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• Vital Signs (cardinal signs)


  Indicators of the body's physiological status and response to physical activity, environmental conditions, and emotional stressors
• Vital Signs (cardinal signs)

  Provide quantitative measures of the status of the cardiovascular/pulmonary system and reflect the function of internal organs
• Vital Signs (cardinal signs)


  Quantify circulatory status
• Vital Signs

  • Temperature
  • Respiration
  • Pulse
  • Blood Pressure
  • Pain
  • Lifestyle factors, patient characteristics, specific tests and measures, pulse oximetry, health literacy, functional status, walking speed, dyspnea, smoking status and continence
• Modifiable factors influencing vital signs

  • Lifestyle
  • Caffeine intake
  • Tobacco use
  • Diet
  • Alcohol consumption
  • Stress
  • Obesity
  • Physical activity level
  • Medications
  • Use of illegal drugs
• Non-modifiable factors influencing vital signs

  • Hormonal status
  • Age
  • Gender
  • Family History
• Culture


  Integration of learned behaviors (not biologically inherited) characteristic of a society
• Ethnicity


  Set of shared behavioral standards that includes fundamental values, belief, and customs
• Ethnicity


  Affiliation with a group of people who share a common cultural origin or background, or common racial, national, religious, linguistic, or cultural characteristics
• Other factors influencing vital signs

  • Time of the day
  • Time of the month (menstrual cycle)
  • General health status
  • Pain
• Patient / Client Management

  • Examination
  • Evaluation
  • Diagnosis
  • Prognosis
  • Intervention
  • Outcome
• What to do if abnormal VS was observed?
• Maintain a professional calm demeanor
• Double check info of that is extremely abnormal or inconsistent
• Double check the equipment used
• Recheck data obtain
• Examine the factors that may alter VS
• When uncertain, ask a more experienced PT to recheck the vital signs
• Make comparison of the subjective data to objective data to determine if what the patient states is consistent with obtained data
• Normative Vital Signs Value by Age

  • Newborn
  • 3 years
  • 10 years
  • 16 years
  • Adult
  • Older adult
• Thermoregulatory System


  Maintains a relatively constant internal body temperature

  Monitors and acts to maintain temperatures that are optimal for normal cellular and vital organ function

  
• Components of Thermoregulatory System

  • Thermoreceptors
  • Regulating center
  • Effector organ
• Types of Thermoreceptors

  • Peripheral
  • Central
• Peripheral Thermoreceptors

  Located in the skin (free nerve endings)

  Sensitive to rapid environmental changes
• Central Thermoreceptors

  Located in the abdominal organs, nervous system and hypothalamus

  Initiate response to conserve or dissipate heat

  Sensitive to core temperature and body warmth

  Cold>warm

  Travels via lateral spinothalamic tract
• Regulating Center

  Hypothalamus

  98.6 ± 1.8˚F (37 ± 1 ˚C)

  Coordinates heat production and loss

  Regulation is transmitted thru somatic and autonomic nervous system
• Effector Responses to Conserve Heat

  • Vasoconstriction
  • Decrease sweat gland activity
  • Piloerection
  • Shivering
  • Hormonal regulation (Norepinephrine, epinephrine, Thyroxine)
• Effector Responses to Lose Heat

  • Radiation
  • Conduction
  • Convection
  • Evaporation
  • Vasoconstriction
• Vasoconstriction

  Sympathetic nerves reduce lumen and blood flow near the surface
• Decrease or Absent of Sweat Glands

  Abolished below 98.6 C to reduce the effect of evaporation
• Cutis Anserina


  Gooseflesh that traps a layer of insulating air near the skin, found in wooly mammals
• Shivering


  Falls below 37 C, activated by cold signals from skin and spinal cord, controlled by posterior hypothalamus, can be inhibited by cortical area
• Hormonal Regulation

  Norepinephrine/epinephrine from adrenal medulla increase metabolism

  Thyroxine from thyroid increases cellular metabolism throughout the body
• Abnormalities in Body Temperature

  • Pyrexia (Elevation of normal body temperature, referred as fever)
  • Hyperpyrexia/Hyperthermia (Extremely high fever, generally above 106°F (41.1°C))
  • Hypothermia (Lowered body temperature)
• Stages of the Course of Fever

  • Prodomal
  • Invasion or onset
  • Stationary phase (fastigium or stadium)
  • Defervescence (termination, resolution)
• Types of Fever

  • Intermittent
  • Remittent
  • Relapsing
  • Constant
• Fever had a strong link to worse GCS, longer MV durations, increased length of ICU stay, higher mortality rates and worse overall outcomes in neurocritical patients. High PCT levels can predict mortality in those patients.
• Hypothermia


  Lowered body temperature, decrease metabolic rate, and body temperature gradually falls
• Symptoms of Hypothermia

  • Decreased PR & RR

  Cold & pale skin

  Cyanosis

  Decreased cutaneous sensation

  Depression of mental and muscular responses

  Drowsiness
• Factors Influencing Body Temperature


  • Time of day
  • Age
  • Emotion/Stress
  • Exercise
  • Menstrual cycle
  • Pregnancy
  • External environmental
  • Site of measurement
  • Infection
  • Ingestion of warm or cold foods