors to Follow When taking a BP • American Heart Association recommends: • Patient should be quite for at least 5 minutes • Take 2 separate readings • Wait at least 30-60 seconds between readings

22. Continued • Correct size and placement of the cuff • Patient should be sitting or lying down • Arm should be freely extended and free of constricting clothes • BP cuff must be deflated and free of any air • BP cuff should be placed over directly over the brachial artery • Edge of cuff should sit 1” above the antecubitalspace

23. How to take a Blood Pressure • Person should be comfortably seated or lying down • Should have rested for 10-15 minutes prior to the reading • Arms that are paralyzed, injured, have an IV or shunt should not be used**** never take BP the same side as a mastectomy • Infant blood pressures can be taken on the leg

24. Blood Pressure Procedure • Excess air should be squeezed out of the cuff • Cuff should be placed snugly on upper arm. • Gauge should be easily visualized • Valve should be closed, but easily able to be opened

25. Blood Pressure Procedure Two techniques for obtaining the pressure TECHNIQUE #1 • Find radial pulse. Pump cuff till pulse no longer palpated. • Then pump another 30 mm Hg higher • Place diaphragm of stethoscope on brachial artery about ½ - 1 inch above the elbow • Release the valve and listen for the two measurements - slowly deflating the cuff.

26. Blood Pressure Procedure TECHNIQUE #2 • Find brachial artery and put diaphragm over the site. • Pump cuff to 120 mm Hg and listen for the heart beat. If it is heard, pump another 30 mm Hg and listen again. • When the pulse is no longer heard, then pump another 30 mm Hg and slowly deflate, listening for the two measurements.

27. Reporting & Recording Reading • If reading is uncertain, wait 30 seconds to 1 minute before remeasuring • Record the reading and report any abnormalities • If the B/P reading is outside of the normal limits, retake it before reporting the value to a supervisor to be certain of accuracy

28. Blood Pressure Skills Lab • OBJECTIVE: • Successful completion of Skills Check list after demonstrating proficiency in this hands on lab experience • Students will have the opportunity to practice taking and recording BP as recommended by the AHA • Successful completion of the skills check list is required to pass this skills section of this lesson

29. Temperature Conversions • Fahrenheit to Celsius • C=(F-32)/ 1.8 • Celsius to Fahrenheit • F=(C X 1.8) + 32