health assessment

• Factors that influence body temperature

  • Age
  • Diurnal variations
  • Exercise
• Temperature

  Balance between the heat produced by the body and the heat lost from the body
• Surface temperature

  Skin, subcutaneous tissue, and fat cells
• Hypothalamus


  Thermoregulatory center of the body
• Exercise affects body temperature
• Guidelines for measuring vital signs: use an organized, systematic approach, know safe vital sign and assessment findings before administering medications, communicate findings, document findings accurately, analyze the vital sign measurements, instruct the client or family caregiver about the assessment and significance of findings
• Elderly clients are more sensitive to environmental temperature
• Vital Signs

  • Temperature or T
  • Pulse Rate or PR
  • Respiratory Rate or RR
  • Blood Pressure or BP
  • Pain
  • Oxygen Saturation
• Core temperature


  Temperature of deep tissue of the body
• Normal body temperature is 36.7°C - 37°C or 98.6°F
• Kinds of temperature

  • Surface temperature
  • Core temperature
• Diurnal variations: body temperature lowers when asleep and higher when active, typically between 8 pm to 12 midnight and 4 am to 6 am
• Purpose of taking vital signs: to obtain baseline data, detect or monitor changes in the client’s health status, and monitor clients at risk for alteration in health
• Vital Signs


  Common, non-invasive physical assessment procedure and the measurement of the body’s most basic functions that are routinely monitored by medical professionals & healthcare providers
• Infants are poikilothermic, meaning their body temperature is easily altered
• Diurnal variations

  • Body temperature lowers when asleep and is higher when active
  • Specific time intervals: 8 pm to 12 midnight, 4 am to 6 am
• Illness

  Infection leads to higher body temperature
• Hormones

  1. Release of progesterone increases body temperature

  2. Release of estrogen lowers body temperature
• Ovulation


  Body temperature decreases and then rises during ovulation
• Types of thermometer

  • Glass thermometers: Mercurial, shaken before use, shorter tips for oral use, longer tips for rectal use
  • Strip thermometers: Contain thermochromic liquid crystals
  • Digital thermometers: Used for verification and calibration
• Signs and symptoms of fever

  • Sweating
  • Chills, shivering or shaking
  • Hot or flushed skin
  • Headache
  • Body ache
  • Fatigue/weakness
  • Loss of appetite
  • Increased heart rate
  • Dehydration
• Exercise

  Increase in muscle activity leads to an increase in adrenaline production, which increases body heat
• Stress


  Sympathetic nervous system stimulation increases epinephrine production, leading to a higher metabolic rate and body temperature
• Environment

  Temperature of the surroundings affects body temperature
• Heat loss

  1. Radiation: Body heat lost to nearby objects without physical touch

  2. Conduction: Body heat lost through direct physical touch

  3. Convection: Body heat lost to surrounding air

  4. Evaporation: Body heat lost through perspiration
• Management for fever

  1. Take temperature and assess symptoms

  2. Rest in bed

  3. Stay hydrated or increase fluid intake
• Terminologies in body temperature

  • Hyperpyrexia: Body temperature above 106.7°F due to hypothalamus changes
  • Febrile/Pyrexia or Hyperthermia: Abnormally high body temperature
  • Hypothermia: Caused by prolonged exposure to cold temperatures
  • Afebrile: Without fever
  • Common types of fever: Intermittent, Remittent, Relapsing/Recurrent, Constant/Continuous
• Management for fever

  1. Take your temperature and assess symptoms

  2. Stay in bed and rest

  3. Keep hydrated or increase fluid intake

  4. Stay cool or manage stress

  5. Tepid sponge bath/use of cold compress

  6. Take over the counter medication or take medication as prescribed
• Pulse


  Wave of blood created by contraction of the left ventricle of the heart
• Pulse points

  • Temporal
  • Brachial
  • Carotid
  • Radial
  • Femoral
  • Dorsalis Pedis
  • Popliteal
  • Posterior Tibialis
• Factors affecting the pulse rate

  • Age
  • Gender
  • Exercise and fever
  • Medication
  • Hemorrhage
  • Stress
  • Position changes
• Characteristics of pulse rate/frequency

  • Refers to the number of pulsations per minute
  • Adult: 60-100 per minute
  • Infant: 100-160 beats per minute
• Medications affecting heart rates

  • Digoxin
• Sites for temperature measurement

  • Oral
  • Rectal
  • Axillary
  • Tympanic
  • Temporal
• Types of pulse

  • Central
  • Peripheral
• Rhythm


  Refers to the regularity
• Pulse rate by age

  • Newborn: 120-160
  • 1 year: 80-140
  • 5-8 years: 75-120
  • 10 years: 50-90
  • Teens: 50-90
  • Adult: 60-100
  • Older Adult: 60-100
• Quality


  Refers to the strength of the palpated pulsations
• Infant

  • 100 - 160 beats per minute
• Pulse Rate/Frequency


  Refers to the number of pulsations per minute