vital signs chapter 15. vital signs various factors that provide information about the basic body...
TRANSCRIPT
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Vital SignsChapter 15
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Vital Signs
• Various factors that provide information about the basic body conditions of the patient
• 4 Main Vital Signs1. Temperature
2. Pulse
3. Respirations
4. Blood Pressure
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Other Vital Signs
• Pain• Scale 0 to 10
• Patients are asked to rate their level of pain on the 0-10 scale (relative to the patient)
• Skin Color• Size of pupils and reaction to light• Level of consciousness• Patient’s response to stimuli• Pulse oximeter reading
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Temperature
• A measurement of the balance between heat lost and heat produced
• Measured:• Oral (O)• Rectal (R)• Axillary (Ax)• Aural (ear) (T)
• aka tympanic• A low or high reading can indicate disease
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Temperature
• Normal range 96.6 to 100.6 F depending on route used• Individuals have different body temperatures• Time of day
• Lower in am, after resting• Higher in the pm or after activity or food intake
• Parts of the body vary• O – 98.6• R – 99.6• Ax – 97.6
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Temperature
• Hypothermia – body temp < 95 F rectally• Death usually occurs if temp < 93 F
rectally
• Hyperthermia – body temp > 104 F rectally• Prolonged exposure will cause brain
damage or serious infection• > 106 F will lead to convulsions, brain
damage, or death
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Temperature
• Clinical thermometer• Red – rectal• Blue – oral or axillary
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Pulse
• The pressure of the blood felt against the wall of an artery as the heart contracts and relaxes
• RATE - # of beats per minute• RHYTHM – refers to regularity• VOLUME – refers to strength
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Pulse
• Usually taken on the radial or carotid artery• Pulse is taken on an artery
• Temporal – sides of forehead• Carotid – sides of the neck• Brachial – inner aspect of forearm• Radial – inner aspect of the wrist• Femoral – inner aspect of the upper thigh• Popliteal – behind the knee• Doralis Pedis – top of the foot arch
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Pulse
• Bradycardia – pulse < 60 bpm• Tachycardia – pulse > 100 bpm
• (except in children)
• Normal Ranges:• Newborn baby - 120 to 160 bpm• Baby aged from 1 to 12 months - 80 to 140 bpm• Baby/toddler aged from 1 to 2 years - 80 to 130 bpm• Toddler/young child aged 2 to 6 years - 75 to 120 bpm• Child aged 7 to 12 years - 75 to 110 bpm• Adults – 60-100 bpm
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Respirations
• Normal ranges:• Adults: 12-20 breaths per minute• Newborns up to 6 months old: 30-60 breaths per minute• Infants 6-12 months old: 24-30 breaths per minute• Toddlers and Children 1-5 years old: 20-30 breaths per
minute• Children 6-12 years old: 12-20 breaths per minute• Adults: 12-20 breaths per minute
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Respirations
• 1 breath consists of 1 inspiration and 1 expiration
• Dyspnea – difficult or labored breathing• Apnea – absence of respirations• Tachypnea – RR > 20 bpm• Bradypnea – RR < 12 bpm• Orthopnea – severe dyspnea in which breathing is very
difficult in any position other than sitting erect or standing
• Respirations should be counted in a way that the patient is unaware of the procedure
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Blood Pressure
• The measurement of the pressure that the blood exerts on the walls of the arteries during the various stages of heart activity
• BP is read in mm of Hg• Medical name: Sphygmomanometer• SYSTOLIC:
• Top number in reading• Normal range 100 to 120 mm Hg
• DIASTOLIC:• Bottom number in reading• Normal range 60 to 80 mm Hg
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Blood Pressure
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Height and Weight
• They are important because they provide necessary information in performing and evaluating:• Lab tests• Calculating dosages of medication• Monitor patients who have cancer and are on
chemotherapy• Monitor patients who have edema (swelling) due to
heart, kidney, or other diseases
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Height and Weight
• For those patients who require daily weights:• Use the same scale each day• Make sure the scale is balanced
before weighing a patient• Weigh the patient at the same time
each day• Make sure the patient is wearing
the same amount of clothing each day
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Balance Beam Scale Bed Scale Chair Scale
Wheelchair Scale Infant Scale
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Pulse Oximeter
• Normal is over 96% O2 saturation• Levels below 96% can indicated a respiratory or
cardiovascular abnormality (congenital heart disease, sickle cell anemia, asthma, etc)