Vital Signs

• Vital signs are indices of health, or signposts in determining client’s condition. This is also known as cardinal signs and it includes body temperature, pulse, respirations, and blood pressure. These signs have to be looked at in total, to monitor the functions of the body.
• The difference between the amount of heat produced by body processes and the amount lost to the external environment is body temperature
• The types of body temperature are core temperature and surface temperature
• Core temperature is the temperature of the deep tissues of the body, such as the abdominal cavity and pelvic cavity. It remains relatively constant.
• Surface temperature is the temperature of the skin, the subcutaneous tissue, and fat. It, by constant rises and falls in response to the environment.
• Pyrexia or Fever - Body temperature above normal range
• Hyperpyrexia/Hyperthermia - Very high fever 41.0C (105.8 F)
• Heatstroke - Prolonged exposure to the sun or a high environmental temperature overwhelms the heat-loss mechanisms of the body.
• Heat Exhaustion - Occurs when profuse diaphoresis results in excess water and electrolyte loss
• Hypothermia - Heat loss during prolonged exposure to cold overwhelms the ability of the body to produce heat
• Classification of Hypothermia

  Mild– 34-360C

  Moderate – 30-340C

  Severe – <300C
• Diurnal Variations (Circadian rhythms) - This refers to the sleep – wake rhythm of the body, a pattern that varies slightly from person to person. Body temperature normally changes throughout the day, varying as much as 1oC between the early morning and the late afternoon.
• Women usually experience more hormones fluctuations than men do. Progesterone secretion at time of ovulation raises body temperature above basal temperature.
• Stimulation of SNS can increase the production of epinephrine and norepinephrine increasing metabolic activity and heat production.
• Heat promoting centers are vasoconstriction, sympathetic stimulation, skeletal muscles, thyroxine
• A glass clinical thermometer is most commonly used to measure body temperature.
• Mercurial thermometer is already faced-out worldwide because of mercury. It is used for 7 minutes for an accurate result.

  Rounded tip - for rectal

  Security tip - oral and rectal

  Long tip - for oral
• Digital thermometer is used on axillary and oral
• An electronic thermometer has an oral probe and a rectal probe. A disposable probe cover is placed on the probe, and the temperature registers in about 2-60 seconds.
• A tympanic thermometer is fast and accurate, measuring temperature in 1-3 seconds. For infants, pull the ear straight back and down. For adults and children over one year, pull the ear up and back.
• A chemical dot thermometer is disposable and provides an accurate result in 3-5 minutes. Leave the chemical dot thermometer in place for 45 seconds, and then read the temperature by noting the last dye dot that has changed color, or "fired."
• HYPERTHERMIA or PYREXIA= 37.6 TO 40C

  HYPERPYREXIA = greater than 41C predispose the patient to have convulsion

  HYPOTHERMIA= below 35C

  FEBRILE= Patient with fever

  AFEBRILE= temperature is within normal limits
• INTERMITTENT FEVER - the body temperature alternate at regular interval between periods of fever and periods of normal or subnormal temperature. (temperature returns to acceptable value at least once in 24hours)
• RELAPSING FEVER - Short febrile periods of few days are interspersed with periods of 1 to 2 days normal temperature.
• CONSTANT FEVER/ SUSTAINED FEVER - The body temperature fluctuates minimally but always remains above normal.
• FEVER SPIKE - A temperature that rises to fever level rapidly following a normal temperature and then return to normal within a few hours.
• Mechanisms of heat loss: radiation, conduction, convection, and evaporation
• RADIATION- is the transfer of heat from the surface of one object to the surface of another without contact between the two objects.
• CONDUCTION- is the transfer of heat from one molecule to a molecule of lower temperature.
• CONVECTION - is the dispersion of heat by air currents.
• EVAPORATION - is continuous evaporation of moisture from the skin.
• Pulse - palpable bounding of blood flow in a peripheral artery. Blood flows through the body in a continuous circuit
• Stroke volume - the amount of blood that enters the arteries with each contraction in a healthy adult
• Compliance of the arteries is their ability to contract and expand
• Peripheral pulse - the pulse located in the periphery of the body
• Apical pulse - a central pulse. Located at the apex of the heart. It is also referred to as the point of maximal impulse (PMI)
• Infant - 120-160 beats/min

  Toddler - 90-140 beats/min

  Pre-schooler 80-11- beats/min

  School-age child - 75-100 beats/min

  Adolescent - 60-90 beats/min

  Adult - 60-100 beats/min
• Tachycardia - pulse rate of above the normal rates

  Bradycardia - pulse rate below the normal rates

  Dysrhythmia or Arrhythmia - Irregular-uneven time interval between beats
• Rate - the number of pulse beats per minute

  Pulse rhythm - pattern of the beats and the intervals between the beats. Equal time elapse between beats of a normal pulse

  Pulse Volume - also called the pulse strength or amplitude
• 0 Absent

  1+ Thread and weak easily obliterated

  2+ Normal, easily identified, not easily obliterated

  3+ Increase pulse, moderate pressure for obliterated

  4+ full/strong, cannot be obliterated (bounding pulse)